Up to 1-in-5 TB deaths attributed to tobacco use

Up to 1-in-5 TB deaths attributed to tobacco use

With 50% of all deaths from lung disease linked to tobacco use, control of the substance is high on the agenda of the 39th World Conference on Lung Health in Paris, France.

“Up to one in five TB (tuberculosis) deaths could be avoided if TB patients were not smokers,” Dr Nils Billo, Executive Director of the International Union Against Tuberculosis and Lung Disease (IUATLD), said during the conference.

Smoking is also associated with recurrent TB and people with the disease who smoke have a higher risk of mortality than non-smokers with TB. The scaling-up of tobacco cessation services for people with TB is therefore a clear priority.

Dr Mario Raviglione, Director of the Stop TB Department under WHO discussed the Practical Approach to Lung health (PAL) with delegates at the conference. The approach focuses on comprehensive treatment for all respiratory conditions and diseases, not just TB.

About 80% of smokers live in low and middle-income countries and 520 million people will die from tobacco-related illnesses in the next 50 years, according to available data. By 2030 the annual number of deaths from tobacco will increase from five million to more than eight million.

The IUATLD has helped raise awareness of tobacco hazards, encouraging its partners to play an active role in tobacco control and recognize the link between tobacco and TB.

It has also promoted effective tobacco control policies through technical resources, training a new generation of managers and practitioners and supporting effective programs through grants.
WHO and the union published a joint monograph on TB and tobacco control in 2007 and key elements of the policy include the identification and offers of counselling for smokers assessed for TB or other respiratory diseases.

The monograph also called for the operation of smoke-free public health centres and the training of health workers to deliver smoking cessation treatment.

Concerns over the high rates of tobacco use among doctors and healthcare providers in high TB-burdened countries were also raised during discussions at the conference. In some regions more than 50% of healthcare workers use the drug, making it difficult for them to play a genuine role in tobacco cessation programs.

Up to 1-in-5 TB deaths attributed to tobacco use

Up to 1-in-5 TB deaths attributed to tobacco use

With 50% of all deaths from lung disease linked to tobacco use, control of the substance is high on the agenda of the 39th World Conference on Lung Health in Paris, France.

“Up to one in five TB (tuberculosis) deaths could be avoided if TB patients were not smokers,” Dr Nils Billo, Executive Director of the International Union Against Tuberculosis and Lung Disease (IUATLD), said during the conference.

Smoking is also associated with recurrent TB and people with the disease who smoke have a higher risk of mortality than non-smokers with TB. The scaling-up of tobacco cessation services for people with TB is therefore a clear priority.

Dr Mario Raviglione, Director of the Stop TB Department under WHO discussed the Practical Approach to Lung health (PAL) with delegates at the conference. The approach focuses on comprehensive treatment for all respiratory conditions and diseases, not just TB.

About 80% of smokers live in low and middle-income countries and 520 million people will die from tobacco-related illnesses in the next 50 years, according to available data. By 2030 the annual number of deaths from tobacco will increase from five million to more than eight million.

The IUATLD has helped raise awareness of tobacco hazards, encouraging its partners to play an active role in tobacco control and recognize the link between tobacco and TB.

It has also promoted effective tobacco control policies through technical resources, training a new generation of managers and practitioners and supporting effective programs through grants.
WHO and the union published a joint monograph on TB and tobacco control in 2007 and key elements of the policy include the identification and offers of counselling for smokers assessed for TB or other respiratory diseases.

The monograph also called for the operation of smoke-free public health centres and the training of health workers to deliver smoking cessation treatment.

Concerns over the high rates of tobacco use among doctors and healthcare providers in high TB-burdened countries were also raised during discussions at the conference. In some regions more than 50% of healthcare workers use the drug, making it difficult for them to play a genuine role in tobacco cessation programs.

Living on the outside: The impact of diabetes-related stigma

Living on the outside: The impact of diabetes-related stigma



"Who will marry my daughter who has diabetes?" asks Ram Anuj, a native of Ganga Jamuni village, Bahraich district in India. Ram Anuj's 14 years old daughter Munni (name changed) has type 1 diabetes and needs daily insulin injections.



The family members stopped sending Munni to school when other children made fun of Munni when she took her insulin. In a village-setting, giving insulin injections to Munni, is a public knowledge. Munni often gets scorned for being a burden on the family. Munni's family doesn't have enough money to take adequate care of her and provide the treatment she needs.



Stigma-related to diabetes, is particularly more pronounced for girls. Stigma in response to illness is not a new issue in some parts of the world. Stigma has long been associated with mental illness, physical disability, leprosy, cancer and tuberculosis. However, diabetes-related stigma is particularly severe as diabetes is a life-threatening chronic condition. Stigma is particularly complex as it operates at many different levels and has both social and psychological aspects. Diabetes-related stigma at the workplace or in the community and self-stigma has adverse impact on the mental health and feeling of wellness of people with diabetes.



Primary definitions of stigma usually refer to Irving Goffman (1963) whose text provides seminal critique: "Stigma can be seen as an attribute that discredits the individual, denying full social acceptance, and where notions of social inclusion and exclusion are firmly brought to the fore."



There are many factors surrounding stigma including denial, shame, blame, fear, rejection and discrimination. For any child or adolescent living with diabetes, learning to cope with it is often a daunting task.



Dealing with a chronic illness such as diabetes may cause emotional and behavioral challenges, at times, leading to depression. The need for high-quality counseling sessions, for the people with diabetes and their family members, is paramount at the diabetes care and treatment centres, which may eventually help combat stigma. It may also help them to adjust to the lifestyle changes needed to stay healthy.



"Counseling and emphasizing that diabetes is not a disease but a metabolic condition and every person with diabetes should be referred to as a 'person with diabetes' and not a 'diabetic patient' will go a long way in reducing the diabetes-related stigma" stresses Dr Sharad Pendsey, a noted expert on diabetes, who runs a charitable trust - Diabetes Research Education And Management Trust (DREAM Trust, www.dreamtrust.org) in New Delhi. This trust provides free insulin, syringes, blood glucose monitoring strips and complete healthcare to the poor children with Type-1 diabetes. "Our centre has an education wing where diabetes educators regularly conduct educational classes, one to one counseling with patient and the family members. We have counselors at our centre and we have noticed a remarkable change in reducing diabetes related stigma" shares Dr Pendsey.



In addition, lack of skilled healthcare staff, apart from the treating diabetes physician, exacerbates the situation. There are not enough nurse educators, diabetes counselors, nutritionists, podiatrists (foot experts) and other health educators to help raise awareness and understanding of unique care and treatment needs of people with diabetes in society. This not only fuels the diabetes-related stigma but also reduces the quality of healthcare for people with diabetes. The treating physician is usually single-handedly dealing with all the different responsibilities of being a counselor, educator, doctor, nutritionist, podiatrist, to name a few. "The patients' inability/ unwillingness to pay for this additional support also hinders the treatment" says Dr Surendra Khanna, a Physician at Diabetes Centre in Kanpur.



According to International Diabetes Federation (IDF, www.idf.org), over 250 million people live with diabetes around the world. In addition, more than 200 children are diagnosed with type 1 diabetes every day, requiring them to take multiple daily insulin shots and monitor the glucose levels in their blood. Currently, over 500,000 children under the age of 15 live with diabetes. With such an enormous number of people with diabetes requiring attention, it is clearly vital to make the treatment, care and support services for people with diabetes made available in public sector hospitals without any further delay.



"Diabetes-related stigma can block access to existing diabetes-care services. If people with diabetes are felt to not be well anymore, then many mainstream systems do not want to spend their scarce resources on them, when they are fighting to have enough antibiotics and IV fluids to combat infections and diarrhoea, still the leading causes of death in children in the developing world. There are not enough specialists in many regions who are knowledgeable of diabetes to take care of all the children," said Mr Phil Riley, Campaign Director, World Diabetes Day Campaign (www.worlddiabetesday.org).



On this year's World Diabetes Day (14 November), let's hope that governments and other stakeholders will commit themselves to invest resources in mobilizing communities in a radical scale-up of awareness programmes, health education initiatives and treatment literacy efforts directed towards not only those living with diabetes but also their family members and people in the community. To reduce the diabetes-related stigma, and to create an enabling environment where people living with diabetes can live a normal healthy life, it is crucial to spread the message that often with appropriate lifestyle modifications type 2 diabetes is preventable, and that proper, affordable and accessible treatment, care and support programmes for people living with both type 1 and type 2 diabetes exist.



Amit Dwivedi



(The author is a Special Correspondent to Citizen News Service (CNS). Email: amit@citizen-news.org)



Published in

Asian Tribune, Bangkok, Thailand

News Track India, Delhi

News Blaze, USA

Op-Ed News (OEN), UK

Thai Indian News, Bangkok, Thailand

Truth Feeds

Zimbabwe Guardian, Harare, Zimbabwe

Ghana News, Accra, Ghana

African Path, South Africa

Xirincs

Assam Times, Guwahati, Assam

The Med Guru

Citizen News Service (CNS)

Pakistan Post, Karachi, Pakistan

My News, Delhi

Standard Times, Sierra Leone

Northern News Lines, Chandigarh

Media for Freedom, Nepal

Bihar and Jharkhand News Service

Madhumeh

Bihar Times, Patna, Bihar

Two Circles

The Bangladesh Today, Dhaka, Bangladesh

Banderas News, Mexico

The Guatemala Times, Guatemala

Chincoteague Local News

Howrah News Service, West Bengal

News from Bangladesh, Dhaka, Bangladesh

Children with diabetes Forum

Living on the outside: The impact of diabetes-related stigma

Living on the outside: The impact of diabetes-related stigma



"Who will marry my daughter who has diabetes?" asks Ram Anuj, a native of Ganga Jamuni village, Bahraich district in India. Ram Anuj's 14 years old daughter Munni (name changed) has type 1 diabetes and needs daily insulin injections.



The family members stopped sending Munni to school when other children made fun of Munni when she took her insulin. In a village-setting, giving insulin injections to Munni, is a public knowledge. Munni often gets scorned for being a burden on the family. Munni's family doesn't have enough money to take adequate care of her and provide the treatment she needs.



Stigma-related to diabetes, is particularly more pronounced for girls. Stigma in response to illness is not a new issue in some parts of the world. Stigma has long been associated with mental illness, physical disability, leprosy, cancer and tuberculosis. However, diabetes-related stigma is particularly severe as diabetes is a life-threatening chronic condition. Stigma is particularly complex as it operates at many different levels and has both social and psychological aspects. Diabetes-related stigma at the workplace or in the community and self-stigma has adverse impact on the mental health and feeling of wellness of people with diabetes.



Primary definitions of stigma usually refer to Irving Goffman (1963) whose text provides seminal critique: "Stigma can be seen as an attribute that discredits the individual, denying full social acceptance, and where notions of social inclusion and exclusion are firmly brought to the fore."



There are many factors surrounding stigma including denial, shame, blame, fear, rejection and discrimination. For any child or adolescent living with diabetes, learning to cope with it is often a daunting task.



Dealing with a chronic illness such as diabetes may cause emotional and behavioral challenges, at times, leading to depression. The need for high-quality counseling sessions, for the people with diabetes and their family members, is paramount at the diabetes care and treatment centres, which may eventually help combat stigma. It may also help them to adjust to the lifestyle changes needed to stay healthy.



"Counseling and emphasizing that diabetes is not a disease but a metabolic condition and every person with diabetes should be referred to as a 'person with diabetes' and not a 'diabetic patient' will go a long way in reducing the diabetes-related stigma" stresses Dr Sharad Pendsey, a noted expert on diabetes, who runs a charitable trust - Diabetes Research Education And Management Trust (DREAM Trust, www.dreamtrust.org) in New Delhi. This trust provides free insulin, syringes, blood glucose monitoring strips and complete healthcare to the poor children with Type-1 diabetes. "Our centre has an education wing where diabetes educators regularly conduct educational classes, one to one counseling with patient and the family members. We have counselors at our centre and we have noticed a remarkable change in reducing diabetes related stigma" shares Dr Pendsey.



In addition, lack of skilled healthcare staff, apart from the treating diabetes physician, exacerbates the situation. There are not enough nurse educators, diabetes counselors, nutritionists, podiatrists (foot experts) and other health educators to help raise awareness and understanding of unique care and treatment needs of people with diabetes in society. This not only fuels the diabetes-related stigma but also reduces the quality of healthcare for people with diabetes. The treating physician is usually single-handedly dealing with all the different responsibilities of being a counselor, educator, doctor, nutritionist, podiatrist, to name a few. "The patients' inability/ unwillingness to pay for this additional support also hinders the treatment" says Dr Surendra Khanna, a Physician at Diabetes Centre in Kanpur.



According to International Diabetes Federation (IDF, www.idf.org), over 250 million people live with diabetes around the world. In addition, more than 200 children are diagnosed with type 1 diabetes every day, requiring them to take multiple daily insulin shots and monitor the glucose levels in their blood. Currently, over 500,000 children under the age of 15 live with diabetes. With such an enormous number of people with diabetes requiring attention, it is clearly vital to make the treatment, care and support services for people with diabetes made available in public sector hospitals without any further delay.



"Diabetes-related stigma can block access to existing diabetes-care services. If people with diabetes are felt to not be well anymore, then many mainstream systems do not want to spend their scarce resources on them, when they are fighting to have enough antibiotics and IV fluids to combat infections and diarrhoea, still the leading causes of death in children in the developing world. There are not enough specialists in many regions who are knowledgeable of diabetes to take care of all the children," said Mr Phil Riley, Campaign Director, World Diabetes Day Campaign (www.worlddiabetesday.org).



On this year's World Diabetes Day (14 November), let's hope that governments and other stakeholders will commit themselves to invest resources in mobilizing communities in a radical scale-up of awareness programmes, health education initiatives and treatment literacy efforts directed towards not only those living with diabetes but also their family members and people in the community. To reduce the diabetes-related stigma, and to create an enabling environment where people living with diabetes can live a normal healthy life, it is crucial to spread the message that often with appropriate lifestyle modifications type 2 diabetes is preventable, and that proper, affordable and accessible treatment, care and support programmes for people living with both type 1 and type 2 diabetes exist.



Amit Dwivedi



(The author is a Special Correspondent to Citizen News Service (CNS). Email: amit@citizen-news.org)



Published in

Asian Tribune, Bangkok, Thailand

News Track India, Delhi

News Blaze, USA

Op-Ed News (OEN), UK

Thai Indian News, Bangkok, Thailand

Truth Feeds

Zimbabwe Guardian, Harare, Zimbabwe

Ghana News, Accra, Ghana

African Path, South Africa

Xirincs

Assam Times, Guwahati, Assam

The Med Guru

Citizen News Service (CNS)

Pakistan Post, Karachi, Pakistan

My News, Delhi

Standard Times, Sierra Leone

Northern News Lines, Chandigarh

Media for Freedom, Nepal

Bihar and Jharkhand News Service

Madhumeh

Bihar Times, Patna, Bihar

Two Circles

The Bangladesh Today, Dhaka, Bangladesh

Banderas News, Mexico

The Guatemala Times, Guatemala

Chincoteague Local News

Howrah News Service, West Bengal

News from Bangladesh, Dhaka, Bangladesh

Children with diabetes Forum

Whither The Light Of Democracy

Whither The Light Of Democracy
Shobha Shukla

Deepawali is the festival of lights which is celebrated all over India . It marks the advent of the winter season and signifies peace and prosperity and the victory of truth over evil. This year’s Diwali (it falls on 28th October) is a bleak one indeed.

As I peer hard through the darkness of hatred and violence, I struggle to find a single ray of bright hope. The atrocities committed by the British Raj on the Indian citizens during its rule in India are now being re enacted by another Raj - the megalomaniac, self styled leader of the Marathas. He seems to be holding the common people to ransom with nary a soul daring to lift a finger against him. The seeds of hatred (between different Hindu communities) so systematically sown by him in Mumbai, some time ago, are spreading like tenacious weeds throughout the country. His diktats against non-Maharashtrians (perhaps with a view to forging new political alliances) have resulted in large scale arson, stampedes, insensitive rioting mobs and killing of innocents - all in the name of protecting the interests of Maharashtra state.

The recent backlash against him in Bihar has killed more innocents, holding public life and security to ransom. And as trains are being torched, public property being damaged and commoners being attacked in the name of avenging misdeeds of the Maharashtra Nav Nirman Sena, Raj Thackarey is being accorded a hero’s welcome by his goons in Mumbai.

Fiery statements by politicians for and against the Mumbaikars are helping in opening a Pandora’s box, with ‘an eye for an eye’ and ‘two slaps for one slap’. It is no longer just Hindus versus Muslims or Christians. New battle lines have been drawn now with one Indian state pitched against another; one caste targeting another caste; all in the name of achieving new political objectives. But does anyone care for the moral objectives?

All of us seem to have become impotent in not being able to control the actions of one madman. Neither the judiciary, nor the government, nor the executive has done anything ( sans issuing the bail able warrant of arrest against him) to douse the fire of hatred and violence that started from Mumbai and is now spreading to other states. The chief minister of U.P.recently feared for the safety of Maharashtrians in other states, thereby hinting subtly at more retaliations rather than reconciliations. Our prime minister, Dr. Manmohan Singh seems to be more affected by the current financial crisis (the economist that he is) rather than the human crisis ( the non humanist that he seems) engulfing the nation. Violence is begetting violence and no political party, worth its salt, is opposing it. They are busy planning strategies for the winning the forthcoming elections. Why should they care for the common person on the street who has lost his/her property, job or even life in the senseless mania that seemed to have gripped the powers that be?

Let us pray to God to give us some sanity on this festival of lights so that we can dispel the darkness of ignorance and wayward behaviour of a miniscule few who are holding humanity to ransom.

Shobha Shukla

The author teaches Physics at India's Loreto Convent and has been writing extensively in English and Hindi media. She serves as Editor of Citizen News Service (CNS).

Published in
The Statesman, India
The Seoul Times, Seoul, South Korea
Asian Tribune, Bangkok, Thailand
Ghana News, Accra, Ghana
News Track India, Delhi
Assam Times, Guwahati, Assam
Two Circles
Guatemala Times, Guatemala
Citizen News Service (CNS)
Media for Freedom, Kathmandu, Nepal
Bihar Times, Patna, Bihar
Bihar and Jharkhand News Service (BJNS)
News Blaze, USA
Northern News Lines, Chandigarh
Sahil Online News, Bhatkal, Karnataka
Standard Times, Sierra Leone
My News, Delhi
Khabar Express, Bikaner, Rajasthan
Pakistan Post, Islamabad, Pakistan
Central Chronicle, Madhya Pradesh and Chhattisgarh
OpEd News (OEN), UK
Hindu News
The Bangladesh Today, Dhaka, Bangladesh
Howrah News Service (HNS), Kolkata, West Bengal

Whither The Light Of Democracy

Whither The Light Of Democracy
Shobha Shukla

Deepawali is the festival of lights which is celebrated all over India . It marks the advent of the winter season and signifies peace and prosperity and the victory of truth over evil. This year’s Diwali (it falls on 28th October) is a bleak one indeed.

As I peer hard through the darkness of hatred and violence, I struggle to find a single ray of bright hope. The atrocities committed by the British Raj on the Indian citizens during its rule in India are now being re enacted by another Raj - the megalomaniac, self styled leader of the Marathas. He seems to be holding the common people to ransom with nary a soul daring to lift a finger against him. The seeds of hatred (between different Hindu communities) so systematically sown by him in Mumbai, some time ago, are spreading like tenacious weeds throughout the country. His diktats against non-Maharashtrians (perhaps with a view to forging new political alliances) have resulted in large scale arson, stampedes, insensitive rioting mobs and killing of innocents - all in the name of protecting the interests of Maharashtra state.

The recent backlash against him in Bihar has killed more innocents, holding public life and security to ransom. And as trains are being torched, public property being damaged and commoners being attacked in the name of avenging misdeeds of the Maharashtra Nav Nirman Sena, Raj Thackarey is being accorded a hero’s welcome by his goons in Mumbai.

Fiery statements by politicians for and against the Mumbaikars are helping in opening a Pandora’s box, with ‘an eye for an eye’ and ‘two slaps for one slap’. It is no longer just Hindus versus Muslims or Christians. New battle lines have been drawn now with one Indian state pitched against another; one caste targeting another caste; all in the name of achieving new political objectives. But does anyone care for the moral objectives?

All of us seem to have become impotent in not being able to control the actions of one madman. Neither the judiciary, nor the government, nor the executive has done anything ( sans issuing the bail able warrant of arrest against him) to douse the fire of hatred and violence that started from Mumbai and is now spreading to other states. The chief minister of U.P.recently feared for the safety of Maharashtrians in other states, thereby hinting subtly at more retaliations rather than reconciliations. Our prime minister, Dr. Manmohan Singh seems to be more affected by the current financial crisis (the economist that he is) rather than the human crisis ( the non humanist that he seems) engulfing the nation. Violence is begetting violence and no political party, worth its salt, is opposing it. They are busy planning strategies for the winning the forthcoming elections. Why should they care for the common person on the street who has lost his/her property, job or even life in the senseless mania that seemed to have gripped the powers that be?

Let us pray to God to give us some sanity on this festival of lights so that we can dispel the darkness of ignorance and wayward behaviour of a miniscule few who are holding humanity to ransom.

Shobha Shukla

The author teaches Physics at India's Loreto Convent and has been writing extensively in English and Hindi media. She serves as Editor of Citizen News Service (CNS).

Published in
The Statesman, India
The Seoul Times, Seoul, South Korea
Asian Tribune, Bangkok, Thailand
Ghana News, Accra, Ghana
News Track India, Delhi
Assam Times, Guwahati, Assam
Two Circles
Guatemala Times, Guatemala
Citizen News Service (CNS)
Media for Freedom, Kathmandu, Nepal
Bihar Times, Patna, Bihar
Bihar and Jharkhand News Service (BJNS)
News Blaze, USA
Northern News Lines, Chandigarh
Sahil Online News, Bhatkal, Karnataka
Standard Times, Sierra Leone
My News, Delhi
Khabar Express, Bikaner, Rajasthan
Pakistan Post, Islamabad, Pakistan
Central Chronicle, Madhya Pradesh and Chhattisgarh
OpEd News (OEN), UK
Hindu News
The Bangladesh Today, Dhaka, Bangladesh
Howrah News Service (HNS), Kolkata, West Bengal

Care for children and adolescents living with diabetes

Care for children and adolescents living with diabetes



"Diabetes is a deadly disease, and each year, almost 4 million people die from diabetes-related causes. Children, particularly in countries where there is limited access to diabetes care and supplies, die young", according to International Diabetes Federation (IDF) which is an umbrella organization of over 200 member associations in more than 160 countries. IDF leads World Diabetes Day (www.worlddiabetesday.org) which falls on 14th November. The campaign is focusing its efforts on raising awareness of diabetes in children and adolescents.



Diabetes is one of the most common chronic diseases to affect children. Every day more than 200 children are diagnosed with type 1 diabetes, requiring them to take multiple daily insulin shots and monitor the glucose levels in their blood. It is increasing at a rate of 3% each year among children and rising even faster in pre-school children at a rate of 5% per year. Currently, over 500,000 children under the age of 15 live with diabetes, according to IDF.



Since diabetes often requires life-long monitoring, care and treatment, is hospital-based approach better than home-based care approaches or a mix of these two approaches for effectively responding to care needs of those with diabetes?



Dr Sonia Kakar, a New Delhi based doctor, said: "hospital-based approach should be for the management of acute and/or chronic complications arising out of diabetes. But as 99% of diabetes care is self-care, empowering people with right information can make home-based care approach more feasible and economical."



She also felt that, "adolescents often have the motor and cognitive skills to perform all diabetes-related tasks and determine insulin doses based on blood glucose levels and food intake. Thus, they must be supervised in their diabetes tasks and allowed gradual independence with the understanding that the independence will be continued only if they adhere to the diabetes regimen and succeed in maintaining reasonable metabolic control."



"During mid-adolescence, the family and healthcare team should stress upon the teenagers the importance of checking blood glucose levels prior to driving a car to avoid hypoglycemia while driving" stressed Dr Kakar.



Managing diabetes in children and adolescents becomes more effective when the entire family gets involved. Families should be encouraged to share their concerns with physicians, diabetes educators, dietitians, and other healthcare providers to get help in the day-to-day management of diabetes. Extended family members, teachers, school nurses, counselors, coaches, day-care providers, and other resources in the community can provide information, support,and guidance regarding skills to cope with the disease.They may also act as resource persons for health education, financial services, social services, mental health counseling, transportation, and home visits.



"Diabetes is stressful for both - the child as well as his/ her family. Parents should be alert for signs of depression, eating disorders or an unexplained loss of weight and seek appropriate medical help. While all parents should talk to their children about avoiding tobacco, alcohol, and other drugs, this is particularly important for parents of children with diabetes. Smoking and diabetes, both increase the risk of cardiovascular diseases and those people with diabetes who are smokers are at an increased risk of heart/ circulatory problems. Hence parents/ family members of children/ adolescents living with diabetes should refrain from tobacco use in order to avoid sending wrong signals to their wards" recommends Dr Anoop Misra, Director and Head, Department of Diabetes and Metabolic Diseases, Fortis Hospitals New Delhi and Noida.



Depending on their age and level of maturity,children living with diabetes should be encouraged to take care of themselves. Most school-age children can recognize symptoms of hypoglycemia and if they are over 12 years old they may be able to take insulin injections of correct dosage by themselves. They can also be involved in planning their diet chart.



Treatment of diabetes in adolescents is complex and should only be handled by experienced physicians. Also, such patients should be looked after by a team consisting of diabetologist, nutritionist, diabetes educator, and psychologist.



Educating people with diabetes about diet, exercise and drugs is the most important part of the initial management of the disease and should be accomplished in several sessions. Insulin management should be discussed and demonstrated to children and parents, so that they can take insulin injections themselves. Parents, along with their children, should be made aware about healthy eating habits, physical exercise, and dosage management of drugs/ insulin.



IDF is bringing together key opinion leaders to push for action to secure care for the thousands of children with diabetes in developing countries without access to care at a meeting in London on October 25. The meeting, Access to Essential Diabetes Medicines for Children in the Developing World will focus on ways to help keep more children alive and healthy with diabetes. Ministries of Health from various developing countries, leaders from the pharmaceutical industry, philanthropic foundations, leading supply-chain management firms, diabetes associations, as well as professional societies in paediatrics and diabetes education have been invited to the meeting.



Close to 75,000 children in low-income and lower-middle income countries are living with diabetes in desperate circumstances. These children need life-saving insulin to survive. Even more children are in need of the monitoring equipment, test strips and education required to manage their diabetes and avoid the life-threatening complications associated with diabetes.



"We are bringing together the people and the organizations that can provide not only the interim humanitarian response to save lives but can lay the groundwork for sustainable solutions that will benefit all children with diabetes," said Dr Martin Silink, President of the International Diabetes Federation (IDF).



Amit Dwivedi



(The author is a Special Correspondent to Citizen News Service (CNS). Email: amit@citizen-news.org)



Published in

The Seoul Times, Seoul, South Korea

Media for Freedom, Kathmandu, Nepal

Ground Report

The New Nation, Dhaka, Bangladesh

The Zimbabwe Guardian, Harare, Zimbabwe

Ghana News, Accra, Ghana

Asian Tribune, Bangkok, Thailand

Medical News Today

Northern News Lines, Chandigarh

African Path

Diabetologica

Kerala News, Thiruvananthapuram, Kerala

Assam Times, Guwahati, Assam

News from Bangladesh, Dhaka, Bangladesh

News Track India, Delhi

Thai Indian News, Bangkok, Thailand

Darjeeling Times, Darjeeling, West Bengal

Standard Times, Sierra Leone

Pakistan Post, Karachi, Pakistan

Bihar Times, Patna, Bihar

Bihar and Jharkhand News Service

Citizen News Service (CNS)

Central Chronicle, Madhya Pradesh and Chhattisgarh

National Examiner

The Med Guru

Madhumeh

Medical Lexicon

Diabetes News (Buzz Tracker)

Day Life, New York, USA

OpEd News (OEN), UK

My News, Delhi

News-Medical.net

News Blaze, USA

Howrah News Service (HNS), Kolkata, West Bengal

Med India

Blogging Zoom

Today India - daily newspaper

Care for children and adolescents living with diabetes

Care for children and adolescents living with diabetes



"Diabetes is a deadly disease, and each year, almost 4 million people die from diabetes-related causes. Children, particularly in countries where there is limited access to diabetes care and supplies, die young", according to International Diabetes Federation (IDF) which is an umbrella organization of over 200 member associations in more than 160 countries. IDF leads World Diabetes Day (www.worlddiabetesday.org) which falls on 14th November. The campaign is focusing its efforts on raising awareness of diabetes in children and adolescents.



Diabetes is one of the most common chronic diseases to affect children. Every day more than 200 children are diagnosed with type 1 diabetes, requiring them to take multiple daily insulin shots and monitor the glucose levels in their blood. It is increasing at a rate of 3% each year among children and rising even faster in pre-school children at a rate of 5% per year. Currently, over 500,000 children under the age of 15 live with diabetes, according to IDF.



Since diabetes often requires life-long monitoring, care and treatment, is hospital-based approach better than home-based care approaches or a mix of these two approaches for effectively responding to care needs of those with diabetes?



Dr Sonia Kakar, a New Delhi based doctor, said: "hospital-based approach should be for the management of acute and/or chronic complications arising out of diabetes. But as 99% of diabetes care is self-care, empowering people with right information can make home-based care approach more feasible and economical."



She also felt that, "adolescents often have the motor and cognitive skills to perform all diabetes-related tasks and determine insulin doses based on blood glucose levels and food intake. Thus, they must be supervised in their diabetes tasks and allowed gradual independence with the understanding that the independence will be continued only if they adhere to the diabetes regimen and succeed in maintaining reasonable metabolic control."



"During mid-adolescence, the family and healthcare team should stress upon the teenagers the importance of checking blood glucose levels prior to driving a car to avoid hypoglycemia while driving" stressed Dr Kakar.



Managing diabetes in children and adolescents becomes more effective when the entire family gets involved. Families should be encouraged to share their concerns with physicians, diabetes educators, dietitians, and other healthcare providers to get help in the day-to-day management of diabetes. Extended family members, teachers, school nurses, counselors, coaches, day-care providers, and other resources in the community can provide information, support,and guidance regarding skills to cope with the disease.They may also act as resource persons for health education, financial services, social services, mental health counseling, transportation, and home visits.



"Diabetes is stressful for both - the child as well as his/ her family. Parents should be alert for signs of depression, eating disorders or an unexplained loss of weight and seek appropriate medical help. While all parents should talk to their children about avoiding tobacco, alcohol, and other drugs, this is particularly important for parents of children with diabetes. Smoking and diabetes, both increase the risk of cardiovascular diseases and those people with diabetes who are smokers are at an increased risk of heart/ circulatory problems. Hence parents/ family members of children/ adolescents living with diabetes should refrain from tobacco use in order to avoid sending wrong signals to their wards" recommends Dr Anoop Misra, Director and Head, Department of Diabetes and Metabolic Diseases, Fortis Hospitals New Delhi and Noida.



Depending on their age and level of maturity,children living with diabetes should be encouraged to take care of themselves. Most school-age children can recognize symptoms of hypoglycemia and if they are over 12 years old they may be able to take insulin injections of correct dosage by themselves. They can also be involved in planning their diet chart.



Treatment of diabetes in adolescents is complex and should only be handled by experienced physicians. Also, such patients should be looked after by a team consisting of diabetologist, nutritionist, diabetes educator, and psychologist.



Educating people with diabetes about diet, exercise and drugs is the most important part of the initial management of the disease and should be accomplished in several sessions. Insulin management should be discussed and demonstrated to children and parents, so that they can take insulin injections themselves. Parents, along with their children, should be made aware about healthy eating habits, physical exercise, and dosage management of drugs/ insulin.



IDF is bringing together key opinion leaders to push for action to secure care for the thousands of children with diabetes in developing countries without access to care at a meeting in London on October 25. The meeting, Access to Essential Diabetes Medicines for Children in the Developing World will focus on ways to help keep more children alive and healthy with diabetes. Ministries of Health from various developing countries, leaders from the pharmaceutical industry, philanthropic foundations, leading supply-chain management firms, diabetes associations, as well as professional societies in paediatrics and diabetes education have been invited to the meeting.



Close to 75,000 children in low-income and lower-middle income countries are living with diabetes in desperate circumstances. These children need life-saving insulin to survive. Even more children are in need of the monitoring equipment, test strips and education required to manage their diabetes and avoid the life-threatening complications associated with diabetes.



"We are bringing together the people and the organizations that can provide not only the interim humanitarian response to save lives but can lay the groundwork for sustainable solutions that will benefit all children with diabetes," said Dr Martin Silink, President of the International Diabetes Federation (IDF).



Amit Dwivedi



(The author is a Special Correspondent to Citizen News Service (CNS). Email: amit@citizen-news.org)



Published in

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Not only the rich are at risk of diabetes

Not only the rich are at risk of diabetes

[To listen to the audio podcast of this article, click here]

A media report labeled diabetes as a lifestyle disease. Rightly so, but it doesn't imply that poor and underserved communities are not at risk of diabetes. In fact, the World Diabetes Day (WDD) was created by the International Diabetes Federation (IDF) and the World Health Organization in 1991, to draw attention of the world community towards escalating incidences of diabetes amongst the rich and poor, old and young alike. WDD is celebrated world wide on 14th November, on the birth anniversary of Fredrerick Banting, co-discoverer of insulin.

"Diabetes is affecting all classes of our society, be it rich or poor, high caste or low caste, urban or rural residents. So it is no longer the disease of the rich alone," said Dr Ambady Ramachandran, Director, India Diabetes Research Foundation (IDRF), Chennai, Tamil Nadu. In a recent study conducted by IDRF in the South Indian state of Tamil Nadu, prevalence rates of diabetes were found to at par in rural and urban areas, dispelling the misconception that diabetes is only affecting the rich living in urban areas.

Dr Ramachandran further said that "Diabetes exerts a life-long financial burden for treatment. It is not only the cost of medicines but the recurring costs of ongoing home monitoring, laboratory investigations and hospitalizations also add to the financial burden. Also, the changing prevalence of disease patterns is likely to increase the burden of chronic diseases like diabetes in developing countries such as India."

According to Diabetes Atlas published by the International Diabetes Federation (IDF), there were an estimated 40.9 million people with diabetes in India in 2007 which is about 16.7% of the global number of people living with diabetes. This number is predicted to rise to almost 70 million people by the year 2025. The countries with the largest number of people with diabetes will be India, China and USA by 2025. It is estimated that every fifth person with diabetes will be an Indian. The economic burden on India due to such a high incidence of diabetes is amongst the highest in the world.

India is, therefore, often referred to as the 'diabetes capital of the world'. Several studies have revealed that the prevalence of diabetes is increasing in rural areas too. However, there are no diagnostic tests available at Primary Health Centres for diabetes or diabetes-related complications. Dr Viswanathan Mohan, Director, Madras Diabetes Research Foundation, Chennai, Tamil Nadu said that "there is an urgent need to establish diagnostic centres for diabetes at every ante-natal clinic (ANC) especially in rural areas to detect and reduce the burden of diabetes at an early stage in children and adolescents".

Comparatively, the urban adolescents are more prone to type-2 diabetes than those residing in the rural areas. These urban adolescents have a higher intake of refined cereals as well as high fat and calorie-dense foods. Moreover, they are less likely to engage in regular physical activities. These factors lead to an increased incidence of obesity and consequently a higher risk for the onset of type-2 diabetes at an early age. Overall, patients with young-onset type-2 diabetes are only found in urban areas, and more so in affluent households. On the other hand, type-1 diabetes can occur equally in urban or rural areas. India is a land of famines, floods, local conflicts, large population and a high illiteracy rate. All these factors, coupled with uncertain economic conditions, are likely to impede the diabetes' prevention and awareness programmes.

It may be pertinent to mention here that the theme for World Diabetes Day 2008, (www.worlddiabetesday.org) as envisaged by IDF is 'Diabetes In Children and Adolescents', keeping in mind the increasing incidence of diabetes in youth. This is a matter of grave concern and needs to be tackled. No child should die of diabetes.

Dr Sharad Pendsey ,an expert on diabetes, runs a charitable trust - Diabetes Research Education And Management Trust (DREAM Trust, www.dreamtrust.org) operational in New Delhi/ Noida region which provides free insulin, syringes, blood glucose monitoring strips and complete health care to the poor children with Type-1 diabetes. Dr Pendsey said that "children should be routinely screened for diabetes at diagnostic centres and appropriate follow- up action should be taken , as agreed upon by the primary healthcare providers and the diabetes experts". Dr Pendsey emphasized on the role of boosting up primary prevention strategies to limit or delay the onset of diabetes which will prove cost-effective as well.

Without primary prevention strategies at the public health level, the number of undiagnosed and uncared for people with diabetes will increase, as also the number of complications arising out of this disease, thus requiring a higher technological input. This in turn will limit access to health care for a large numbers of patients.

Amit Dwivedi

(The author is a Special Correspondent to Citizen News Service (CNS). Email: amit@citizen-news.org)

Published in
The Zimbabwe Guardian, Harare, Zimbabwe
Asian Tribune, Bangkok, Thailand
Thai Indian News, Bangkok, Thailand
Pakistan News, Islamabad, Pakistan
Guatemala Times, Guatemala
Ghana News, Accra, Ghana
Kerala News online, Thiruvananthapuram, Kerala
Assam Times, Guwahati, Assam
Just Samachar
Madhumeh
Media for Freedom, Kathmandu, Nepal
Citizen News Service (CNS)
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The Med Guru
Global Oneness
News from Bangladesh, Dhaka, Bangladesh

Not only the rich are at risk of diabetes

Not only the rich are at risk of diabetes

[To listen to the audio podcast of this article, click here]

A media report labeled diabetes as a lifestyle disease. Rightly so, but it doesn't imply that poor and underserved communities are not at risk of diabetes. In fact, the World Diabetes Day (WDD) was created by the International Diabetes Federation (IDF) and the World Health Organization in 1991, to draw attention of the world community towards escalating incidences of diabetes amongst the rich and poor, old and young alike. WDD is celebrated world wide on 14th November, on the birth anniversary of Fredrerick Banting, co-discoverer of insulin.

"Diabetes is affecting all classes of our society, be it rich or poor, high caste or low caste, urban or rural residents. So it is no longer the disease of the rich alone," said Dr Ambady Ramachandran, Director, India Diabetes Research Foundation (IDRF), Chennai, Tamil Nadu. In a recent study conducted by IDRF in the South Indian state of Tamil Nadu, prevalence rates of diabetes were found to at par in rural and urban areas, dispelling the misconception that diabetes is only affecting the rich living in urban areas.

Dr Ramachandran further said that "Diabetes exerts a life-long financial burden for treatment. It is not only the cost of medicines but the recurring costs of ongoing home monitoring, laboratory investigations and hospitalizations also add to the financial burden. Also, the changing prevalence of disease patterns is likely to increase the burden of chronic diseases like diabetes in developing countries such as India."

According to Diabetes Atlas published by the International Diabetes Federation (IDF), there were an estimated 40.9 million people with diabetes in India in 2007 which is about 16.7% of the global number of people living with diabetes. This number is predicted to rise to almost 70 million people by the year 2025. The countries with the largest number of people with diabetes will be India, China and USA by 2025. It is estimated that every fifth person with diabetes will be an Indian. The economic burden on India due to such a high incidence of diabetes is amongst the highest in the world.

India is, therefore, often referred to as the 'diabetes capital of the world'. Several studies have revealed that the prevalence of diabetes is increasing in rural areas too. However, there are no diagnostic tests available at Primary Health Centres for diabetes or diabetes-related complications. Dr Viswanathan Mohan, Director, Madras Diabetes Research Foundation, Chennai, Tamil Nadu said that "there is an urgent need to establish diagnostic centres for diabetes at every ante-natal clinic (ANC) especially in rural areas to detect and reduce the burden of diabetes at an early stage in children and adolescents".

Comparatively, the urban adolescents are more prone to type-2 diabetes than those residing in the rural areas. These urban adolescents have a higher intake of refined cereals as well as high fat and calorie-dense foods. Moreover, they are less likely to engage in regular physical activities. These factors lead to an increased incidence of obesity and consequently a higher risk for the onset of type-2 diabetes at an early age. Overall, patients with young-onset type-2 diabetes are only found in urban areas, and more so in affluent households. On the other hand, type-1 diabetes can occur equally in urban or rural areas. India is a land of famines, floods, local conflicts, large population and a high illiteracy rate. All these factors, coupled with uncertain economic conditions, are likely to impede the diabetes' prevention and awareness programmes.

It may be pertinent to mention here that the theme for World Diabetes Day 2008, (www.worlddiabetesday.org) as envisaged by IDF is 'Diabetes In Children and Adolescents', keeping in mind the increasing incidence of diabetes in youth. This is a matter of grave concern and needs to be tackled. No child should die of diabetes.

Dr Sharad Pendsey ,an expert on diabetes, runs a charitable trust - Diabetes Research Education And Management Trust (DREAM Trust, www.dreamtrust.org) operational in New Delhi/ Noida region which provides free insulin, syringes, blood glucose monitoring strips and complete health care to the poor children with Type-1 diabetes. Dr Pendsey said that "children should be routinely screened for diabetes at diagnostic centres and appropriate follow- up action should be taken , as agreed upon by the primary healthcare providers and the diabetes experts". Dr Pendsey emphasized on the role of boosting up primary prevention strategies to limit or delay the onset of diabetes which will prove cost-effective as well.

Without primary prevention strategies at the public health level, the number of undiagnosed and uncared for people with diabetes will increase, as also the number of complications arising out of this disease, thus requiring a higher technological input. This in turn will limit access to health care for a large numbers of patients.

Amit Dwivedi

(The author is a Special Correspondent to Citizen News Service (CNS). Email: amit@citizen-news.org)

Published in
The Zimbabwe Guardian, Harare, Zimbabwe
Asian Tribune, Bangkok, Thailand
Thai Indian News, Bangkok, Thailand
Pakistan News, Islamabad, Pakistan
Guatemala Times, Guatemala
Ghana News, Accra, Ghana
Kerala News online, Thiruvananthapuram, Kerala
Assam Times, Guwahati, Assam
Just Samachar
Madhumeh
Media for Freedom, Kathmandu, Nepal
Citizen News Service (CNS)
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India should strengthen its public distribution system to reduce food scarcity

India should strengthen its public distribution system to reduce food scarcity

Sarika Tripathi

The Food and Agriculture Organization (FAO) of United Nations has recently issued a report which reveals that currently there are 75 million (7.5 crore) people in the world who have fallen victim to famine and if the current crisis of price rise persists this count may reach the total of 920.25 million (92.25 crore).

India too is facing the same harsh situations where poorest of the poor of our country have to go to bed hungry. But at this crucial time when the country expects some stringent steps from the government’s side, it is defending itself by saying that food crisis is a global problem which has already struck over 30 countries, most of which have witnessed food riots. It is not interested in finding and disclosing the root cause of this havoc.

The FAO report further says that in 2007-08 there has been a 52% increase in the price of grains and that of fertilizers has doubled. In India, the retail price of many food commodities have seen a sharp rise in the past six months- pushing te inflation level around 12 at the end of September. Experts have cited various reasons behind this food crisis like increasing population, growing inclination towards bio-diesel crops, weakening of US currency, frequent natural calamities. Even the US president blamed Indians of eating more due to growing purchasing power. But in Indian context the pro market biased policies of the government and “planned weakening” of Public Distribution System (PDS) to benefit corporate sector are responsible for food crisis. Though the signs of the food and agricultural crisis were noticed by the government in its early stage but it continued with its neo liberal policies to benefit corporate sector. All this liberalization has been done under the pressure of US and World Bank who have been constantly pressurizing India to break its tariff walls and open its market for wheat import. It was due to their influence only that India became a wheat importer from wheat exporter. All this was done to benefit major grain corporate companies like Glencore, Cargill India and the Australian Wheat Board. This imported wheat was unaffordable for the poor people of India.

In spite of rising inflation and panic regarding food availability our government still believes that to sustain in world economy we need investment and support of corporate companies. The Economic Advisory Council to the Prime Minister advocates the role of corporate sector in agriculture and says that activities other than food grain production like commercial crops, horticulture etc. have contributed most to agricultural GDP. The council recommends removal of subsidies related to grain procurement and Public Distribution System, making more room for the private sector in agriculture and promoting contract farming. These recommendations were made as per the wishes of US and World Bank who have asked India to shift from subsidy based agro-economy to more diversified agriculture sector so as to allow corporate companies to enter this sector.

To give entry to various giant grain corporations, the Indian government slowly and systematically weakened its Public Distribution System (PDS) by slowing down grain procurement, especially wheat. Taking advantage of this situation Multi National Companies like Glencore, Cargill India, the Australian Wheat Board, Indian companies like ITC and Adani group procured 30 lakh tones of wheat as compared to the government’s 9.2 million between 2005-07. Due to this reduced procurement by public sector, a number of families which comes under Below Poverty Line (BPL) and collect subsidized rations from Fair Price Shops were devoid of their bread. The cost of wheat decided by corporate companies is far away from their purchasing power. This disrupted the supply and demand ratio and food insecurity prevailed in the country.

FAO’s Assistant Director General Hafez Ghanem has emphasized on two important points. First, to make available grains for poor countries of the world. Second, to encourage small scale farmers to improve crop productivity. Now, it’s the high time when the Indian government should also realize that those small scale farmers, who are the worst sufferer of liberal agro-economy, can be made a key to the solution of food crisis. The agricultural sector of India is mainly covered by small and marginal farmers, so our government should promote small scale agriculture. Besides, the agriculture sector should be solely covered by the public sector from investment up to marketing and distribution. Even if there is any kind of corporate investment, that should be properly regulated by the public authorities.


Sarika Tripathi

The author is a Correspondent of Citizen News Service (CNS) and also a post-graduate scholar of Public Health Management at Lucknow University in India. She can be contacted at sarikasarika_49@rediffmail.com

Published in
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