URC Recognizes World Diabetes Day

Wednesday, November 14th is World Diabetes Day, celebrated every year on the birthday of Frederick Banting, who helped discover insulin in 1922 with Charles Best. This day, made official by a United Nations resolution, serves to raise awareness about diabetes. This year, the theme is diabetes education and prevention.

What Is Diabetes?

Diabetes is a chronic, noncommunicable disease (NCD) that occurs when the pancreas does not produce enough insulin or the body cannot use the insulin it produces effectively. Over time, raised blood sugar, a common effect of uncontrolled diabetes, can lead to serious damage to many of the body's systems, especially the nerves and blood vessels. There are several types of diabetes.

  • Type 1 diabetes is characterized by deficient insulin production and requires daily administration of insulin. Neither the cause nor how to prevent type 1 is known.
  • Type 2 diabetes results from the body's ineffective use of insulin. Often associated with excess body weight and physical inactivity, about 90% of people with diabetes worldwide have type 2.
  • Gestational diabetes is high blood sugar first recognized during pregnancy.
  • Impaired glucose tolerance and impaired fasting glycemia are intermediate conditions often referred to as "pre-diabetes" because they are associated with a higher likelihood of developing future diabetes.

Global Burden of Diabetes

The World Health Organization (WHO) reports that, around the world, 347 million people, more than the entire population of the United States, have been diagnosed as having diabetes. Many more are undiagnosed.

While once thought of as a developed-country ailment, research shows that more than 80% of people with diabetes live in low- and middle-income countries.

While this chronic condition can be managed, and many complications prevented, through a combination of diet, exercise, insulin, and other medications, the consequences of uncontrolled diabetes are dire. The WHO projects that premature deaths due to diabetes will double between 2005 and 2030.

What We're Doing about Diabetes

Advocating for a Focus on Noncommunicable Diseases

URC is a member of the CORE Group NCD Interest Group and contributed to brief highlighting why NCDs, including diabetes, matter for achieving the United Nations Millennium Development Goals 4 & 5, reduce child mortality and improve maternal health, respectively. The brief aims to help partners working in the area of maternal, newborn, and child health MNCH) to advocate for the importance of NCDs in MNCH work.

Developing National Care Guidelines

The USAID Primary Health Care Project in Iraq is developing clinical guidelines to support Ministry of Health efforts to achieve the goal of quality primary health. When the project's baseline assessment provided good information about the NCDs in Iraq, including diabetes, the project developed clinical guidelines and training materials on diabetes. The project is also providing on-the-job training on these guidelines to primary health care clinic staff.

Addressing Important Co-morbidities

In developing countries, diabetes is one of the most important predisposing risk factors for TB, along with malnutrition, substance abuse, and HIV.  TB occurs more frequently among people with diabetes and causes greater morbidity and mortality. This is further complicated by the atypical clinical presentation of TB in people with diabetes, making it more difficult to diagnose.  In South Africa, URC works with and supports a partner organization studying the link between diabetes and TB.

Highlighting Critical Quality-of-Care Gaps in Diabetes Care

A four-country assessment conducted by Dr. Kathleen Hill and Dr. Tamar Chitashvili in Albania, Armenia, Georgia, and Russia demonstrated many critical quality of care gaps related to diabetes diagnosis and care in health clinics. For example, less than 50% of doctors on average could correctly define internationally agreed diagnostic criteria for diabetes. A follow-on implementation activity in Georgia is improving systematic counselling and screening directed at major lifestyle and physiologic risk factors for type 2 diabetes.

Serving Populations Disproportionately Affected by Diabetes

In Cumberland County, New Jersey, URC's not-for-profit affiliate, the Center for Human Services (CHS), provides diabetes management services to the African-American, Latino, and migrant and seasonal farmworker populations. With funding from the New Jersey Department of Health and Senior Services, Office of Minority and Multicultural Health, and in partnership with CompleteCare Health Network, Inc., a non-profit, community-based medical and dental care provider, CHS works to increase awareness about disparities in diabetes, increase screening and identification of individuals living with diabetes, and improve access to care and resources to improve diabetes management. CHS also provides project participants with yoga classes; nutrition classes, which include cooking demonstrations; and access to the local food bank.

Strengthening Health Systems to Deliver Chronic Care Services

DiabetesURC works to address several noncommunicable diseases. For example, in Uganda and Tanzania, URC is supporting health workers in hospitals and health centers to improve care for HIV and other chronic conditions like diabetes and hypertension applying the chronic care model. Important aspects of the chronic care model include patient self-management support and community involvement (e.g., using expert patients), re-organization of service delivery to support continuity of care, improvement of chronic care information systems using local data, and decision-making support for health care providers.

November 14, 2012
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