INTRODUCTION
Available data from many countries of the Eastern Mediterranean Region (EMR)
indicate that diabetes mellitus has become a problem of great magnitude and a major
public health concern. Studies have demonstrated that, in some countries, diabetes affects
up to 10% of the population aged 20 years and older. This rate may be doubled if those
with impaired glucose tolerance (IGT) are also included.
The manifestations of diabetes cause considerable human suffering and enormous
economic costs. Both acute and late diabetic complications are commonly encountered.
Long-term complications represented by cardiovascular diseases, cerebrovascular
accidents, end-stage renal disease, retinopathy and neuropathies are already major causes
of morbidity, disability and premature death in countries of this Region.
The development of long-term complications is influenced by hyperglycaernia. Poor
control of diabetes accelerates their progression. Thus, to prevent complications, good
control of diabetes is essential and the management of diabetes should therefore aim to
improve glycaemic control beyond that required to control its symptoms. Intensified
therapy and maintaining near-normal blood glucose levels can result in considerable
reduction in the risk of development of retinopathy, nephropathy and neuropathy.
However, despite the high prevalence of diabetes and its complications and the
availability of successful prevention strategies, essential health care requirements and
facilities for self-care are often inadequate in this Region. Action is needed at all levels of
health care and in the various aspects of diabetes care to bridge this gap and to improve
health care delivery to people with diabetes. Education of the health care team on the
management of diabetes and on how to educate people with diabetes is one major aspect
that requires strengthening.
Even though resources vary widely within the Region, the primary resource in diabetes
care is now recognized to be the people with diabetes themselves, supported by well
trained and enthusiastic health care professionals. This resource can be strengthened
nearly everywhere by education.
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