DiabetesVoice - IDF and Lions Club International: Working together to tackle diabetes
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DiabetesVoice
GLOBAL PERSPECTIVES ON DIABETES Volume 65 - Issue 1 - April 2018
IDF and Lions Club
International:
Working together to
tackle diabetes
Learn.
Learn.
Discover.
Discover.
Connect.
Connect.
www.idf.org/hyderabad2018
www.idf.org/hyderabad2018
#IDF2018
#IDF2018
Introducing
Introducing
thethe
newnew
IDF IDF
Diabetes
Diabetes
Complications
Complications
andand
FootFoot
Congress
Congress
2018!
2018! I
25-27
25-27
October,
October,
Hyderabad,
Hyderabad,
India
India 2
IDF isIDF
launching
is launching
a newaseries
new series
of liveofeducational
live educational
eventsevents
to tackle
to tackle
the issues
the issues
aroundaround
diabetes
diabetes
complications.
complications. I
The first
Theoffirst
these
of these
biennial
biennial
events
events
will have
will a
have
focus
a focus
on theondiabetic
the diabetic
foot. The
foot.aim
Theofaim
theofcongress
the congress
is to provide
is to provide T
participants
participants
with the
withlatest
the latest
research,
research,
treatments
treatments
and tools
and tools
to limit
to and
limittreat
and treat
diabetes
diabetes
complications.
complications. p
The ultimate
The ultimate
goal is
goal
to improve
is to improve
outcomes
outcomes
and quality
and quality
of lifeoffor
life
people
for people
with diabetes.
with diabetes. T
Who Who
should
should
attend:
attend:
- Primary
- Primary
care Physicians
care Physicians - Cardiologists
- Cardiologists
CALL
CALL
FORFOR -
-
-
Endocrinologists
- Endocrinologists
Orthopaedists
- Orthopaedists
-
-
Nephrologists
- Nephrologists
Ophthalmologists
- Ophthalmologists
ABSTRACTS
ABSTRACTS -
-
- Podiatrists
- Podiatrists - Nurses
- Nurses -
- General
- General
surgeons
surgeons - Educators
- Educators -
- Vascular
- Vascular
surgeons
surgeons - Physiotherapists
- Physiotherapists Abstract
Abstract
submission
submission
deadline:
deadline: -
31 May
31 May
20182018
at 23:59
at 23:59
GMTGMT
The IDF
TheDiabetes
IDF Diabetes
Complications
Complications
and Foot
and Foot
Congress
Congress
2018 2018 T
welcomes
welcomes
original
original
abstracts
abstracts
on subjects
on subjects
relevant
relevant
to theto the w
following
following
7 streams:
7 streams: f
• Foot• -Foot
Peripheral
- Peripheral
Arterial
Arterial
Disease
Disease
• Foot• -Foot
Ulcers
- Ulcers
and Infection
and Infection
• Foot• -Foot
Diabetic
- Diabetic
Peripheral
Peripheral
Neuropathy
Neuropathy
and and
Charcot
Charcot Scan to
Scan
view
to view
• Cardiovascular
• Cardiovascular
Risk Factors
Risk Factors
• Coronary
• Coronary
HeartHeart
Disease
Disease
and Heart
and Heart
Failure
Failure
• Diabetes
• Diabetes
and Kidney
and Kidney
Disease
Disease Abstract
Abstract
submission
submission
is only
is only
possible
possible
onlineonline
at at
• Diabetic
• Diabetic
Eye Disease
Eye Disease
www.idf.org/hyderabad2018
www.idf.org/hyderabad2018
Organising
Organising
Committee
Committee
ChairChair
Dr Shaukat
Dr Shaukat
Sadikot
Sadikot
Questions
Questions
aboutabout
abstracts:
abstracts:
Programme
Programme
ChairChair
Dr Ammar
Dr Ammar
Ibrahim
Ibrahim programme@idf.org
programme@idf.org
ChairChair
National
National
Advisory
Advisory
Committee
Committee
Dr Banshi
Dr Banshi
SabooSaboo
DIABETES VIEWS 4
International Diabetes Federation
The Global Voice of Diabetes Promoting diabetes care, prevention and a cure worldwide
Nam H. Cho 4
Editor-in-Chief: Douglas Villarroel
NEWS IN BRIEF 6 Editor: Elizabeth Snouffer
Editorial Coordinator: Lorenzo Piemonte
IDF REGIONAL NEWS 16 All correspondence should be addressed to:
diabetesvoice@idf.org
OPINION EDITORIAL 21
Diabetes Voice is available online at:
www.diabetesvoice.org
Insulin: Concierge Medication or Human Right?
Joyce Lee 21
© International Diabetes Federation, 2018 - All rights
reserved. No part of this publication may be reproduced or
T H E G L O B A L C A M PA I G N 24 transmitted in any form or by any means without the written
prior permission of the International Diabetes Federation (IDF).
Lions Club and International Diabetes Federation come Requests to reproduce or translate IDF publications should be
together to tackle diabetes addressed to communications@idf.org.
Elizabeth Snouffer 24
The material in this document is for information purposes only.
IDF and CVD: Getting to the heart of the matter IDF makes no representation or warrantires about the accuracy
Suvi Karuranga, Anne Wiebe Ohlrogge, Sameer Pathan and Els and reliability of any content in the document. Any opinions
Sung 27 expressed are those of their authors, and do not necessarily
Jack’s Story: «I never thought I had a heart problem» 30 represent the views of IDF. IDF shall not be liable for any loss or
damage in connection with your use of this document. Through
Evaluating the cardiovascular risk in a doctor’s office this document, you may link to third-party websites, which are
Douglas Villarroel 31 not under IDF’s control. The inclusion of such links does not
imply a recommendation or endorsement by IDF of any material,
IDF Congress News - Past and Future 32 information, products and services advertised on third-party
A look back at the IDF Congress 2017, Abu Dhabi, UAE websites, and IDF disclaims any liability with regard to your access
Douglas Villarroel 32 of such linked websites and use of any products or services
advertised there. While some information in Diabetes Voice is
Looking ahead to Hyderabad, India: about medical issues, it is not medical advice and should not be
Urgency for diabetes awarness and education construed as such.
Ammar Ibrahim 33
H E A LT H D E L I V E R Y 34
Health for all: Universal health coverage essential for all
people with diabetes
Interview with Dr Svetlana Axelrod, WHO Assistant Director-
General for Noncommunicable Diseases and Mental Health 34
21 25
DIABETES VIEWS
DIABETES VIEWS
THE GLOBAL
DIABETES VIEWS
VOICE OF
DIABETES
NEWS IN BRIEF
IDF REGIONAL NEWS
Professor Nam H. Cho Welcome to the first 2018 issue of many IDF initiatives in place to give
President, International Diabetes Diabetes Voice. The publication made people with a connection to diabetes
Federation 2018-19 its first appearance as a newsletter in access to important information and
1954, reporting on the activities of networks. This reflects IDF’s core
IDF and relevant breakthroughs in mission by giving voice to people living
medical science. For several decades, with, at risk of or connected to diabetes
the printed bulletin was sent by who would otherwise not be heard. It
post to healthcare professionals is our job to hear and understand the
and researchers keen to engage and collective voices of diabetes. Listening
OPINION EDITORIAL
share diabetes-related information to what’s happening locally at grass-
worldwide. Later, Diabetes Voice roots level helps IDF and its members
was distributed as a magazine to IDF define and advance the best possible
members worldwide. policies for diabetes prevention and
care, and helps us protect the rights
Times have moved on but, despite of people living with diabetes.
being over 60, Diabetes Voice hasn’t
retired. It continues to be a key WE ARE A GLOBAL NETWORK
GLOBAL CAMPAIGN
IDF communication channel. Over As the world’s largest civil society
time our community has grown organisation serving to advance
considerably. Today as a digital diabetes care, prevention and a
platform, Diabetes Voice, is one of cure, IDF’s strength depends on
HEALTH DELIVERY
4 DiabetesVoice April 2018 Volume 65 Issue 1
DIABETES VIEWS
unity, teamwork and collaboration. mission – our unified voice – will be action. The work conducted under
For nearly 70 years, IDF volunteers, strengthened by concentrating efforts each stream will be informed by
partners and a variety of collaborative towards the following three areas: scientific evidence and the priorities
stakeholders have worked tirelessly to defined by our Board in open dialogue
support our vision of a world free of £ £ Strengthening our partnerships with key stakeholders.
diabetes. We are not there yet.
£ £ Bringing about positive change PRESENCE
For the 2018-2019 term, our efforts through IDF programmes As the primary global advocate
will be directed towards driving for diabetes, we are informed and
critical action in diabetes care and £ £ Increasing our global presence supported by both our status as the
prevention. We will continue to study global reference for epidemiological
and report on global diabetes trends. PARTNERSHIPS data on diabetes, and the evidence
We will improve care by providing Shared values and commitment and policies developed to execute IDF
high quality evidence-based education provide the foundation for strategic programmes. In the months ahead,
on diabetes and its complications. partnerships. We must, however, we will engage with international
We will empower people living with make sure that the voice of those bodies, leading political platforms
diabetes to play a central role in their we represent is heard. Over the next and national governments in order
own care. Above all, we will make sure two years we will be devoting time to effect tangible, beneficial and long-
our commitment to success results in and energy to strengthening the IDF term change for people with diabetes.
lasting change that benefits the global Member network globally, nationally
diabetes community. and locally. We will look to collaborate Our objective is clear: to outline
more closely with global organisations specific actions that will support
With a force of more than 240 national who share our concern. We will people with diabetes and implement
diabetes representative organizations strengthen and broaden our corporate measures to slow or halt the global
in 170 countries, our broad global partnerships and we will strengthen diabetes epidemic.
network allows us to achieve our our regional networks.
goals and deliver deep-rooted plans In closing, I would like to acknowledge
and initiatives that have the power POLICY AND PROGRAMMES and thank the members of the IDF
to change lives and can benefit local IDF’s mission is achieved through the Board of Directors, the General
communities. Together we can make development of high-quality global Assembly and all 2017 IDF congress
a difference for estimated 425 million programmes that drive policy agendas participants for the resounding
people currently living with diabetes at local, national and regional levels. success of the IDF Congress 2017 in
and the many more at risk. Based on a life-course approach, IDF Abu Dhabi, UAE. Our exchange of
programmes for 2018-2019 are divided ideas and strategies was an integral
A THREE-PRONGED APPROACH into six main work streams: Diabetes step towards shaping IDF priorities
While the world can often be prevention; Diabetes education: for the years ahead.
perceived as silent or ignoring the Patient engagement; Access to care;
global diabetes crisis, IDFs vision and Epidemiology; and Humanitarian
April 2018 Volume 65 Issue 1 DiabetesVoice 5
NEWS IN BRIEF
NEWS IN BRIEF
World Diabetes Day
DIABETES VIEWS
2018-19 to focus on
the family
NEWS IN BRIEF
The International Diabetes Federation has announced that the theme for World Diabetes Day 2018 and 2019 is
The Family and Diabetes.
A two-year timeframe has been prevent the complications of diabetes and support be accessible to all people
IDF REGIONAL NEWS
chosen to best align the World and achieve healthy outcomes. All with diabetes and their families to
Diabetes Day campaign to the current families are potentially affected by reduce the emotional impact of the
IDF strategic plan and facilitate diabetes and so awareness of the signs, disease that can result in a negative
planning, development, promotion symptoms and risk factors of diabetes quality of life.
and participation. are vital to help detect it early.
IDF will begin releasing campaign
Materials and actions that IDF will Diabetes can drive families into messages, materials and promotional
develop over the two years of the poverty. Managing diabetes effectively actions for World Diabetes Day
campaign will aim to raise awareness requires daily treatment, regular 2018-19 in April to help the diabetes
OPINION EDITORIAL
of the impact that diabetes has on the monitoring, a healthy diet and and wider community prepare for
family and support network of those lifestyle and ongoing education. In awareness activities throughout the
affected; and promote the role of many countries, the cost of insulin month of November.
the family in the management, care, injection and daily monitoring alone
prevention and education of diabetes. can consume half of a family’s average
disposable income, and regular and
Over 425 million people are affordable access to essential diabetes
currently living with diabetes. Most medicines are out of reach for too
GLOBAL CAMPAIGN
of these cases are type 2 diabetes, many. Improving access to affordable
which is largely preventable through diabetes medicines and care is
regular physical activity, a healthy and therefore urgent to avoid increased
balanced diet, and the promotion of costs for the individual and family,
healthy living environments. Families which impact on health outcomes.
have a key role to play in addressing
the modifiable risk factors for type Less than 1 in 4 family members
2 diabetes and must be provided have access to diabetes education
HEALTH DELIVERY
with the education, resources and programmes. Family support in
environments to live a healthy lifestyle. diabetes care has been shown to have a
substantial effect in improving health MORE INFORMATION:
1 in 2 people currently living with outcomes for people with diabetes. It www.worlddiabetesday.org
diabetes is undiagnosed. Early is therefore important that ongoing
diagnosis and treatment are key to diabetes self-management education
6 DiabetesVoice April 2018 Volume 65 Issue 1
NEWS IN BRIEF
The Global Diabetes
Education Gateway
The IDF School of Diabetes is accredited by the European
Accreditation Council for Continuing Medical Education (EACCME)*
www.idfdiabeteschool.org
HTTPS://WWW.IDFDIABETESCHOOL.ORG/
Certified Online Courses
HTTPS://WWW.IDFDIABETESCHOOL.ORG/CERTIFICATECOURSE Short Courses
HTTPS://WWW.IDFDIABETESCHOOL.ORG/SHORTCOURSE
The IDF School of Diabetes features three Short courses provide opportunities to study specialised
tailor-made certified courses for health professionals. topics in a broad range of diabetes and its complications
in addition to that available through the IDF Certified
Diabetes Educators Online Courses
Credits: Course fees:
11 European CME Low Income country: 50€ Prevention of type 2 diabetes
Others: 75€
Credits: Course fees:
1 European CME Free
Primary Care Physicians
/General Practitioners
Diabetic Retinopathy
Credits: Course fees:
8 European CME Low Income country: 100€ Credits: Course fees:
Others: 150€ 1 European CME Free
Specialists Diabetes and Cardiovascular disease
Credits: Course fees: Credits: Course fees:
13 European CME Low Income country: 200€ 1 European CME Free
Others: 300€
Benef its of Learner
Latest evidence-based clinical recommendations REGISTER
HTTPS://WWW.IDFDIABETESCHOOL.ORG/ACCOUNT/REGISTER
Continued professional development and learning NOW! Assessment & Awards
CME from the European Union of Medical Specialists
IDF Certificate and EACCME
Be part of global multidisciplinary community of
diabetes professionals
*Through an agreement between the European Union of Medical Specialists (UEMS) and the
American Medical Association (AMA), physicians may convert EACCME credits to an equivalent
number of AMA PRA Category 1 CreditsTM. Information on the process to convert EACCME An initiative of
credit to AMA credit can be found at www.ama-assn.org/go/internationalcme.
April 2018 Volume 65 Issue 1 DiabetesVoice 7
NEWS IN BRIEF
Controversy: New ACP
DIABETES VIEWS
guidelines call for higher
HbA1c targets
NEWS IN BRIEF
New guidelines developed by the American College of pulmonary disease or congestive heart failure)
Physicians (ACP) recommend that people with type 2 because the harms outweigh the benefits in this
diabetes should be treated to achieve an HbA1c between population.
7 and 8 percent instead of the previous 6.5 to 7 percent
IDF REGIONAL NEWS
benchmark. The development of the Guidelines, according to the
authors, was prompted by a fundamental shift in diabetes
Published in March 2018 in the journal Annals of Internal management, and the anticipation of treatment decisions
Medicine, the Guidelines state: for type 2 diabetes “based more on cardiovascular risk
than achievement of specific HbA1c targets.” The authors
GUIDANCE STATEMENT 1: argue for higher general targets because previous evidence
Clinicians should personalize goals for glycemic showed “less benefit” of the tighter range compared to
control in patients with type 2 diabetes on the “potential harm” of low blood glucose or hypoglycemia.
OPINION EDITORIAL
basis of a discussion of benefits and harms of Authors propose that benefits of the higher target include:
pharmacotherapy, patients’ preferences, patients’ cost-savings to the patient, less burden on the elderly (self-
general health and life expectancy, treatment management) and reducing the threat of hypoglycemia.
burden, and costs of care.
Those not in favor of the new Guidelines argue how the
GUIDANCE STATEMENT 2: higher target range may encourage complacency among
Clinicians should aim to achieve an HbA1c level doctors whose patients’ blood glucose isn’t well controlled
between 7% and 8% in most patients with type 2 leading to futher complications and earlier mortality.
GLOBAL CAMPAIGN
diabetes.
GUIDANCE STATEMENT 3:
Clinicians should consider de-intensifying
pharmacologic therapy in patients with type 2
diabetes who achieve HbA1c levels less than 6.5%.
GUIDANCE STATEMENT 4:
Clinicians should treat patients with type 2 diabetes
HEALTH DELIVERY
to minimize symptoms related to hyperglycemia and
avoid targeting an HbA1c level in patients with a life
expectancy less than 10 years due to advanced age
(80 years or older), residence in a nursing home, or
chronic conditions (such as dementia, cancer, end-
stage kidney disease, or severe chronic obstructive
8 DiabetesVoice April 2018 Volume 65 Issue 1
NEWS IN BRIEF
Impact of diagnosis
age and risk for CVD
mortality
A new study suggests the younger National Diabetes Services Scheme «Evidence is accumulating,» the
you are when diagnosed with type and access to data on mortality causes authors write, «to suggest that earlier
2 diabetes, the higher your odds of was made available. onset of type 2 diabetes is associated
cardiovascular mortality. Published with an increased risk of complications
in the journal Diabetologia, the study On average, during the study period, and comorbidities compared with later
found associations between the age people received their diagnosis at the onset, and that the development and
at which a person is diagnosed with age of 59, and a total of 115,363 deaths progression of complications might be
diabetes and their risk of heart disease, were recorded. The authors found how more aggressive in those with earlier
stroke, and cancer-related mortality. an earlier diagnosis of type 2 diabetes onset. As such, increased clinical
equating to a longer duration of attention is imperative for individuals
It is very well established that the age disease was associated with a higher with earlier-onset type 2 diabetes.»
at which someone is diagnosed with risk of all-cause mortality, primarily
diabetes is linked to a progression driven by cardiovascular disease
in cardiometabolic risk factors. (CVD) mortality.
The younger the age at the time of
diagnosis, the more likely people Findings suggest that diagnosis 10
MORE INFORMATION:
are to be obese, have higher levels years earlier amounted to a 20 to
https://link.springer.com/
of «bad» cholesterol, and experience 30 percent higher risk of all-cause
article/10.1007/s00125-018-
faster deterioration of their blood mortality, and a 60 percent higher risk
4544-z
glucose control. of dying of heart disease. The results
were just as strong for both men and
Researchers from the Baker Heart women.
and Diabetes Institute in Melbourne,
Australia, set out to investigate the link
between the age of a diabetes diagnosis
and the risk of heart disease, stroke,
and cancer death.
Researchers examined data on
743,709 people from Australia who
were diagnosed with type 2 diabetes
between 1997 and 2011. Participants
were registered with Australia’s
April 2018 Volume 65 Issue 1 DiabetesVoice 9
NEWS IN BRIEF
EADSG Congress and Scientific
DIABETES VIEWS
Session on Prevention of Diabetes
and its Complications
The 4th East Africa Diabetes Study progression of complications in people The EADSG Scientific Congresses are
NEWS IN BRIEF
Group (EADSG) Congress and Annual with diabetes. a comprehensive, multidisciplinary
Meeting 2018 took place from March forum with a stellar faculty of leaders
12th-14th at the Kigali Convention Speaking at the opening ceremony, in diabetes and other NCDs that
Center in Kigali, Rwanda. The the Minister of State in charge of connect the scientific community
conference was organised by the East Public Health and Primary Health and accelerate life science discovery.
Africa Diabetes Group (EADSG) in Care, Dr Patrick Ndimubanzi, told They bring together more than 300
collaboration with Rwanda’s Ministry the audience, “The Government of key stakeholders and leaders to discuss
of Health. Rwanda is committed to fighting ambitions, priorities and actions for
IDF REGIONAL NEWS
non-communicable diseases (NCDs) change in diabetes and NCDs within
The 2018 congress entitled ‘Prevention and mitigating their impact so as the East Africa Region.
of Diabetes and its complications’ to empower our population to live
highlighted the importance of the as healthy and prosperous lives as MORE INFORMATION:
prevention of diabetes and treating possible,” he said. http://eadsg.org/
diabetes, including how to stop the
OPINION EDITORIAL
Kuwait shuts doors to people with
diabetes, high BP
GLOBAL CAMPAIGN
Recent News sources report that Kuwait decision which dates back to 2001. leaving the country, as per international
will no longer offer residency permits to laws including: Aids, Herpes, Hepatitis
expatriates who are suffering from a list The Under-secretary also explained that B and G, Malaria, Leprosy, Syphilis,
of 22 diseases, including cancer, diabetes, the main aims behind the decision are to Tuberculosis, and Gonorrhea.
high blood pressure and numerous other reduce the costs of expatriate healthcare
non-infectious diseases. on the country’s government and ensure According to Arabic language paper, Al
HEALTH DELIVERY
that foreigners arriving in the Gulf state Watan, sources say the most recent move is
According to a statement from the Assistant are fit to work. set to be criticized by international human
Under-secretary for General Health Affairs rights organizations because it is unusual
in the country’s Ministry of Health, Majida Before the implementation of this most to ban people from entering countries
Al Qattan, confirmed the news, stating recent expat ban, Kuwait barred people if the illnesses they suffer from are not
that it comes in line with a GCC council with infectious diseases from entering or infectious.
10 DiabetesVoice April 2018 Volume 65 Issue 1NEWS IN BRIEF
Global costs of diabetes will rise
substantially by 2030
Researchers from the University of in individuals aged 20–79 years using
Göettingen in Germany found the epidemiological and demographic
global costs of diabetes will increase data, and recent GDP forecasts for
substantially by 2030, according to a 180 countries. Three scenarios were «The global costs of diabetes and
study published online in Diabetes Care. assumed: prevalence and mortality 1) its consequences are large and will
increased only with urbanization and substantially increase by 2030. Even if
Christian Bommer and his colleagues population aging (baseline scenario), 2) countries meet international targets,
sought to forecast the full global costs of increased in line with previous trends the global economic burden will not
diabetes in adults through the year 2030 (past trends scenario), and 3) achieved decrease,» the authors write. «Policy
and predict the economic consequences global targets (target scenario). makers need to take urgent action
of diabetes even if global targets under to prepare health and social security
the Sustainable Development Goals Researchers estimate that the absolute systems to mitigate the effects of
(SDG) and World Health Organization global economic burden will increase diabetes.»
Global Action Plan for the Prevention from US $1.3 trillion in 2015 to $2.2
and Control of Noncommunicable trillion in the baseline scenario, $2.5
MORE INFORMATION:
Diseases 2013–2020 are met. trillion in the past trends scenario, and
http://care.diabetesjournals.org/
$2.1 trillion in the target scenario. The
content/early/2018/02/20/dc17-
The researchers modelled the absolute increase in costs as a share of global
1962
and gross domestic product (GDP)- GDP would grow from 1.8% in 2015 to
relative economic burden of diabetes a maximum of 2.2%.
Diabetes
discrimination
is wrong
April 2018 Volume 65 Issue 1 DiabetesVoice 11NEWS IN BRIEF
5 types of diabetes
DIABETES VIEWS
versus 2
NEWS IN BRIEF
IDF REGIONAL NEWS
Researchers in Scandinavia have result in a halting the progression of CLUSTER 4:
proposed classifying diabetes as five complications. For example, cluster Called «mild obesity-related diabetes,»
types of disease, rather than two types, 3 (most resistant to insulin) had the occurs in people who have a milder
according to a new study. highest risk of diabetic kidney disease form of the disease, without as many
and cluster 2 (insulin deficient) had the metabolic problems as those in cluster
In the new study, published in The highest risk of retinopathy. 3, and they tend to be obese.
Lancet Diabetes & Endocrinology,
OPINION EDITORIAL
researchers found that diabetes CLUSTER 1: CLUSTER 5:
patients in Sweden and Finland fell Called «severe autoimmune diabetes,» Called «mild age-related diabetes,»
into five clusters. One of the clusters is similar to type 1 diabetes. People this form was similar to cluster 4, but
was similar to type 1 diabetes, while in this cluster were relatively young the people were older at their age of
the other four clusters were «subtypes» when they were diagnosed, and not diagnosis. This was the most common
of type 2. Three of the clusters were overweight. An autoimmune disease form of diabetes, affecting about 40
considered severe forms of the disease, prevented people in this cluster from percent of people in the study.
while two clusters were considered producing inulin.
GLOBAL CAMPAIGN
mild forms. Recognizing subtypes of diabetes, as
CLUSTER 2: the new study suggests, might change
Study researchers believe a new Called «severe insulin-deficient the way doctors treat, prescribe
classification system could provide a way diabetes,» is similar to cluster 1 — people and prevent the progression of
to “individualise treatment regimens were relatively young at diagnosis and complications in diabetes.
and identify individuals with increased were not overweight. They were also not
risk of complications at diagnosis.” producing much insulin. But, crucially,
their immune system was not the cause
HEALTH DELIVERY
The study yielded five replicable of their disease. MORE INFORMATION:
clusters of patients with diabetes, http://www.thelancet.com/
which had significantly different CLUSTER 3: journals/landia/article/
patient characteristics and risk of Called «severe insulin-resistant diabetes,» PIIS2213-8587(18)30051-2/
diabetic complications. Classifying occurs in people who are overweight and fulltext?elsca1=tlpr
into the following clusters below could have high insulin resistance.
12 DiabetesVoice April 2018 Volume 65 Issue 1NEWS IN BRIEF
Smoking increases risk
of diabetes
Researchers from the University of Oxford, UK, the Chinese The researchers found that, compared with people who have
Academy of Medical Sciences and Peking University have never smoked, regular smokers have a 15-30 percent higher
examined the association of smoking and smoking cessation risk of developing diabetes, after taking account of the
with the risk of diabetes in a large, nationwide study of effects of age, socioeconomic status, alcohol consumption,
500,000 adults from 10 areas (five urban and five rural) of physical activity and adiposity. The study also showed a
China. clear dose-response relationship with amount smoked and
the earlier a person started smoking.
The study included only people with no history of diabetes
at the baseline, whose health status was monitored for nine Among urban men, smokers had an adjusted HR of 1·18
years through death and hospital admission records. During for diabetes. HRs increased with younger age at first
this time over 13,500 participants developed new-onset type smoking regularly (1·12, 1·20, and 1·27 at ≥25 years, 20–24
2 diabetes. years, andNEWS IN BRIEF
IDF Board
DIABETES VIEWS
of Directors
2018-19
NEWS IN BRIEF
The International Diabetes Federation, the largest global voluntary health organisation advocating improved diabetes
awareness, education and care, is pleased to present the members of its Board of Directors for 2018-2019.
IDF REGIONAL NEWS
Prof. Nam H. Cho
PRESIDENT
Republic of Korea
OPINION EDITORIAL
Prof. Andrew Boulton
PRESIDENT-ELECT
United Kingdom
GLOBAL CAMPAIGN
Ms. Sharon Fraser
VICE-PRESIDENT STRATEGIC GOVERNANCE
Belize
HEALTH DELIVERY
14 DiabetesVoice April 2018 Volume 65 Issue 1NEWS IN BRIEF
REGIONAL CHAIRS
Africa:
Dr. Naby Baldé, Guinea
VICE-PRESIDENTS:
Prof. Stephen Colagiuri
Australia
Europe:
Prof. Şehnaz Karadeniz, Turkey
Prof. Angus Forbes
United Kingdom
Middle East and North Africa:
Prof. Abdul Basit, Pakistan
Mr. Serge Langlois
Canada
North America and Caribbean:
Ms. Glynis Alonzo-Beaton, Guyana
Mr. Fredrik Löndahl
Sweden
South and Central America:
Dr. Balduino Tschiedel, Brazil
Ms. Zobida Ragbirsingh
Trinidad and Tobago
South East Asia:
Dr. Ali Siyan, Maldives
Prof. Eugène Sobngwi
Cameroon
Western Pacific:
Prof. Linong Ji, China
April 2018 Volume 65 Issue 1 DiabetesVoice 15REGIONAL NEWS
IDF REGIONAL NEWS
IDF EUROPE
Improving the lives of people
DIABETES VIEWS
with diabetes and those at risk in
the IDF European Region
NEWS IN BRIEF
Sehnaz Karadeniz
IDF European (EU) Region is a Forum’. Young people are the Through our IMPACT Diabetes Pledge,
wonderful example of unity-in-diversity future of the IDF Member Associations we want to strengthen our network
IDF REGIONAL NEWS
-different cultures, healthcare systems, and all seven regions and they have of European Parliamentarians, to
different levels of resources. There are an immense capacity with their out- make our voice heard more strongly,
a multitude of unique experiences from of-the-box thinking. We need more to prioritise diabetes on the political
country to country where we can learn youth involvement from the Member agenda, and to motivate the decision-
from each other and adapt to our own Associations and from the European makers to do follow-up of the political
culture where appropriate. Region of the YLD program to commitments made.
flourish this program. I want to take
However, the increasing numbers this opportunity to thank to the Board We very much hope that in this term
show that the EU is facing a diabetes Members: Kyle Jacques Rose, Cristina we will keep on building on the past
OPINION EDITORIAL
pandemic similar to the rest of the Petrut, Iryna Vlasenko and Elisabeth achievements of IDF Europe together
world, despite the favourable outcomes Dupont from our Regional Office for with our Member Associations in our
of scientific studies to prevent diabetes their guidance and coordination, and region.
and its burden. to all the youth advocates who are
currently participating.
In our recent publication ‘Integrating
Diabetes Evidence into Practice: When it comes to “improving the
challenges and opportunities to bridge lives of people with diabetes and those
GLOBAL CAMPAIGN
the gaps’, we mapped the challenges at risk in our region” as the vision of
and the opportunities to bridge the 2018-19 by the IDF Europe Board,
gaps between the available scientific we must concentrate, with all means,
evidence and the real life practices at the implementation of the political
different levels across Europe, including commitments as declared by several
the healthcare system level, healthcare political institutions.
professional level and at the level of
people living with diabetes.
HEALTH DELIVERY
Şehnaz Karadeniz
Our region has the highest number
is the Chair of the
of children and adolescents with IDF European Region
type 1 diabetes in the world. We have
also started the YOURAH program,
‘IDF’s Europe Youth Advocate
16 DiabetesVoice April 2018 Volume 65 Issue 1IDF REGIONAL NEWS
IDF MIDDLE EAST AND NORTH AFRICA
Road map for
better diabetes care
Abdul Basit, Erum Ghafoor
The IDF Middle East and North For the new term, the activities calendar as an IDF Center of Education and IDF
America (MENA) region is a diverse developed in the MENA region Center of Excellence in diabetes care
and unique territory with great ethical specifically targets preventive measures to meet the urgent need. The network
and cultural differences and socio- including launching of diabetes mobile of 100 mini-clinics led by trained
economic extremes. Approximately units by Bahrain Diabetes Society and diabetes educators is a commendable
38.7 million adults are living with Diabetes Palestine; and campaigns for diabetes education initiative by Sudan.
diabetes and almost half (49.1%) of the prevention of blindness by Sudan. Additionally, the Qatar Diabetes
them are unaware of their condition.1 Saudi Diabetes & Endocrine Association Association offers a structured training
The prevalence of diabetes is on a rapid is aiming to initiate Sweet Smile Clubs program for school nurses across the
upsurge in the MENA region. for children with type 1 diabetes country along with the Al-Bawasil-camp
and mass screening campaigns as a for children with type 1 diabetes. Al-
Several countries of this region have preventive measure. Shurooq Diabetes Camp for Children
implemented high-impact prevention is organized by the Bahrain Diabetes
approaches to reduce diabetes and its The MENA region is currently in need Society annually. Additional activities
complications. A major preventive of a substantial number of trained include continuous education on healthy
initiative is the National Diabetes and healthcare providers. Pakistan has cooking techniques, guidelines for safe
Diabetic Foot Program in Pakistan earned the recognition of nomination fasting during Ramadan and training
where 115 diabetes clinics have been
established and the rate of amputation
has been halved.2 Similarly, Footwear
for every Diabetic (FED) is another
ingenuity by which ten risk assessment
clinics have been established
countrywide, providing low-cost
footwear for people with diabetes
thereby reducing ulcer rates. Recently,
In Mansoura, Egypt, an IDF MENA
Diabetic Foot Workshop was conducted
with trainees from Afghanistan,
Pakistan, Lebanon, Sudan, Jordan, and
Egypt.
April 2018 Volume 65 Issue 1 DiabetesVoice 17IDF REGIONAL NEWS
programs for safe traveling, including registered more 500 type 1 children and References
pilgrimage, are some of the education provides free services in Jerusalem and
1. International Diabetes Federation
initiatives of the region. Gaza. Another major initiative is a joint
DIABETES VIEWS
(IDF), Atlas 8th edition 2017. Available
project of World Diabetes Foundation from: https://w w w.idf.org/our-
It is extremely worrisome that amongst (WDF) and IDF-MENA region for network/regions-members/middle-
east-and-north-africa/welcome.html
the highest prevalent countries with providing diabetes care services and free
(last assessed on March 24, 2018)
diabetes worldwide, five countries insulin to Syrian refugees in Lebanon. 2. Basit A, Nawaz A. Preventing diabetes
belong to the IDF MENA region. There In the future, the Diabetes and Disaster related amputations in a developing
is an urgent demand for epidemiological stream for the IDF World Congress country – steps in the right direction.
Diabetes Voice 2013; 58: 36-39.
initiatives to address such an alarming would benefit by addressing strategies
3. Basit A, Khan A, Khan RA. BRIGHT
state. Recently, Pakistan has conducted not only for natural calamities but also Guidelines on Self-Monitoring of
NEWS IN BRIEF
the 2nd National Diabetes Survey for manmade emergencies and disasters. Blood Glucose. Pak J Med Science
of Pakistan (NDSP) 2016-17 which 2014; 30(5):1150-1155. https://www.
ncbi. n l m . n i h . gov / pmc / ar t i cl e s /
revealed that 26% of the population Continuous medical education through PMC4163252/
over the age of 20 has type 2 diabetes. regular meetings and conferences
Some of our member associations have is another important area which is
already taken up the task to replicate it getting recognized in the MENA region.
in their countries. Furthermore, Diabetes Registry of
IDF REGIONAL NEWS
Pakistan (DRoP) is another promising
Advocacy is another prerogative aim initiative in collaboration with the
of IDF-MENA to support people with Ministry of Health. The presentation
diabetes and stop the diabetes epidemic of MENA region guidelines for the
which is strengthened through launching management of type 2 diabetes is
and implementation of effective advocacy another strong step towards better
campaigns amongst MENA countries. care. Pakistan has also developed the
Furthermore, influencing international BRIGHT guidelines3 to provide low cost
bodies, political platforms, community and effective strategies for improving
OPINION EDITORIAL
leaders, and national governments is self-management of blood glucose.
required to implement practical, real
time and long-term measures. Other In summary, the IDF MENA region
outstanding plans for the coming term is aiming to achieve a resilient global
include: launching the Dia-Ambassador presence by promoting advocacy not
program in Iran; mass campaigns for safe only for people with diabetes but also
fasting during Ramadan and decreasing for those who are at risk, emphasizing
the use of tobacco in Morocco and Iraq; empowerment for people with diabetes
GLOBAL CAMPAIGN
and online education courses for people and strengthening the International
with diabetes in Sudan and Pakistan. recognition of IDF and diabetes. We
Provision of regional advocacy strategies believe these measures will go a long
are major goals. way in achieving better diabetes care
and prevention.
More than half of the MENA region
consists of resource constrained Abdul Basit
countries. The access to basic diabetes is Chair of the IDF-MENA Region, Director of the Baqai Institute of Diabetology &
HEALTH DELIVERY
care and the crisis of insulin is a Endocrinology (BIDE), Professor of Medicine at Baqai Medical University (BMU) and Joint
Secretary, Diabetic Association of Pakistan (DAP).
common issue. Insulin My Life (IML)
project in Pakistan has already provided Erum Ghafoor
is a Consultant Diabetes Educator at the Baqai Institute of Diabetology & Endocrinology,
more than 20,000 free insulin vials to Expert Trainer for Conversation Map Tools in Pakistan and
over 1,900 children with type 1 diabetes. Joint Secretary of the National Association of Diabetes Educators of Pakistan.
Likewise, Diabetes Palestine has
18 DiabetesVoice April 2018 Volume 65 Issue 1IDF REGIONAL NEWS
IDF NORTH AMERICA AND CARIBBEAN
EDUCATION! EDUCATION!
EDUCATION! The key to diabetes
management
Glynis Alonzo-Beaton
Education is the driving force to Young Leaders of Diabetes (YLD) £ £ The President of NAC, Glynis
achieve proper management of living with type 1 diabetes in Beaton, will be a guest speaker in
diabetes. Holistic education for Belize. Given this tragic loss, Atlanta, Georgia (USA) on “How
patient understanding is so critical for the association took on the need Diabetes Works”. The rest of the
success and for improving outcomes to prioritize care for people year is packed with YLD Awareness
for people with diabetes that advocates with type 1 diabetes, especially outreaches and Exhibitions.
and medical professionals must provide with professional counselling.
diabetes education for people at all Beginning in April, Belize is ££ T h e A m e r i c a n D i a b e t e s
levels, including patients with low working with the World Diabetes Association is hosting their Annual
levels of literacy. We need to help Federation on a new project Scientific Sessions in Orlando,
people with diabetes understand their entitled “Belize National Diabetes Florida from June 22-26, 2018
condition fully and be motivated to Self-Care Programme”. and representatives from the NAC
take care of themselves willingly. The Region will attend.
North American and Caribbean (NAC) £ £ For Guyana, 2017 was a stellar year.
Region is prioritizing education and The YLDs led many programs and Despite our recent challenges in the
has developed their diabetes education collaborated with the Ministry of NAC region, we are happy to say we all
programs to suit all education levels. Public Health on lay training for have one common ground on which we
“non-medical personnel” and helped will be emphasizing diabetes education
What follows are association activity strengthen the Guyana Education as a key focus for our communities this
examples from the NAC region: Department on behalf of the NCD year.
Commission, the Management
£ £ St. Kitts and Nevis started 2018 Board and the Guyana Diabetic
with blood glucose screening, Association. The association
testing and providing diabetes collaborated with the Ministry of
education in local schools. Public Health and the Georgetown
Lectures have been organized for Public Hospital Corporation to
medical personnel and the general provide CME for four credits on
public, and are ongoing. They will Kidney Disease and Women. This Glynis Alonzo-Beaton
continue this trend with increased year we will watch Guyana unfold is the Chair of the
education during the year. an exciting cricket competition for IDF North America and
Caribbean (NAC) region
the third consecutive year for boys
£ £ The year started with a sad note (under 17) with YLD hosting the
on the loss of one of the IDFs education sessions and testing.
April 2018 Volume 65 Issue 1 DiabetesVoice 19IDF REGIONAL NEWS
IDF SOUTH AND CENTRAL AMERICA
Brazilian government
DIABETES VIEWS
to provide analog
insulin for type 1 diabetes
NEWS IN BRIEF
Vanessa Pirolo and Balduino Tschiedel
After social media outcry, the Brazilian £ £ People who perform self- for 20 minutes but was asked to leave
Ministry of Health is discussing final monitoring blood glucose tests a for the final discussion according to
IDF REGIONAL NEWS
steps with the National Committee minimum of three times a day. the National Committee for Health
for Health Technology (Committee) Technology protocol procedure.
to make rapid-acting analog insulin £ £ People who have had severe ADJ was not given access to the final
available for people with type 1 diabetes hypoglycemia over the last three discussions.
in the Brazilian Public Health System months, and/or who have had
(SUS). repeated and/or nocturnal non- Other issues which need defining are:
severe hypoglycemia. type and size of the insulin pen and
The Secretary of Science, Technology determining reusability; and place of
and Strategic Inputs from the Ministry The Committee also highlighted how dispensing (primary care offices or
OPINION EDITORIAL
of Health signed the incorporation on people with type 1 diabetes who qualify specialized care). Advocacy leadership
February 22, 2017. It is critical for the must also have access to at least 100 test is closely monitoring each step and
health of people with type 1 diabetes to blood glucose strips for testing per believes that newer, faster insulin and
have accessibility to more efficacious month, and for pregnant women, 150 technology will benefit the Brazilian
analog insulins and the delay of almost to 200 test strips in order to achieve best population by decreasing the number
one year is unacceptable. self-monitoring practices and safety. of diabetes complications and hospital
stays due to the lack of access.
Advocates, people with diabetes, The Juvenile Diabetes Association
GLOBAL CAMPAIGN
Committee members and government Brazil (ADJ) was invited to attend the Update: The bidding procedure to
representatives expect that the change disclosure of the meeting protocol purchase the rapid-acting insulin took
in insulin benefits for people with type place on April 2nd and at the time of
1 diabetes will take effect by July 2018. publication, ADJ has not been informed
Under discussion are the determining of the results.
criteria for patient qualification. Draft
recommendations include:
Vanessa Pirolo
is a journalist, Advocacy Coordinator for
HEALTH DELIVERY
£ £ People who have used regular ADJ Diabetes Brazil and a member of
the board of the IDF South and Central
insulin for at least three months.
America (SACA) region.
£ £ People who are under the care of Balduino Tschiedel
is Chair of the IDF South and Central
an endocrinologist and are seen at America Region.
least twice a year.
20 DiabetesVoice April 2018 Volume 65 Issue 1
Vanessa PiroloOPINION
OPINION EDITORIAL
GUEST EDITORIAL
Insulin:
Concierge Medication
or Human Right?
Joyce Lee, MD, MPH
this means that they need at least three for long acting insulin. These costs are
vials of insulin a month, which costs increasingly being passed onto patients
nearly $1400– tragically higher than and their families as the number of
the cost of their rent or a mortgage. individuals on high deductible health
The high cost of insulin doesn’t include plans or who are uninsured grows.
all of the additional supplies they need
for self-monitoring, including blood This crisis in insulin pricing is taking
glucose testing strips (as high as $1 per a human toll. Families are now using
strip), sensors for continuous glucose crowdfunding sites like GoFundMe to
monitoring ($350 a month), glucagon fundraise to pay for their insulin. And
($280), visits to a healthcare provider there are too many stories in the news
and more. about patients, who when faced with
There is a growing recognition that we a $1300 insulin bill at the pharmacy,
are reaching a crisis in the US diabetes must ration their insulin and suffer
community with regard to the price of HAS INSULIN ALWAYS BEEN THIS EXPENSIVE? catastrophic consequences, including
insulin. If you search for “insulins” on an increased risk of complications and
GoodRx.com you will see a huge range The answer is no. There are clinicians even death.
of prices for different types of insulin. and patients who can remember when
The insulins that I have traditionally a vial of insulin used to cost $20, and
used for my patients with type 1 diabetes studies have shown that the costs of WHY IS INSULIN SO EXPENSIVE?
include short acting analog insulins like insulin have increased dramatically
Humalog ($549) or Novolog ($551), over the last few decades. For example, Here are just a few of the contributing
and long acting insulins like Lantus studies using Medicaid data have factors:
($274), Levemir ($436), and the new shown that annual payments for a
generic/“follow-on” long acting insulins patient requiring 40 units of insulin £ £ The US government lacks
like Basaglar ($234). a day increased from $771 in 2001 to negotiating power with regard to
$2852 in 2014 (a 370% increase) for drug pricing, and therefore pays
Because some of my patients with rapid acting insulin, and from $891 in more for insulin than any other
diabetes use more than 100 units a day, 2001 to $2848 in 2014 (a 320% increase) country, leading to a prescription
April 2018 Volume 65 Issue 1 DiabetesVoice 21OPINION EDITORIAL
drug market that prices “primarily 1. They blame the “complicated“ net prices of Lantus over the
on the basis of what the market will healthcare system: cumulative period of the last five
bear.” years actually went down,» she
DIABETES VIEWS
“There are no quick and easy said.”
£ £ Companies that want to make answers, because the system is
generic insulin, may lack the complex and complicated,” Lilly 3. The pharmacy benefit managers and
manufacturing capabilities and a spokesman, Gregory Kueterman insurers blame the pharmaceutical
supply chain for producing insulin. said. “Even just simply lowering companies.
prices, while that seems like
£ £ The use of “evergreening” by an easy answer, it wouldn’t “Rebates don’t raise drug prices,
pharmaceutical companies, in necessarily lower the prices of the drug makers raise drug prices.”
NEWS IN BRIEF
which they make very minor high-deductible plan. They’d have
tweaks in a drug to extend the life to keep paying till they hit that
of a drug patent, through minor deductible.” The public has been outraged by a
modifications in the drug itself but number of different prescription
even more commonly now though 2. The pharmaceutical companies drug pricing scandals in the news,
updates to drug delivery devices blame the pharmaceutical benefit including the mark-up of Epipen prices
rather than the drug itself. managers and insurers. When the 3 by CEO Heather Bresch of Mylan
IDF REGIONAL NEWS
manufacturers of insulin in the US Pharmaceuticals, or the 5000% price
£ £ The use of patent infringement were asked about pricing of insulin: increase for Daraprim orchestrated
lawsuits by pharmaceutical by now convicted ex CEO of Turing
companies, who file them to “Sanofi, Lilly and Novo Nordisk Pharmaceuticals Martin Shrkeli. The
prevent or delay entry of generic/ all highlighted discounts they increases in insulin price may not have
follow-on competitors for up provide, and also pointed the been as dramatic and have occurred
to years. For example, a lawsuit finger at health insurers.” more gradually over a longer period of
against the follow-on to Lantus time, but do the companies involved in
called Basaglar resulted in a “Ashleigh Koss, a spokeswoman the pricing of insulin deserve any less
OPINION EDITORIAL
30-month delay in approval, during for Sanofi, told Business Insider negative attention? Scientists Frederick
which the company could charge that Lantus had not had a price Banting, Charles Best, and James Collip
more for Lantus before it went off increase since November 2014 who discovered and established the
patent. in the US. «In fact, because first patent for insulin, sold it for $1 to
of aggressive discounting and
£ £ The rise of the pharmacy benefit rebates to insurance plans, PBMs,
manager, which is an entity and government programs, the
that negotiates rebates with
GLOBAL CAMPAIGN
pharmaceutical companies, taking
a proportion of the drug cost as
profit without any sort of price
transparency.
£ £ And let’s not forget, that very
important factor called greed.
HEALTH DELIVERY
Not surprisingly, the major players
with the ability to change the
pricing (pharmaceutical companies,
pharmacy benefit managers, and
insurers) put the blame on anyone
except themselves.
22 DiabetesVoice April 2018 Volume 65 Issue 1OPINION EDITORIAL
ensure the discovery could be accessed £ £ The Juvenile Diabetes Research Everyone in the diabetes community
by all individuals with diabetes. They Foundation has developed a Type needs to speak up and advocate
would be outraged if they could see 1 diabetes Health Insurance Guide for our patients on this critically
how difficult it is for people to afford to help patients navigate health important issue. As the advocate and
insulin today. insurance issues. endocrinologist Dr Irl Hirsch said in
his publication, Insulin in America: A
Insulin has tragically become a £ £ The American Diabetes Association Right or a Privilege?
concierge medicine, available only to has asked politicians to examine
those who are well off and have good the supply chain for insulin and “But to those who detest the thought
insurance, when it should be a right. As have asked for transparency of of having our government involved in
James Elliott, advocate and individual pricing. the distribution of insulin, I would say
with type 1 diabetes said, “We’re locked that I detest more the pain, suffering,
into paying whatever insulin companies £ £ Finally, politicians themselves have cost, and potential death from diabetic
decide. It’s like paying for oxygen and begun to advocate. US Senator ketoacidosis resulting from patients’
having three companies decide what Bernie Sanders and Congressman inability to afford insulin.”
the price should be.” Elijah Cummings have asked the
Justice Department and Federal
In response to the crisis there have been Trade Commission to investigate
a number of developments: anticompetitive conduct and made
accusations of price collusion
£ £ The patient community has begun among the companies, as there
the important advocacy on this have been suspicious increases in
topic, organizing protests at Eli insulin prices among brands in lock
Lilly, and planning protests at the step (i.e. a 16.1% increase in Lantus
other insulin companies. followed by a 16.1% increase in
Levemir the next day; or an 11.9%
£ £ Type 1 International is a global increase in Lantus, followed by
diabetes advocacy organization an 11.9% increase in Levemir).
working to improve sustainable It’s possible that governmental
access to insulin, supplies, care and intervention may be the only way
treatment for everyone with type 1 to address this crisis.
diabetes.
£ £ The Diabetes Patient Advocacy
Coalition has started the Affordable
Insulin Project, offering tools, Joyce Lee
resources, and data for patients, MD, MPH, is the Robert P. Kelch, MD
Research Professor of Pediatrics at the
caregivers, employers, and
University of Michigan Medical School
healthcare professionals to support and Professor at the Medical School and
increasing affordable access to at the University of Michigan School of
Public Health.
insulin.
Her research agenda focuses on the
overarching areas of type 1 and type 2
diabetes, and obesity, and her current
work includes focus on the creation
of learning health systems using the
methods of clinical informatics, quality
improvement, and patient-centered
participatory design. For more
information, visit her website:
http://www.doctorasdesigner.com
April 2018 Volume 65 Issue 1 DiabetesVoice 23THE GLOBAL CAMPAIGN
THE GLOBAL CAMPAIGN
Lions Clubs International and
DIABETES VIEWS
International Diabetes Federation
come together to tackle diabetes
Elizabeth Snouffer
NEWS IN BRIEF
On Saturday, March 24, 2018, Lions came together to help prevent diabetes LCI’s 40th annual Lions Day with the
Clubs International (LCI) and the and improve the quality of life for those United Nations (UN) commemorated
International Diabetes Federation living with diabetes worldwide. their long-standing relationship as a
(IDF) signed a Memorandum of consultative NGO to the UN which
Understanding (MoU), on the occasion LCI is the world’s largest service club began in 1945. The theme for the
IDF REGIONAL NEWS
of Lions Day at the UN, to establish a organization, with 48,000 clubs and event “Working Together Globally to
cooperative alliance in the global fight over 1.4 million members serving in Combat Diabetes” was attended by
against diabetes. The two organizations 200 countries or geographic areas. Lions members, Leos—young leaders
OPINION EDITORIAL
GLOBAL CAMPAIGN
HEALTH DELIVERY
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