[health-vn] Lancet special issue: Diabetes

[Vern Weitzel]

Subject: [procor] Lancet special issue: Diabetes
Date: Fri, 22 May 2009 13:10:37 -0400
From: ProCor <procor at procor.org>
Reply-To: Global Dialogue <procor at list.procor.org>
To: Global Dialogue <procor at list.procor.org>

A Lancet special issue on diabetes--one of the greatest contributors to the 
global burden of disease--focuses on some of the major causes and most 
devastating complications of diabetes (www.thelancet.com).

The introductory editorial to the 23 May 2009 issue states, "Although much of 
this week's research focuses on treatment of patients in developed countries, 
diabetes is a global problem. Four-fifths of all patients with diabetes live in 
developing countries. The country with the highest prevalence is the Micronesian 
island of Nauru, where 31% of its 14 000 inhabitants have diabetes (the USA has 
a prevalence of 9%). Six of the ten countries with the highest rates of diabetes 
are in the eastern Mediterranean and Middle East region (United Arab Emirates, 
Saudi Arabia, Bahrain, Kuwait, Oman, and Egypt). Across Africa, the Middle East, 
and South and Central America, the prevalence of diabetes is estimated to rise 
by about 80% over the next 15 years."

Contents include:

- A comprehensive meta-analysis showing that women with gestational diabetes 
have a seven-fold increased risk of subsequently developing type 2 diabetes 
compared with women with a normoglycaemic pregnancy (and an accompanying Seminar 
on gestational diabetes).

- A meta-analysis suggesting that intensive glucose control can significantly 
reduce rates of adverse coronary events, without increasing the risk of death.

- FIELD trial results indicating that treatment of diabetic patients with the 
lipid-lowering agent fenofibrate reduces the incidence of limb amputations, a 
debilitating but under-studied complication of diabetes.

The editorial also points out that research efforts in developed countries have 
produced effective screening and prevention programmes and drug treatments for 
management of diabetes, but that "...little of this expertise is available in 
developing countries that are only now beginning to recognise the burden of 
chronic non-communicable diseases. A child born with type 1 diabetes in the USA 
can expect to live to about 68 years of age; a child born with the same disease 
in Mozambique is unlikely to survive beyond 12 months. Developing countries are 
faced with many pressing health issues, especially communicable diseases, which 
mean that non-communicable diseases are poorly understood and under-prioritised 
by governments. Few diabetes drugs feature on essential drugs lists, and those 
countries that have access to insulin often store it at a central location, 
beyond the reach of the majority."

Link to:

Table of Contents (Lancet 23 May 2009 Volume 373 Number 9677)
http://www.thelancet.com/journals/lancet/issue/current

Editorial "Diabetes, a global threat"
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60954-5/fulltext