Newspaper Diabetas
The newspaper of the Lithuanian Diabetes Association.
No 2 (22) May 10, 1999

Eli Lilly - the general sponsor.
The newspaper is supported by: Joint stock company Berlin Chemie - Menarini Group, corporation "Eksmos MTC", corporation Ferrosan, company "Inmeda", company "Korys".

Page 1
Lithuanian Diabetes Association is a member of the IDF.

     People are invited to join the Association. There is a reminder of the newspaper's subsription.

Pages 2-5
IV General Assembly of LDA

     On 24th of April 1999 IV General Assembly of LDA took place. There were 127 delegates and 111 guests. Vice-President of IDF/Europe Anders Ericsson, representative of Latvian Diabetes Federation Inara Puzule, representative of Ministry of Health Ona Abraityte congratulated participants of Congress. Greeting letters and telegrams were received from WHO representative prof. Isuf Kalo, Mary Frances McKenna (Irish DA), Mrs. Lilly Karn (Germany), prof Juozas Danilevicius.
     Every country meets the same similar problems of people with diabetes, but they are solved in different ways depending on different circumstances. But we have the same goal, said Anders Ericsson. In order to make life better of the people with diabetes we have to pay attention to the individual experience of every patient and every med. doctor. This is a new appriach to the disease and the patients. This is the base. Education and training still remains as earlier one of the main fields but individual experience and it's evaluation is especially important in order to reach with joint efforts progress and attempts to block this quickly spreading disease.
     Photo (2) Vice-President of IDF/Europe Anders Ericsson and LDA president Vida Augustiniene in the IV General Assembly in Vilnius.
     Photo (3) Prof. Antanas Norkus, MD Egidija Baltrusaitiene, MD Arnoldas Doviltis, Vida Augustiniene.
     Photo (4) Close corporation "Eksmos MTC" representatives Jurate Margelyte and Algirdas Zilionis introduce production of Roche Diagnostics.
     Photo (5) In the IV General Assembly.

Not only medicine cures…
     St Vincent Declaration National Committee chairman prof. Antanas Norkus marked that during 10 years the treatment of diabetes changed significantly, there are a lot new medicines registered that prolong the effect of pills, new eye medicine invented, research is caried out and percaps in the future insulin will be sprayed and taken through the nose. Professor mentioned that positions of foot care and medical nurse-diabetes educator will be officially legitimated. But education and training remain one of the main goals.A person himself/herself can control the disease and help. The captain of the raft "Bliuskis" Vladas Kasperavicius invited this summer also to travel on this raft. He promised that from Kaunas to Rusne there will be a possibility to check glucose in blood for public during the stops. Vilkaviskis diabetes club chairman Juozas Janusaitis shared working experience. He invited to keep optimizm, to keep interest in cultural life. According to J. Janusaitis there is a lack of enocrinologists, foot care specialists, diabetes educators in the rural areas.
     Kelme diabetes club chairwoman Larisa Rarovskaja was happy to invite more members. This helps to solve more quickly arising problems.
     Novo Nordisk representative Arunas Teiberis donated 100 glucometers to LDA.
     Juzefa Uleckiene reminded that every patient has to have valid document with a photo. She also spoke about youth, if they take part in the events for the diabetes patient they would be able to take better care of their health an children especially harm themselves not keeping to the regime. That is why it is very important that parients also participate in clubs activities.
     A leader of the publishing house "Senoja" Maryte Saltyte suggested to all the clubs and pharmacy companies to take an initiative and help to distribute the newspaper "Diabetas". All the speakers thanked LDA president for her thorough work and sincerity.

Page 6
Lithuanian Diabetes Association
IV General Assembly of April 24, 1999 in Vilnius
RESOLUTION
regarding diabetes care and prevention strategy

     Lithanian Diabetes Association General Assembly listened to the report of President Vida Augustiniene for 1996-1998 accounting period and speeches of the delegates and other participants paying attention to the remarks and suggestions of members, sick with diabetes, their family members, medical specialists as well as sponsors the following resolution has been adopted:

1. To make a suggestion to the Government of republic of Lithuania to carry out diabetes care policy based on public health principlles that would act to the benefit of the sick and guarantee the following:
     1.1. Right forseen by the law to a qualified and available health care for the people with diabetes and patients rights and protection;
     1.2. Diabetes prevention for the population;
     1.3. Effective cooperation of health care, social security, education, justice and other sectors and cordination in the field of diabetes;
     1.4. Active participation of LDA and other NGO's making decisions and integration of the services provided by them into general diabetes care system;
     1.5. Objectiveness and publicity of the diabetes care system.

2. Invite all levels of executive officials to participate actively with organizations representing people with diabetes. Their activities and services are accepted as necessary in implementing state health and social policy. These organizations should become equal partners not only in decision making in the field of diabetes health policy area but also in providing health services to the patients.

3. Offer to Ministries of Health Care, Social Security and Labour, Education and Science to combine funds and support important diabetes prevention innovative scientific projects and guarantee their sustainability expansion of these services in Lithuania.

4. Offer to county administrations and municipalities as well as to district clubs to undertake the responsibility for diabetes care strategy in the regions.

5. Recommend Public Health Education Center to disseminate more actively information about diabetes in the society.

6. Suggest to National Radio and TV Board to allocate time for diabetes prevention promotion.

7. Suggest to the Ministry of Health legitimate positions of med7 nurses-diabetes educators and foot care specialists.

8. Suggest to MOH, Department of Medications Policy to include into the list of compensated medicines, diseases and medical services for out-patient treatment glucagon, broad range antibiotics necessary for foot care; glycolised haemoglobin, microalbuminurium tests; diagnostic strips for cheching glucose in blood for patients with type II diabetes, increase their member for insulin dependent patients (especially for children).

9. Suggest to MOH, counties and municipalities and heads of health institutions to guarantee functioning of out-patient diabetes centres, foot care and diabetes education rooms established by pharmacy companies Eli Lilly and Novo Nordisk.

10. Suggest to National Health Board under Seimas of Republic of Lithuania to discuss health policy strategy regarding deabetes treatment, research and prevention by inviting all the interested institutions and representatives of health and social science.

11. Offer to prioritize diabetes in the health policy field paying attention to World Health Organization, International Diabetes Federation and St. Vincent declaration recommendations.

12. Suggest to National St. Vincent Declaration Committee established by MOH to strive more actively for reaching the main goals set by the Committee, i.e. to make better quality of life of people with diabetes, their state of health, to decrease complications.

13. Prepare and legitimate patient's with diabetes identification card.

14. Recommend diabetes clubs to organize more actively activities in the districts: diseminate information about the disease, distribute the newspaper "Diabetas', unite as many members as possible.

Pages 7-8
We act and thank for the supporters

     At the end of February a meeting of Skuodas "Diabetes" club members took place. The purpose of the meeting was to discuss problems of elderly people as this year is devoted to them. They also talked about usefulness of summer camp for young patients, where they learn to live with diabetes.

Mis America 1999 Nicole Johnson
     Nicole Johnson fell ill with diabetes when she was 19 years old. After 24th birthday she became crowned as Mis America 1999. Her activities differ from former Mises, she supports actively American Diabetes Association and takes care of people with diabetes. Her goal to disseminate knowledge about dangers of diabetes disease, advocate for healthy life style, to organize compains for collecting funds.

A Guest from Israel
     It was a pleasure to meet again endocrinologist Feige Narevicius, the first iniciator, Founder of Vilnius Diabetes Club "DIA" and Diabetes School and the Association, Honorary member of LDA. Since 1991 F. Narevicius lives in Israel, works in Haifa medical center "RAMBAM". After the passed through all necessary qualification examinations following Israel requirements she continued to provide treatment to people with diabetes and other endocrinological diseases. She answered to some guestions. She told about Israel Diabetes Association, the main trends of diabetes treatment in Israel, its presention, who takes care of the patients, in what cases they are hospitalized, compensations, what tests are carried out, who takes care of children with diabetes and others. She also sent her regards to the Association and readers of the newspaper "Diabetes". She wished prosperity. Continue working. Patients have and must live full life. That is why the patient needs to get as much knowledge as possible, try to rich normal glycemia. Education of patients, out-patient care are the main working directions.
     Photo: On the left: Nijole Remeikiene; Feige Narevicius, MD; Grazina Katiliene, MD; Daiva Lauzikiene in Vilnius "DIA" club.

Our Wealth in Health
     In December 17, 1998 in Klaipeda the club of the Blind and Low Vision sick with diabetes organized a seminar "Person's Physical, Spiritual and Social Wealth". Seminar's participants were trained how to take care of health. The reports were presented by psychotherapist B. Aleksandraviciene, kinetherapist R. Peciuliene and other specialists.
     Photo: the seminar "Physical, Spiritual and Social Wealth" in the club of Klaipeda Blind and Weak Eyesigthed sick with diabetes.

Page 9
Do you want to sanatorium

     There is information from "State News" about patients with diabetes, possibilities to go through treatment in sanatoria "Versme", in Birstonas, "Zvorune" in Palanga, "Energetikas" in Sventoji. The treatment is 100% compensated by medical insurance.
     Company "Palangos Zvorune" invites to come for treatment to its endocrinological department.

Pages 10-11
In the mornings, immediately after getting up there is too much sugar in blood

     Dr. K. J. Traumann's article from "Diabete Journal" (1996, No 6). The article is prepared by L. Kaulakiene. The article reviews problems and cause, their studies and treatment of too much sugar in blood.

Independent change of insulin doses
     MD E. Baltrusaitiene presents practical advice how to regulate glucose amount in blood paying attention to selfcontrol results when changing insulin doses and regulating nutrition.

Page 12
Competition of Meals

     LDA and Novo Nordisk company invited to participate in the competition of the most tasteful and healthy meal.
     There is also a recipe "Chicken with rice and vegetables".
     An advertisment of Ferrosan's vitamin complex "Multitabs".

Page 13
     Roche Diagnostics representatives in Lithuania company "Eksmos MTC" information about selfcontrol means.

Page 14
     Lilly company's information about Diabetes centres in Lithuania.

Page 15
If old age approaches

     Psychiatrist Jurate Deksniene gives advice to elderly people.

Let's look for the products by company SchneeKoppe
     Firm "Korys" information about products with fructose supplied to the patients with diabetes in Lithuania.

Page 16
When a teenager embraced by sorrow

     V. Augustiniene prepared information following J. Burlingame, medical nurse, article from 'Diabetes Forecast" magazine.

Attention
     Novo Nordisk company invites to use info telephone free of charge.

Page 17
LDA Chronicle

· In 1999, February 17-20 a seminar "Training of chairmen of diabetes clubs" took place in Vilnius. Broather information is on page 17.
· Questions on preparation for the IV General Assembly were discused on March 3 in the LDA Board meeting.
· Cooperation plans were discussed with the head of Novo Nordisk company in Lithuania Kirsti vikki an d LDA on March 4.
· On March 22 plans on travelling with raft "Bliuskis" were discussed with captain Vladas kasperavicius.
· On March 23 Rokiskis club delegation was received by LDA. Its members checked glycolised haemoglobin in the Diagnostic center.
· On March 24-27 LDA prepared a poster and seminar on diabetes for the Baltic Fair Exibition "Health and Beauty".
Participants who wanted could check glucose in blood. Read on page 18.
· On March 27 LDA President Vida Augustiniene participated in the meeting of Marijampole diabetes club.
· At the beginning of April Lithuania was visited by LDA honorary member, endocrinologist Feige Narevicius living in Israel. She visited club "DIA", met leadership of LDA. Read on page 7.
· On April 8 LDA met with representatives of company "Diagnosta" Daiva Balciunaite and Regina Drukteniene and discussed cooperation plans.
· On April 9 LDA President was invited to participate in the opening of new room of diabetes club in Silute.
· On April 10 in Vilnius "DIA" club conference took place. MD's E. Gruodyte, D. Slapsyte read reports about kidney diseases; J. Deksniene read a report on depresion and V. Augustiniene provided information about sanatorium treatment.
· On April 12 LDA cooperation plans were discussed with Berlin-Chemie Menarini Group representative Mindaugas Papievis.
· On April 13 LDA read report about diabetes on the radio.
· On April 24 IV General Assembly of LDA took place. Read on page 2.
· On June 17 a meeting of children LDA members with Ms. Lilly Karn from Germany will take place.
· EASD conference will take place on September 28 – October 2 in Brussels (Belgium).
· Ten years anniversary of St. Vincent Declaration will be celebrated on October 9-12 in Istambul, Turkey.
· On the 9th of December LDA will celebrate its 10 years anniversary.

    There are also condolences and greetings advertisements.

Seminar for Leadership of Diabetes Clubs
     LDA organized two seminars (each two days) for chairmen of diabetes clubs on February 17-20, in Vilnius Higher Medical School. Chairmen of diabetes clubs received knowledge about comunication with organization members, authorities, mass media. They were trained how to write fundraising programs. The main lecturer of seminar was Ricardas Dirzys. Md Aldona Ereliene told about the main ways of diabetes control. Medical nurse Juzefa Uleckiene taught about diabetes control and nutrition. The main sponsor of the seminar was EU Phare Civil Society Development Program, as well as Vilnius Higher Medical School, close corporation "Eksmos MTC" and Abbott Medisense.

Page 18
Excerpt from "State News" No 39 of May 5, 1999

     There is information about a possibility to get 3 months prescription for the medicines, being sick with long-term diseases (diabetes) and terms of getting diagnostic strips compensated by medical insurance office.

Let's help each other
     L. Vitkauskiene, Kaunas "Likimas" society chairlady shared her working experience, adviced club leaders to organize more actively activities in the districts, to look for funds themselves and not to wait for instructions from above, to recruite more vollunteers. She wished successful work and health.

Trips, future plans
     P.Grigola a member of Plunge daibetes club rejoices about the job done by chairman V. Luza. He shared impresions about Plunge people trips and other activities to the benefit of health.

Page 19
A Noble Person

     Photo: International seminar in Palanga. In the middle A. V. Stepanas.
     Our sincere friend , a teacher and supporter is doctor Antanas Vytautas Stepanas from Australia. Recognized and evaluated as the highest qualification specialist endocrinologist in the capital of Australia he never forgot being a Lithuanian. He provides every possible assistance to Lithiuanian doctors, medical nurses-educators as well as to the patients sick with diabetes. Dr. A. V. Stepanas is a man of broad interests. He was a participant of Adelaide Youth Choire and Lithuanian folk dance group. He is interested in philately and numismatics, Lithuanian cartography. He travel a lot around the world. From 1997 this noble man got sick but is still writing letters to Lithuania providing valuable advice, takes care of the patients situation. Lithuanian Diabetes Association is expressing their gratitude to this honorable friend. But there are no words to express the warmth of the heart that was created by this noble man – Antanas V. Stepanas.

In the Exibition "Health and Beauty"
     On March 24-27 a lot of people visited exhibition "Health and Beauty" organized in Vilnius Concert and Sports Palace. Exhibition promoted most of all healthy life style and rational nutrition. Seminars were organized by Baltic-American Clinic, Vilnius University Stomatological Clinic and Lithuanian Diabetes Association. Visitors were able to get acquainted with interesting non-traditional medical news.
     Lithuanian Diabetes Association talked on the subject "Let's block the way to the dangerous disease" about risk factors having diabetes of type 2, ways of treatment, nutrition mistakes, healthy life style and self-control importance and means. The reports were read by MD's Saulius Grigonis, Gintaras Zaleckis, prof. Leonardas Lukosevicius. LDA president Vida Augustiniene told about Association activities. During the exibition visitors were able to check glucose in blood at the poster of LDA free of charge, have consultations, get important information about health. 266 people were examined. From them 27 were diagnosed as having diabetes. Even 22% glucose exceed the norm. It means that diabetes control is bad. There is a big probability of complications. From 239 people who checked health 30 people had more glucose than norm. They were offered to get examined in the medical institution if they are sick with diabetes. 22 examined people (73,3%) were older than 40 years, 20 (66,7%) had overweight, 8 (26,7%) had relatives sick with diabetes. To have unpaid examinations close corporation "Eksmos MTC" and representative of Abbott Medisense in Lithuania supported LDA. We are very grateful for that. The check was carried out with "Glucotrend" and "Precission" devices.
     LDA is sincerely thankful for the exibition space that was given free of charge by the organizers "Baltic Fairs". We are also thankful to Vytautas Luza, Laima Kaulakiene, Daiva Lauzikiene and others.
     Photo: MD Saulius Grigonis reads a report in the seminar "Let's block the way for the insidious disease in time".

Page 20
Evaluation of the Examination Results

     In issue No 1(21) of the newspaper "Diabetes" a questionnaire on "Diabetes Care in Lithuania" has been published. The answers were received from 27 Lithuanian regions. Most of them from Marijampole, Plunge, Klaipeda, Varena.
     Questionnaires were sent only by 3,3% of the newspaper readers. There were answered by 53% of the patients with type 1 diabetes, 36% were of type patients using insulin and only 11% type 2 using pills. Duration of the disease varied from 8 months up to 33 years. 92% are treated with insulin injected by pens, only 8% are using animal insulin. Prescriptions for medicines to type 1 patients with diabetes (52%) and type 2 (79%) were prescribed by endocrinologist, for the rest – by therapeutist. Only 52% of people that have the right to get 150 diagnistic strips free used that right. 17% of people received only 100 strips and 17% - only 50 strips, 14% did not get them at all. 10% indicated that they did not know about such rights, 6% did not get prescriptions from doctors, 12% did not check blood at home, 17% indicated that a doctor did not give a prescription because a person did not have a meter or diagnostic strips did not fit the device.
     Answers about education on disease control indicated that 41% mentioned polyclinics, 57% - hospitals, 32% - diabetes centers, 32% - clubs, 7% - summer camps.
     Glucose checked only in polyclinics by 29% of people. Those who do it at home make 12-17% 1-2 times and 10% 2-3 times/day.
     50% of those who filled in questionnaire used the advantage provided by Lithuanian Diabetes Association to get glucometers, 31% brought it from doctors, 5% had won in the lotteries organized by clubs, 2% got as a present.
     58% of people got treatment in sanatorium. Those who did not indicated the following reasons: 16% did not want, 12% did not have a possibility to go, 20% were not sent.
     9% did not receive a compensation for dietary nutrition.
     Questionnaires were filled in by 24% employers, 44% pensioners, 14% students, 10% unemployed, 4% were handicapped of the I degree, 60% of the II degree, 16% of the III degree and 20% handicapped from childhood.
     From all the members of respondents 85% are handicapped people.
     64% indicated having eye diseases, 49% foot complications, 29% - kidney, 44% - heart diseases. 24% experienced all four complications.
     58% of respondents consulted regarding diabetes a medical nurse-educator, 39% - a podiatrician, 19% - psychologist, 83% - eye specialist, 41% - neuropathologist.
     53% had treatment in the hospital, hospitalization duration at the average was 18 days.
     95% of respondents subscribe to the newspaper "Diabetes", 83% belong to the Lithuanian Diabetes Association's members. 30% of non-members indicated that there are no clubs in the district, 20% are living far from regional center.
     Questionnaire was filled in by people of 8-78 years. Average of the age 49 years. Up to 35 years only 15% answered a questionnaire. 76% wrote suggestions, expressed their oppinion about activities of LDA, a newspaper "Diabetes".
     Majority of people in the countryside suggested to provide a possibility to get insulin, pills and strips from general practioners and sending to sanatorium from polyclinic. A lot of people rejoiced about the newspaper "Diabetes" where they can find important information as well as Association where they always get advice and are listened to.
     There was a wish to establish clubs in Telsiai, Kretinga, Sirvintai. Specialists are invited to come more often as well as representatives from the Association. There is a lack of information in polyclinics6 people had to stand in long queues at the room of endocrinologists.

Diabetes complications
     This article is prepared following foreign press.

Page 21
Let's plan camly family composition

     The article is prepared following foreign press.

Pages 22-24
     There is broad information from different foreign companies about self-control devices, food sweeteners.