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More than 200 million people worldwide have diabetes. Many of them do not receive the care that they need. The lnternational Diabetes Federation (IDF) has chosen 2006 as the year of the disadvantaged and the vulnerable.

With the slogan 'Diabetes Care for Everyone', the World Diabetes Day 2006 campaign aims to raise awareness of communities and groups in both developed and developing countries that experience difficulties in accessing optimal healthcare because they are outside the healthcare system, or for some reason are less likely to access or are less aware of the services available to them.

World Diabetes Day campaigning and celebrations involve the entire global diabetes community. The yearlong campaign is the key awareness-raising event for diabetes representative organisations everywhere.

The main aims for the 2006 campaign are to:

- Underscore the message that every person with diabetes or at risk of diabetes deserves the best quality of education, prevention and care that is possible.

- Draw public attention to communities and groups that are disadvantaged or vulnerable in terms of their access to appropriate diabetes education prevention and care.

- Increase awareness among the international assistance community of the need to provide greater funding for non-communicable diseases.

- Focus the attention of the public and private sectors on the low levels of investment in diabetes education, prevention and care.

- Persuade governments to tighten the welfare net so that individuals with diabetes do not slip through.

- Raise awareness among people with diabetes or at risk of diabetes of the education, prevention and care available to them.

- Engage networks, groups and individuals working with target communities to join the campaign and promote the campaign messages.

- Share best practice in diabetes education, prevention and care that targets disadvantaged and vulnerable groups.

- Stimulate research that will foster a better understanding of the socio-cultural origins of diabetes among disadvantaged and vulnerable communities in order to inform the development of policies and practices that are culturally relevant to the prevention and management of diabetes.

Diabetes Facts

- The World Health Organisation (WHO) estimates that more than 180 million people worldwide have diabetes. This number is likely to more than double by 2030.

- In 2005, an estimated 1.1 million people died from diabetes.

- Almost 80% of diabetes deaths occur in low and middle-income countries.

- Almost half of diabetes deaths occur in people under the age of 70 years; 55% of diabetes deaths are in women.

- WHO projects that diabetes deaths will increase by more than 50% in the next 10 years without urgent action. Most notably, diabetes deaths are projected to increase by over 80% in upper-middle income countries between 2006 and 2015.

Diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin, or alternatively, when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar. Hyperglycaemia, or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body's systems, especially the nerves and blood vessels.

Type 1 diabetes (previously known as insulin-dependent or childhood-onset) is characterised by a lack of insulin production. Without daily administration of insulin, Type 1 diabetes is rapidly fatal. The symptoms include excessive excretion of urine (polyuria), thirst (polydipsia), constant hunger, weight loss, vision changes and fatigue. These symptoms may occur suddenly.

Type 2 diabetes (formerly called non-insulin-dependent or adult-onset) results from the body's ineffective use of insulin. Type 2 diabetes comprises 90% of people with diabetes around the world, and is largely the result of excess body weight and physical inactivity. The symptoms may be similar to those of Type 1 diabetes, but are often less marked.

As a result, the disease may be diagnosed several years after onset, once complications have already arisen. Until recently, this type of diabetes was seen only in adults but it is now also occurring in obese children.

Gestational diabetes is hyperglycaemia which is first recognised during pregnancy. Symptoms of gestational diabetes are similar to Type 2 diabetes. Gestational diabetes is most often diagnosed through prenatal screening, rather than reported symptoms.

Stress induced hyperglycaemia is usually associated with illness, surgery, infection, trauma, etc. It is caused by counter-regulatory hormone and cytokine responses to drugs given in situations like a heart attack or asthma causing gluconeogenesis and glycogenolysis in different organs.

What is the economic burden of diabetes?

Diabetes and its complications impose significant economic consequences on individuals, families, health systems and countries.

How can the burden of diabetes be reduced?

Without urgent action, diabetes-related deaths will increase by more than 50% in the next 10 years. To help prevent type 2 diabetes and its complications, people should:

- Achieve and maintain healthy body weight.

- Be physically active - at least 30 minutes of regular, moderate-intensity activity on most days. More activity is required for weight control.

Early diagnosis can be accomplished through relatively inexpensive blood testing. Treatment of diabetes involves lowering blood glucose and the levels of other known risk factors that damage to blood vessels. Tobacco cessation is also important to avoid complications.

Interventions that are both cost saving and feasible in developing countries include:

- Moderate blood glucose control. People with type 1 diabetes require insulin; people with type 2 diabetes can be treated with oral medication, but may also require insulin;

- Blood pressure control;

- Foot care.

Other cost saving interventions include:

- Screening for retinopathy (which causes blindness);

- Blood lipid control (to regulate cholesterol levels);

Screening for early signs of diabetes-related kidney disease.
These measures should be supported by a healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use.