News

  • 20 November - Universal Children's Day

    November 11 2017

    Children living with type 1 diabetes are first and foremost children

    In Europe, 286.000 children live with type 1 diabetes and 28.100 new cases are diagnosed every year. While insulin was discovered more than 100 years ago, in some European countries children are discriminated as access to diabetes care is still not free nor affordable for many families. This situation can lead to early complications, poor quality of life, struggle to complete education, gainful employment and death.

    Today the World celebrates the United Nations Universal Children's Day, a day dedicated to promoting the well-being and human rights of the world's children, especially those suffering the impacts of poverty, armed conflict, discrimination and exploitation. Today, as every other day, IDF Europe would like to remind that government in every European country must take action to ensure that no children die of diabetes. We must remember that children living with type 1 diabetes are first and foremost children. These children should have guaranteed access to insulin, test strips, medical care. In order to thrive, there is also a need to create a positive environment in which they can grow that goes beyond the formal boundaries of the health system. This requires information, education and support so that the child develops in a supportive environment that ensures they are empowered to manage their diabetes on a daily basis.

    DavidOn Universal Children Day we spoke to Dr David Beran, a Researcher and Lecturer at the Geneva University Hospitals and University of Geneva within the Division of Tropical and Humanitarian Medicine. Before this David was the Project Coordinator of the International Insulin Foundation based at University College London (UCL) where he developed and implemented a health systems tool to assess to access to diabetes care. This work was carried out in Kyrgyzstan, Mali, Mozambique, Nicaragua, Vietnam and Zambia and led to the development of specific policies and projects to address the barriers identified. He is currently working with colleagues on the Addressing the Challenge and Constraints of Insulin Sources and Supply (ACCISS) Study looking at improving access to insulin.

    David, what is the situation of type 1 diabetes in Europe?
    Tough question. The IDF Europe Region is so diverse in terms of country health systems, socio-economic situations, etc. that there is not one situation for type 1 diabetes. Access to care and insulin in Europe can probably be subdivided into 3 categories. In the first category are the well-funded health systems, where care is well organised, and insulin is available for free or at a price that the individual can afford. In the second category, one of these two factors is missing. Either the health system is weak and does not have the resources and infrastructure to properly manage type 1 diabetes, or insulin is not provided for free. Finally, the third category is a country where there is both a lack of health system capacity to manage diabetes and insulin is not available and/or affordable.

    As you know, type 1 diabetes is a complex condition that requires both access to medicine and care to ensure successful management. For those living in countries in both categories two and three mentioned here, diabetes management becomes even more difficult to achieve and often comes with a substantial financial, emotional and physical burden on the individual and their families. That said even in well-developed and funded health systems certain vulnerable groups may face difficulties accessing care.

    Children living with type 1 diabetes do best when they have access to well-developed paediatric services that are staffed with doctors, nurses and other health professionals, creating a protected environment for the child with type 1 diabetes. This already exists in many countries in Europe. This Universal Children Day the IDF should guarantee this in all its Member countries, but also not forget that children become adolescents and then adults and that we need to ensure proper diabetes care throughout the individual’s life course.

    Access to basic need such as insulin and strips is still a major issue in some countries in Europe. How do you explain this situation?
    I would say that there is both a global and national responsibility for this situation. Globally, the power of the insulin and test strip manufacturers is such that they can charge high prices for these products, and thus limit access of these medicines and supplies to health systems and individuals. For insulin, it is unbelievable that a medicine discovered in 1921 is still not globally affordable and/or available to all who need it. Similarly, the price of test strips is a problem in many settings, in some cases, their prices are even higher than that of insulin. In addition, frequent updates to glucometers and their test strips mean people have to keep up with these changes and sometimes have problems finding the right strips in their country.

    At a national level, some governments in Europe still do not cover insulin and/or test strips. With regards to insulin though there is no debate as it is a life or death situation for a person with type 1 diabetes. The issue of strips is complex due to their high price. Some countries limit the number of strip reimbursed, others do not cover this aspect of diabetes care. Whether or not governments should pay for this aspect of diabetes management is a large debate.

    This is what we are studying with the ACCISS led by Health Interaction International: understand of what is causing the barriers to insulin access so inequities and inefficiencies in the global insulin market can be addressed. http://haiweb.org/what-we-do/acciss/about-acciss/

    ACCISS is a really interesting programme. What can be done to improve these situations?
    Globally, the diabetes community should continue to get informed and raise awareness around these issues, to ensure that the basic treatment needs of those living with type 1 diabetes are provided. In Europe, people in countries who are lucky enough to receive great treatment and care must stand together with those in other parts of the continent and the world that struggle with access to even the basic levels of care. Nationally, the IDF and its members have as their duty to hold governments to account. This means that national diabetes associations need to represent the interests of people with diabetes and ensure that they have access to insulin and care.

    Universal Health Coverage is one of the main target of the Sustainable Development Goals of the United Nations. Is it the solution?
    Universal Health Coverage can limit the financial burden of diabetes, as long as diabetes is included in the package of services covered. I think that moving towards Universal Health Coverage is the solution, but it is not a magic bullet. There are three other actions that must be taken in parallel to ensure access to diabetes care is sustainable and offers the best possible care for those living with diabetes:
    1. Find ways of decreasing the price of insulin
    2. Help strengthen the health system for diabetes care
    3. Monitor the availability and affordability of insulin for the health system and the individual

    Any other information you would like to include

    For more information on type 1 diabetes and children, you can refer to the website of the International Society for Paediatric and Adolescent Diabetes (ISPAD). To support our programme helping children and youth with diabetes in Europe and worldwide, please refer to IDF Life for a child website. For more information on the ACCISS study please visit: http://www.haiweb.org/ACCISS.htm

  • World Diabetes Day - Interviews 5/5

    November 11 2017

    Everything is possible, it’s all about how we choose to see things.

    With 60 million people with diabetes and 32 million more at risk of developing it, Europe is facing a major health and financial pandemic. Today, it is estimated that 1 in 9 women over 25 have diabetes in the continent, and 1 in 7 births is affected by gestational diabetes, leading within 10 years after pregnancy to type 2 diabetes in 50% of all cases. In addition to their direct relations with diabetes, women are key agents in the adoption of healthy lifestyles which are crucial to prevent type 2 diabetes and also to maintain appropriate blood glucose levels and decrease the risk of debilitating complications. Furthermore, mothers will also often be the ones looking after the therapeutic and psychological aspects of a child with type 1 diabetes.

    On the occasion of World Diabetes Day, IDF Europe decided to run a series of interviews of women having a direct relation with diabetes. Whether they have diabetes, have someone in their family living with the condition or they advocate at international level, they all have one thing in common: diabetes is at the centre of their daily life and they are all committed fight for stronger rights and lesser discrimination.

    Today, we spoke to Ms Cristina Maria Petrut member of the Board of IDF Europe from Romania after being and IDF young leader. Cristina is a clinical psychologist and psychotherapist with a great interest for the psychological aspects of diabetes has been diagnosed with type 1 diabetes 16 years ago.

    Cristina, you were diagnosed at the age of 11. Do you remember what was your first reaction and the one of your family?

    My memory of that moment is a mix of fear, confusion but also of relief. I did not know what was happening to me and I did not understand why everyone was so nervous around me. I was feeling extremely sick and was suffocating because of the high blood sugar ketones and I really thought I was not going to make it through the day. To make it worse, doctors didn't know what was going on with me and put me on glucose as standard treatment! I ended up in a coma. By the time I woke up, I realized I was alive and feeling better and that was enough for me for the day.

    My family went through the same rollercoaster. They were extremely afraid to lose me on that day, they kept asking themselves, why me. They also understood what was going to be the impact of diabetes on my life as my grandparents had type 2 diabetes and were insulin-dependent. My family was really strong in front of me, giving me courage. My mother was always with me at the hospital and, together with my father and brother, they tried their best to make me not feel the burden of diabetes. But they were suffering a lot and to be honest, even today after all these years, whenever we talk about my diabetes and how hard it has been at the time of my diagnoses, I can feel that they are still sad, affected and very sensitive on the subject. But the good thing is that this initial period is part of the past and now we all agree that we are blessed to be together and that life is beautiful as long as we learn to look at the bright side of it.

    You were diagnosed as a teenager. How did diabetes impact you as a youth and now as a woman?

    From the start, we decided with my family that diabetes was not, is not and will not be a burden to my life. I have always spoken free about my disease and everyone around me know that I have diabetes. That positive attitude had an interesting impact: at school, everyone wanted to be my friend, asking me about my diabetes or to show them my insulin pump and to check their blood sugar level.

    As a teenager, diabetes made me grow faster and sometimes I felt I was a bit too mature for my age, I wasn’t a “good fit” with those of my age. Of course, sometimes I felt worried, anxious about my future and afraid not to be able to do a lot of the things I’ve dreamed about since I was a child. I also had my times of rebellion when I just wanted a break from my diabetes, I hated checking my blood glucose or changing my insulin set.

    The good thing is that I never felt alone and I’ve understood pretty quickly that I needed to take care of myself in order to enjoy the time with my friends, at school and to do whatever I wanted to do. Diabetes shaped and still shapes my life. It is surely at the origin of my vocation as psychologist to help and be close to people, and I am convinced that it makes me enjoy life more than otherwise. Today, I am surrounded by a lot of amazing people with diabetes from all around the world and I have met my very best friends who also have diabetes.

    To answer your question, I've lived a beautiful teenage period, I did everything I wanted to do and really don't have any regrets. Through the years, I have learned a very important lesson: Everything is possible, it’s all about how we choose to see things. Despite the struggles, the hard work of keeping my condition under control and being stuck with this “companion” forever, life is still beautiful and I can still achieve every dream I have.

    You are very active locally, nationally and internationally as advocate for diabetes. What are your main concerns and fights in regard to woman and diabetes?

    Diabetes is a very complex medical condition affecting the body, the mind and the daily life. Being a woman and living with diabetes can be quite challenging. There are so many psychological aspects involved like diabetes burnout, depressing, low self - image, eating disorders, bad behavior, irrational cognitions and so on which can affect quality of life but also diabetes management.

    Being a teenager is often a difficult period and if you include diabetes in the picture, it can quickly become extremely complex. At that age, you want to be “like everyone else” and may wrongly feel that with it is not possible, leading sometimes to isolation and depression. For example, you want to start a love relationship but you might be afraid of the reaction of your partner, you do not want to be judged. Later in life, you may become anxious about finding someone who will accept you, and your diabetes, as a partner for life or about becoming a mother because of the higher risk of having children with diabetes.

    Being a mother of a child with diabetes can also be extremely stressful. There is the guilt of giving birth to someone who will develop type 1 diabetes, the anxiety of being considered a bad mother by the child who may consider that she is the person that causes him/her suffering by daily injections, food restrictions and so on. The person is also more likely to get depressed especially because of the constant preoccupation to know if her child is ok at night, at school, during trips and so on.

    My main concern is education especially in regard to the psychological aspects of this chronic condition. With proper supports, women with diabetes can get through hard times from accepting their diagnoses, to preventing or treating any psychological pathology, having a higher quality of life and being able to achieve their dreams and live a normal life. This is my daily fight as a person with diabetes, professional and volunteer at the local, national and international level!

  • World Diabetes Day - Interviews 4/5

    November 11 2017

    my diabetes requires a daily routine

    With 60 million people with diabetes and 32 million more at risk of developing it, Europe is facing a major health and financial pandemic. Today, it is estimated that 1 in 9 women over 25 have diabetes in the continent, and 1 in 7 births is affected by gestational diabetes, leading within 10 years after pregnancy to type 2 diabetes in 50% of all cases. In addition to their direct relations with diabetes, women are key agents in the adoption of healthy lifestyles which are crucial to prevent type 2 diabetes and also to maintain appropriate blood glucose levels and decrease the risk of debilitating complications. Furthermore, mothers will also often be the ones looking after the therapeutic and psychological aspects of a child with type 1 diabetes.

    On the occasion of World Diabetes Day, IDF Europe decided to run a series of interviews of women having a direct relation with diabetes. Whether they have diabetes, have someone in their family living with the condition or they advocate at international level, they all have one thing in common: diabetes is at the centre of their daily life and they are all committed fight for stronger rights and lesser discrimination.

    Today, we spoke to Lala Rabemananjara, who has been working for the International Diabetes Federation since 1999 and is Regional Executive at IDF Europe since 2002 about books, risk factors and love in the family.

    Lala, you have been diagnosed with type 2 diabetes this year. What was your reaction?

    You know diabetes is part of my life for a long time now, way before I joined IDF in 1999. I come from a family crippled with type 1 diabetes and I was diagnosed with impaired glucose tolerance in 1981 so I knew I was at high risk of developing type 2 diabetes.

    For me, this is an important message: Type 2 diabetes is not only a lifestyle condition, the genetically predisposition plays an important role too. In fact, you are two to six times more likely to get type 2 diabetes if you have a parent, brother, sister, or child with diabetes. Often people thinks that it is only linked to the way you eat, your level of physical activity and that, in some ways you pay for your excess. You know, I have always been living with diabetes like a sword of Damocles since my childhood. The diet motto was “no fat, no sugar, no salt” and I continued it with my children. I do invite people a lot around the house and the food I serve has always been considered healthy by my various guests along the years

    But still, despite my family history and the knowledge I have acquired on the condition since 1999, the diagnosis was a shock. It took me a few weeks to accept the fact that I was now going to live with a chronic condition for the rest of my life.

    Following your diagnosis, did you receive a specific training on diabetes self-management?

    Being part of the International Diabetes Federation, I fully understood the crucial role played by patient association to support people with diabetes. Therefore, one of the first thing I have done after the diagnosis was to register myself to the Association Belge du Diabète (Belgian Diabetes Association). Having worked with them on several occasions around World Diabetes Day, I knew that I could find there a lot of useful advice from professionals and other people with diabetes and also extremely well-made brochures and guidelines. I am a compulsive reader, I will have new reading interests 

    You have been diagnosed a few months ago, how are you today?

    I have to admit so that since September the preparation of World Diabetes Day has taken a lot of my time and I did not take advantage as much of the association as I could. This is still something I need to learn and accept: my diabetes needs daily routine, check and attention and I must find the time to look after it daily.

    You know, after the initial shocked, it took me a bit of time to accept the situation and adjust to diabetes. I am lucky to be surrounded by loving and caring children and friends who helped me go through the initial shock and support me when I feel a bit down. This is another important lesson and message for me: The entourage plays a crucial role in the daily management of the condition and the way you accept and live with diabetes.

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