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E U ISS GLOBAL PERSPECTIVES ON DIABETES Volume 59 – June 2014 SPECIAL BRIDGES: from the ivory tower to real life 16 29 47 32 International Diabetes Federation All correspondence and advertising enquiries link to third-party websites, which are not under Promoting diabetes care, prevention and should be addressed to the Managing Editor: IDF’s control. The inclusion of such links does not imply a recommendation or an endorsement by a cure worldwide International Diabetes Federation, Chaussée de IDF of any material, information, products and La Hulpe 166, 1170 Brussels, Belgium services advertised on third-party websites, and IDF Diabetes Voice is published quarterly and is Phone: +32-2-538 55 11 – Fax: +32-2-538 51 14 disclaims any liability with regard to your access of such linked websites and use of any products or freely available online at www.diabetesvoice.org. services advertised there. While some information This publication is also available in French and © International Diabetes Federation, 2014 – All in Diabetes Voice is about medical issues, it is not rights reserved. No part of this publication may Spanish. medical advice and should not be construed as such. be reproduced or transmitted in any form or by any means without the written prior permis- ISSN: 1437-4064 Editor-in-Chief: Rhys Williams sion of the International Diabetes Federation Guest Editor: Linda Siminerio (IDF). Requests to reproduce or translate IDF Cover photo : © William Vazquez Managing Editor: Olivier Jacqmain, publications should be addressed to the IDF [email protected] Communications Unit, Chaussée de La Hulpe The production of this Special Issue has been 166, B-1170 Brussels, by fax +32-2-5385114, or made possible thanks to the support of BRIDGES. Editor: Elizabeth Snouffer by e-mail at [email protected]. BRIDGES is an IDF programme supported by Editorial Assistant: Agnese Abolina an educational grant from Lilly Diabetes. Advisory group: Pablo Aschner (Colombia), The information in this magazine is for information Ruth Colagiuri (Australia), Maha Taysir Barakat purposes only. IDF makes no representations or (United Arab Emirates), Viswanathan Mohan warranties about the accuracy and reliability of any (India), João Valente Nabais (Portugal), Kaushik content in the magazine. Any opinions expressed are those of their authors, and do not necessarily Ramaiya (Tanzania), Carolyn Robertson (USA). represent the views of IDF. IDF shall not be liable Layout and printing: Ex Nihilo, Belgium, for any loss or damage in connection with your use www.exnihilo.be of this magazine. Through this magazine, you may CONTENTS 40 64 DIABETES VIEWS 4 Integrated efforts key for optimal diabetes care in China 36 Ming-xia Yuan and Shen-yuan Yuan NEWS IN BRIEF 9 SELF-MANAGEMENT AND EDUCATION IDF BRIDGES Professional workshops help fill gaps in IDF and BRIDGES span the globe to tackle diabetes 16 diabetes self-management 40 Ronan L’Hévéder Heloisa de Carvalho Torres, Ilka Afonso Reis and BRIDGES at a glance 20 Mariana Almeida Maia Education to change the course of diabetes PREVENTION in the Caribbean 44 Schools open doors to lifestyle lessons in Tunisia 22 Errol Morrison, Shelly McFarlane, Cliff Riley and Novie Younger-Coleman Jihene Maatoug, Nawel Zammit, Firas Chouikha, Sana Bhiri, Aymen Salem, Nathalie Farpour-Lambert Health coaching increases self-esteem and and Hassen Ghanem healthy smiles 47 Reducing diabetes risk after gestational diabetes 25 Ayse Basak Cinar and Lone Schou Ruth McManus, Lois Donovan, David Miller, Education helps decision-making for affordable, Isabelle Giroux, Michelle Mottola, Trisha Joy, Charlotte McDonald and Patricia Rosas-Arellano healthy food and control 52 Bettina Tahsin Lifestyle intervention eases battle with diabetes 29 Asma Ahmed and Qing Qiao Everything you ever needed to know about gestational diabetes 56 Valerie Holmes and Claire Draffin HEALTH DELIVERY Can a peer support intervention improve type 2 Motivating better diabetes self-care with diabetes outcomes? 60 SMS text messaging 32 Tim Johansson, Sophie Keller, Henrike Winkler, Josefien van Olmen, Grace Marie Ku, Raimund Weitgasser and Andreas Sönnichsen Maurits van Pelt, Christian Darras and Guy Kegels LIST OF PROJECTS SUPPORTED BY IDF BRIDGES 64 June 2014 • Volume 59 • Special Issue DiabetesVoice 3 DIABETES VIEWS UNITED IN OUR VISION TO SAVE SIGHT Diabetic retinopathy (DR) will become the leading type 2 diabetes and the doctors who treat them. cause of blindness worldwide in the next 20 years. The survey estimates that 42 percent of people By 2035, it is estimated that 177 million people or with type 2 diabetes do not reach blood glucose ⅓ of all people living with diabetes will be at risk goals, putting them at high risk for complications, for DR. including blindness. Dr David Strain, Chairman of Time2DoMore’s Steering Committee tells us, “When These troubling statistics are thrown around people are first diagnosed they regard diabetes as quite a lot. How many times have we heard about a ‘mild condition’. Our data suggests the majority the serious and often tragic connection between of people with diabetes regard complications as diabetes and blindness? The messages are shocking, something that may happen in the future, and but the reality is often forgotten. Just like other therefore not something to be concerned about in hard-to-detect diabetes complications, DR can be the early years.” difficult to recognise until it is too late. One of the key principles the International Diabetes How uncanny that a case of blurred vision is often Federation (IDF) will be working towards is better the first-step before a person is even diagnosed with engagement between healthcare practitioners and diabetes. When an individual finally sees a doctor, people with diabetes, but that’s not all. Greater the blurred vision translates to a double diagnosis of collaboration is required locally, nationally and diabetes and eye disease. These circumstances reveal globally among policy makers, service providers, just how long a person can live with undiagnosed the private sector and communities, to reduce the diabetes (often more than a decade) and not know impact of DR. it. It also validates a global need for greater diabetes and DR awareness. For this very reason, The Fred Hollows Foundation and IDF formed a ten year partnership at the end The global burden of diabetes and DR also brings of 2013. IDF’s alliance with the Foundation is the to mind another important issue. Findings from the most significant initiative ever executed by IDF soon-to-be published Time2DoMore global survey leadership in order to help “save sight” for millions highlight the “clinical inertia” among people with of people with diabetes. 4 DiabetesVoice June 2014 • Volume 59 • Special Issue DIABETES VIEWS The Fred Hollows Foundation works throughout will be meaningful to people who live with diabetes Asia, Africa and the Pacific as well as with and vision challenges. Indigenous communities in Australia. A hallmark of the Foundation’s approach is working closely I hope you will join us in advocating the right of all with partners like IDF on blindness and people living with diabetes to see the future. prevention programmes, particularly in poor and isolated regions. Our partnership will provide an opportunity to raise awareness of eye disease as a health priority. Brian Doolan, CEO of The Fred Hollows Foundation, believes the combined efforts of IDF and the Foundation will increase the capacity to influence change. The focus of the global partnership will be advocacy, workforce development, research, programmes and technology development, and community education and awareness. Over the next ten years, IDF and Hollows will: ■ Embed DR as a health priority, and advocate for increased resources, research and global guidelines for DR prevention and care. ■ Collaborate on and roll out diabetes and eye healthcare programmes in a range of developing countries. ■ Promote investment in innovative, cost effective technology for screening and treatment services for DR to build the capacity and extend the service reach of programmes and services. ■ Contribute to building a skilled workforce to provide good quality care in all aspects of screening, treatment and management of the condition. In closing, I would like to point out that this second 2014 issue of Diabetes Voice is devoted to IDF’s BRIDGES programme. As a small step forward, and to empower all people living with diabetes and eye disease, this issue has been specially formatted for the visually impaired. IDF will continue this Michael Hirst practice for all publications in the future. The President, International difference may seem minor, but the new format Diabetes Federation June 2014 • Volume 59 • Special Issue DiabetesVoice 5 DIABETES VIEWS BUILDING BRIDGES FOR DIABETES PREVENTION AND TREATMENT I have had the opportunity to observe advances blood glucose and hemoglobin HbA1c testing in diabetes over the course of 50 years. Looking provided the needed information to people with backward and forward, the process tells a story diabetes and healthcare providers. The diabetes of promise. community yet again breathed a sigh of relief. If there was a way to monitor glucose, of course In the 1960s, I recall watching my father who complications could be prevented. struggled with the crude treatments and tools available to people with diabetes at the time. He When monitoring became available, scientists and was prescribed a strict diet, urine testing, and a governments from around the world in the 1980s dose of insulin delivered through a glass syringe and 90s were finally able to invest time and funds with a very long needle. There were no tests for to find answers to pending questions. Does blood monitoring. All of his care decisions were based glucose control really prevent the complications of on guesses. Despite his best efforts, his diabetes diabetes? If people are at risk, can we prevent diabetes led to a series of complications and a tragic end.