Clinical Care

English

The IDF 'Global Guideline for Type 2 Diabetes': background and methods

The International Diabetes Federation (IDF) is not in the business of delivering clinical care to people with diabetes; but it is committed to the view that everyone with diabetes should benefit from the best possible care that could be available to them. One foundation of such care is to ensure that it is based on the best possible scientific knowledge. In this Supplement to Diabetes Voice we summarize in non-technical language the evidence base and recommendations of the IDF Global Guideline.

Diabetes management in a primary care setting: the Kenyatta National Hospital

Diabetes is increasingly common worldwide, and Kenya is no exception. The Ministry of Health estimates the prevalence of diabetes to be around 10% (3.5 million people). The cause of much human suffering, diabetes also places a considerable economic burden on individuals and families, and healthcare systems.

Sexual dysfunction in people with diabetes

Diabetes is associated with numerous long-term complications. Many of these, like kidney failure and ischaemic heart disease, are life threatening. Others, such as eye damage and nerve damage, impact heavily on quality of life. But sexual difficulties, which affect both women and men with diabetes, often receive less attention than they deserve, despite the high levels of distress they generate. Mac Robertson looks at the risks for sexual dysfunction in men and women with diabetes and describes the current management options.

Obesity and the metabolic syndrome in young people

As the number of children with obesity continues to grow, the health implications of the condition are becoming increasingly evident: an unprecedented epidemic of type 2 diabetes is emerging in obese and overweight young people. At the time of diagnosis of diabetes, cardiovascular disease may already be present, even in young adults. The close association between type 2 diabetes and cardiovascular disease led to the hypothesis that the two may arise from a common antecedent, the metabolic syndrome – a cluster of metabolic disorders.

Metabolic syndrome, pregnancy and the risk of cardiovascular disease

While a proportion of women with the metabolic syndrome become pregnant, pregnancy itself creates a milieu that is similar to the syndrome, including the development in some women of insulin insensitivity and increased levels of blood

Treating the syndrome today and in the future

We can take advantage of the metabolic syndrome: it can be used as a simple and effective tool to assess health risks in people with type 2 diabetes and those without the condition. We can benefit from the universal availability of the tools needed to make a diagnosis – at no further cost. Given the excessive levels of death and disability suffered by people with type 2 diabetes and its associated conditions, it is of the utmost importance that early and appropriate steps are taken once a diagnosis of the metabolic syndrome is made. Fortunately, there

The metabolic syndrome: genetics, lifestyle and ethnicity

Over a few million years, human genes gradually evolved, enabling us to survive frequent periods of famine. Our genes are still essentially the same; but we are currently exposed to lifestyles for which we are not programmed. We were

Continuous glucose monitoring: overcoming the obstacles

Systems that allow people with diabetes to continuously monitor glucose changes over a period of several days are now available and new models with advanced features will soon follow. These systems require the insertion of a needle or a catheter into the fatty tissue under a person’s skin. But people with diabetes look forward to the introduction of a non-invasive system – one which does not penetrate their skin.

Pulmonary insulin: current status

Attempts to develop the lungs as a route for the delivery of insulin began as early as the 1920s. But inhalers that could deliver insulin via the lungs in a clinically viable manner were not developed until the 1990s. The lungs offer a large surface area of 100 m² to 140 m² (roughly the size of a tennis court) for the absorption of inhaled insulin. Moreover, the very thin alveolar-capillary barrier on the surface of the lungs allows for rapid uptake of insulin into the blood, similar to that seen with the rapid-acting insulin analogues – or even faster. Jay Skyler brings us up to date

'Double diabetes' in young people and how to treat it

In most countries around the world, there has been an increase in the number of children and young people with diabetes. While in general it is relatively easy to distinguish whether a child or teenager has type 1 diabetes or type 2 diabetes, in some cases, young people have elements of both kinds of the condition. This new phenomenon has been labelled ‘double diabetes’ or ‘hybrid diabetes’. Francine Kaufman reports on the existence of double diabetes and the implications of this condition for the initial categorization and treatment of young people who are diagnosed with diabetes.

Pages