Clinical Care

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The genetics of type 2 diabetes - a look at the scientific advances of the DGDG project

The International Diabetes Federation estimates that approximately 246 million people around the world have diabetes. Of this number, around 90% are people with type 2 diabetes. The consequences for public health worldwide are devastating. The World Health Organization estimates that one in 20 deaths in the world is caused by diabetes, and that up to 15% of the annual budget for healthcare is devoted to the disease.

Alzheimer's, dementia and diabetes - where are the connections?

Diabetes is considered to be a kind of accelerated aging – by increasing a person’s susceptibility to degenerative conditions, including kidney disease, retinopathy, hypertension, coronary artery disease, stroke, and atherosclerosis. Recently, evidence has accumulated to suggest that diabetes also plays a role in accelerated brain aging. But while it is known that diabetes may be associated with an increased risk of dementia, the exact mechanisms and mitigating factors remain unclear.


Global standardization of the HbA1c assay - the consensus committee recommendations

Since the late 1970s, HbA1c test results have been used to guide diabetes care. The International A1c-AG Study, under way in 10 centres in North America, Europe, and Africa, aims to explore the relationship between HbA1c and average blood glucose. Martin Silink and Jean-Claude Mbanya, who represent IDF on a consensus committee working towards the standardization of the HbA1c assay, report on developments in the measurement and reporting of long- term average blood glucose levels.

The metabolic syndrome in children and adolescents: the IDF consensus

The importance of identifying children who are at risk of developing the metabolic syndrome cannot be underestimated. The syndrome is a cluster of risk factors

The frustrations of trying to lose weight and the alternative of bariatric surgery

Aged 42 years, ‘S’, friend and colleague of the author, weighed 204 kg. Now, three years later, after undergoing intensive dieting and psychotherapy, she has lost nearly 10% of her body weight. But she remains 38 BMI units over and above the 30 kg/m threshold for the ‘obese’ category; she is in the range of ‘morbid obesity’. In a few weeks she will undergo dramatic abdominal surgery for this condition. Rhys Williams tells her story.

Providing support and education to children with diabetes - specific needs, specific care

Ground-breaking research findings from the end of the last century demonstrated that the disabling and potentially life-threatening chronic complications of type 1 diabetes can be delayed or prevented by early and intensive blood glucose control. However, this strict and demanding regimen can present a major challenge for young people with the condition.

Diabetes and HIV/AIDS in sub-Saharan Africa: the need for sustainable healthcare systems

Chronic diseases, such as heart disease, stroke, cancer, chronic respiratory diseases and diabetes, are by far the leading cause of mortality worldwide, representing 60% of all deaths. Contrary to common perception, 80% of chronic disease deaths occur in low- and middle-income countries. This invisible epidemic is an underestimated cause of poverty and hinders the economic development of many countries. Sub-Saharan Africa carries the highest burden of disease in the world, the bulk of which still consists of the communicable diseases HIV/AIDS, tuberculosis and malaria.

Insulin pump therapy in children and adolescents: risks and benefits

During the last decade, insulin pump therapy has gained widespread acceptance in the treatment of children and adolescents with type 1 diabetes. In some of the European and North American paediatric diabetes centres, more than half of the young people with diabetes try to simulate a normal pattern of insulin secretion by means of an insulin pump (continuous subcutaneous insulin infusion).

The changing face of coeliac disease: links with other autoimmune disorders

The onset of coeliac disease, together with type 1 diabetes, influences glycaemic control, and more precisely the development of hypoglycaemia. These conditions share a similar genotype. The main problem of coeliac disease is intolerance to gliadin, a gluten protein found in cereals such as wheat, rye and barley; the only treatment is a gluten-free diet. Spomenka Ljubic and Zeljko Metelko report on the growing body of evidence linking coeliac disease and other autoimmune disorders, including type 1 diabetes, and describe recommended procedures for its diagnosis and treatment.

Breastfeeding and diabetes - benefits and special needs

Breastfeeding has numerous advantages for mothers with diabetes and their babies. Nursing mothers have lower insulin requirements and better control of their blood glucose; breastfed babies may have a lower risk of developing diabetes themselves. Alison Stuebe describes these potential benefits and highlights the special needs of breastfeeding mothers with diabetes.

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