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Newspaper Diabetas
The newspaper of the Lithuanian Diabetes Association
No 1 (37) February 10, 2003

Eli Lilly - the general sponsor.
Abbott Medisense, Berlin-Chemie / Menarini Pharma group, Canderel, Interlux, Limeta, representatives of Roche Diagnostics CSC "Eksmos MTC", Novo Nordisk, Wörwag Pharma GmbH&Co KG support the newspaper.


Page 1

Let’s share our care and love

Bishop Juozas Tunaitis shares his thoughts about the yearly World Diabetes Day on 14 November. The society gets especial care and much information on that day. Every year on 14 November special Mass is scarified in Vilnius cathedral. This year a pray was co-operated with a noble action of Lithuanian Diabetes Association. The participants of Mass were invited to conduct a level of glucose in their blood. Suffering and death is a necessary part of our life. But love can help greatly in this. Thanks to doctors and all workers in health care area. They carefully do this work of intimate love.

 

Page 2

LDA Is the Member of International Diabetes Federation.

The information about LDA working hours is provided. Attention! The address of LDA is changed: Gedimino av. 28/2, 404 room, LT-2600 Vilnius. Tel. +370 5 2620783, fax +370 5 2610639.

 

Page 3

Have you been suffered from medicine limits?

About 2% of readership answered questions of questionnaire published in Diabetes No. 4(36). 48 % of them live in districts or villages and 52% live in cities. 70% of people with diabetes use insulin, 6% use insulin and tablets, 24% use only tablets. 33% of them suffer from 2 or 3 contiguous illnesses or diabetes complications, 45% suffer from 3 or even 5 illnesses, 15% - more than 5, others have at least 1 contiguous illness. To the question “Who prescribes medicine for people with diabetes?” most of respondents said, that therapeutist prescribes, endocrinologist prescribes medicine for 45% of respondents, cardiologist - to 9% of respondents, neurologist – to 9% and oculist to 30% of respondents. Even 21% of respondents refereed to the fact that doctors do not prescribe all the medicine they need any more. 12% of respondents said they lack prescribed medicine even for a month, thus 75% take medical advice once a month, 19% - twice a month, 3% - three times per month or even more. To get a necessary medical advice 45% of people with diabetes need to register themselves 1 – 3 days before a visit, 33% - 1 or 2 weeks before, 22% - 1 or 2 months before or even earlier. 85% of people need to pay in addition for compensated medicine. Extra pay is from 4 Lt to 210 Lt, thus 30% of people pays in addition 20 – 100 Lt, 6% pay in addition even more. Only 80% of people with diabetes who use insulin and dues 150 diagnostically sticks obtained all of them. 11% received only 100 sticks, 9% did not received any of them. To get a medical care people need to travel from 10 to 36 km. People pay to 30 Lt for travel to doctor and waste from 1 to 9 hours. 64% of respondents have invalidity. 95% of them have invalidity because of diabetes complications. About 30% of people bribe doctors. Other troubles were pointed out. Most of respondents torment in rows near doctors’ cabinets. Some people were deteriorated because medicine was changed to cheaper. People have trouble with getting endocrinologist and other specialists. Some people get their compensated medicine only after 3 or 4 days after presenting a prescription. Doctors do not prescribe medicine for some illnesses and even insulin and their reason is medicine limits. The most of readership do not have possibility to pay in addition for a medicine, so they do not buy it. Thus they do not use medicine for some days or diminish a dose. That’s way the health deteriorates constantly. People ask for such things:

¨       Doctors must be permitted to prescribe all necessary compensated medicine as in diabetes case as in other illnesses cases.

¨       The number of compensated diagnostically sticks conducting blood glucose must be increased.

¨       People with diabetes and other chronic illnesses must be permitted to access endocrinologists and other specialists directly and not to suffer in rows near therapeutists’ cabinets only because of sending.

¨       People with diabetes and other chronic illnesses must get sending to health repairing healing or rehabilitation from clinic without additional hospitalisation.

¨       Medicine for people with diabetes and other chronic illnesses must be prescribed for time span till 3 months.

¨       If in-patient department lack particular medicine, patient must get prescription for this medicine.

So this questionnaire showed that joy of Health care ministry and officers’ of State patients’ fund for improving situation and balanced budget is unreal.

 

Newspaper “Diabetes”

LDA reminds of subscribing “Diabetes” for IV quarter.

 

Page 4

Significant celebrations of World Diabetes Day

Prepared by the president of LDA Vida Augustiniene according to “Newsletter IDF-Europe No.1”, 2002 December.

 

New victories

The president of LDA Vida Augustiniene greets a member of diabetes organisation Vidmantas Pilibaitis from Rokiskis who wined new sport victories in 2002. Sportsman thanks to sponsors for support.

 

Pages 5 – 10

Celebrations of World Diabetes Day

Lithuanian Diabetes Association

World Diabetes Day was celebrated in all countries of International Diabetes Federation members. IDF prepared much information on this topic and sended it to all members. Lithuanian Diabetes Association prepared this material in Lithuanian and delivered it to collective members of LDA, that was clubs, communities. An information was published in the newspaper “Diabetes”. On that occasion corresponding information was published not only in newspapers “Lietuvos rytas”, “Respublika” and “Kauno diena”, but in many local newspapers as well. LNK, LTV, Lithuanian radio and other radio stations transmitted occasional coverage.

LDA prepared and delivered information on these topics:

¨       Letter from IDF president Prof. Sir George Alberti;

¨       Message from the World Health Organisation for World Diabetes Day;

¨       Your Eyes and Diabetes: facts and  figures. Did You know that…;

¨       Quiz  “How much do you know about diabetic eye complications?”

¨       Quiz “Multiple Choise on diabetes & eye complications, healthy eating and exercise”

¨       Project EyeCheck: Easily-accessible eye examinations from the optician ‘around the corner’ (Holland);

¨       Your Guide to Your Eyes and Diabetes. Don’t lose sight of the risks.

¨       Booklet “Diabetes. Know about a danger”

¨       Booklet “14 November – World Diabetes Day”

Council for the Affairs of Disabled at the Government of Lithuania was the general sponsor of World Diabetes Day in LDA. JSC “Abovita”, Eksmos MTC, Interlux, Limeta, Medisana and others also supported a celebration.

During the celebrations not only an information about spreading illness was delivered, but prophylactic tests of blood glucose were conducted as well. An information from 37 local clubs was obtained. Total number of tests 8254. 1481 of them were conducted for people with diabetes and 6783 were prophylactic. The results are not joyful. Even 606 (40%) people with diabetes do not control an illness and 1208 (17.8%) people tested prophylactic have not normal level of blood glucose. All of them were suggested to appeal to their doctors and find out if they have not diabetes as soon as possible. 71.5% of people with high level of glucose are under 40, 59% of them have overweight, 16% have relatives with diabetes.

Unfortunately, some clubs did not filled all questionnaires and over 700 results did not get into this account.

LDA is happy for chiefs of clubs who worked sincerely with organising and conducting blood glucose as well as for doctors, nurses and sponsors. Siauliai, LDA, Marijampole, Radviliskis, Vilnius “Dia”, Skuodas, Vilkaviskis, Elektrenai, Druskininkai, Panevezys, Mazeikiai, Klaipeda, Utena, Alytus clubs conducted the biggest number of blood glucose tests.

Bishop J.Tunaitis scarified Mass in Vilnius cathedral for all members of LDA, all people with diabetes, their doctors and nurses. Bishop said this was the first time in the history of Lithuanian church when people could check their health congruous with Mass. LDA acted this noble mission. Local members of LDA helped as well.

Druskininkai

Druskininkai diabetes club “Atgaja” celebrated World Diabetes day along with four-year jubilee. The chief of the club Jelena Simoniene presented an activity of club very inventively. Jelena Simoniene is a member of Druskininkai Council of local government observers.

Jonava

Over 1000 people in Jonava are supposed to have diabetes. Diabetes club “Ramune” unites over 80 people at the moment. Members of the club were happy to have an opportunity to communicate and share their experience. They thanked to their chief Jonas Laiva for that celebration.

Kelme

The chief of Kelme diabetes club Larisa Rarovskaja was happy to find that number of members did not diminished this year and they can begin a celebration without a minute of silence.

Klaipeda

Diabetes club “CD” helped to fund children’s diabetes club “Smalsuciai”. World Diabetes Day in 2002 was organised by this club. Actions of health checking were conducted in market different places.

Mazeikiai

Mazeikiai diabetes club “Zemaiciu speka” co-operates with other patients’ organisations. On World Diabetes Day they were happy for Mazeikiai health coalition funded this year.

Palanga

During 22 – 23 November scientific and practical conference “Urgent question of diabetology” took place.

Radviliskis

Local health community supported prophylactic blood glucose tests for people. Members of diabetes club “Likimas” discussed results with local chief doctor.

Skuodas

Skuodas club “Diabetes” was funded 1990. The chief of club Vincas Dauginis thanks to “Abovita” for a great gift – 33 devices for blood glucose checking and is pity that not every person with diabetes wants to participate in the activity of the club.

Siauliai

The chief of diabetes club “Lemtis” Laima Mikaliuniene is sure that their activity is very useful for inhabitants of Siauliai. Last month over 300 people apply to the club to find out if they have not diabetes. Let’s save a light of eyesight, because most often we think of it only after we lose it, that was the thought of World Diabetes Day.

Silale

People in Silale are not indifferent to their health and participate in activity of the club.

Silute

Members of Silute diabetes club reviewed ten-year activity. Children from children garden “Zvaigzdute” wished to participants happiness and never to ill.

Taurage

Market of handicrafts took part along with World Diabetes Day celebration.

Varena

People during a celebration wrote a letter to members of Parliament (Seimas) asking not to take from them compensations for diet nutrition.

Vilkaviskis

During celebration of World Diabetes Day winners of questionnaire “What do you know about diabetes complications?” were awarded.

 

Page 7

An advertisement on self-control devices Gluco Care by AB Limeta.

 

Page 10

World Diabetes Day

Information about results of blood tests by LDA

In year

Number of people who tested their blood glucose

Number of people with rather high glucose level

%

Number of clubs, which sent data

1993

1943

100

5.1

20

1994

1272

80

6.0

9

1995

3249

295

9.0

31

1996

2880

369

13.0

24

1997

2387

186

8.0

27

1998

1829

130

7.1

20

1999

4813

551

11.4

28

2000

3864

434

11.2

26

2001

4656

996

17.7

31

2002

6883

1208

17.8

37

 

These people who were found with high levels of glucose, were suggested to undergo a proper health examination. Data of such test have been presented to the Ministry of Health.

 

Page 11

An advertisement on self-control devices Super Glucocard II by Interlux.

 

Diabetes – inflammatory illness

An article prepared by associate professor Algimantas Simkus according to Great Britain journal “Practical Diabetes International”.

In Lithuania discussions about diabetes as inflammatory illness began much earlier, even in 1980. Inflammatory origin is the week side of diabetes. We can force this aggressive illness to get back only by healing inflammation produced by bacterium. Insulin and tablets are only the means of patients’ maintenance.

We plan to deliver an information about inflammatory aspects of diabetes and new methods of healing diabetes in our newspaper systematically.

 

Page 12

Health passport “DIABETES”

LDA started spreading health passport for members of diabetes clubs. An example of filling in the passport is presented.

 

Page 13

Chronicle of the Lithuanian Diabetes Association

·         On 6 November 2002, Health Minister R. K. Dobrovolskis and member of Seimas I. Degutiene discussed about health reform during LNK TV broadcast. 10 members of Lithuanian Council of representatives of Patients’ organisations and the president of LDA Vida Augustiniene participated in the discussion.

·         On 8 November the president of LDA congratulated participants of World Diabetes Day celebration in Joniskis.

·         On 9 November V.Augustiniene, Prof. J.Danilevicius and the secretary of LDA J.Dainaraviciene spoke in the celebration of World Diabetes Day and four-year jubilee in Druskininkai.

·         On 11 November V.Augustiniene, J.Dainaraviciene, members of LDA council L.Vitkauskiene and S.Narkunas delivered an information to participants of World Diabetes Day celebration in Jonava.

·         On 12 November Vilnius diabetes club “Beta” invited the representatives of LDA V.Augustiniene, J.Dainaraviciene and Dr. E.Rudinskiene to World Diabetes Day celebration.

·         On 12 November the president of LDA presented information about insidious illness in the radio broadcast assigned to World Diabetes Day.

·         On 13 November V.Augustiniene spoke during the First program of Lithuanian State Radio.

·         On 13 November mass assigned to people with diabetes, their doctors and nurses was scarified in Vilnius cathedral. According to bishop J.Tunaitis, it was the first time when people could check their health in the church. LDA initiated blood glucose tests. Nurses J.Uleckiene and G.Mereskeviciute conducted tests.

·         On 14 November the president of LDA spoke during the Second programme of Lithuanian State Radio.

World Diabetes Day celebrations took part in many districts of Lithuania.

·         On 15 November the representatives of LDA V.Augustiniene, E.Rudinskiene, the member of Parliament A.Rimas and officers of local government took part in the celebration of Mariampole diabetes club.

·         On 21 November V.Augustiniene met children from Klaipeda and their parents. World Diabetes Day and one-year jubilee of children diabetes club were celebrated.

·         During 22 – 23 November V.Augustiniene told about an activity of Lithuanian Diabetes Association in the conference “Urgent questions of diabetology”, organized by Society of doctors endocrinologists

·         On 26 November during the meeting of Lithuanian Council of representatives of patients’ organisations the candidature of the president of LDA was offered to the position of special expert in Health committee of Seimas. On 13 January 2003 candidature was confirmed in Seimas.

·         On 27 November the renewal meeting of Kaisiadorys diabetes club took part.

·         On 29 November V.Augustiniene delivered a report in the conference “Health reform: ways and mistakes” of Mazeikiai coalition of health organisations.

·         On 3 December the problems of people with different illnesses were discussed during the meeting with the members of Lithuanian Seimas I. Degutiene and R. Alekna. The members of the Lithuanian Council of representatives of Patients’ organisations V.Augustiniene and D.Kasubiene took part in the discussion.

·         On 5 December Mrs. Lilly Karn and the member of Viesbaden Lion’s club Schirmer Christa visited Lithuanian Diabetes Association. Quests met children from Vilnius diabetes club “Diabite Plius” and their parents. 1000 EUR were gifted to LDA for buying glucose diagnostic sticks to children.

·         On 6 December the president of LDA participated in the meeting with candidates to Lithuania President in Santariskes clinics.

·         On 9 December V.Augustiniene and J.Simoniene discussed with doctors of KMU children clinics about co-operation organising educational camps for children with diabetes.

·         On 12 December V.Augustiniene reported her speech about diabetes, its’ complications and efforts to co-operate with medicine stores improving situation. The speech was delivered during the conference in the Kaunas College, the centre of medicine and social studies.

·         On 13 December the president of LDA was interviewed by “News’ radio” about patients’ problems.

·         On 14 December V.Augustiniene met the members of Kaisiadorys diabetes club.

·         On 14 December Vilnius diabetes club “Dia” celebrated 15-year jubilee.

·         On 16 December during the meeting of the Lithuanian Council of representatives of Patients’ Organisations suggestions about health reform improvement were discussed.

·         On 17 December the meeting of State diabetes program committee took place in Health ministry.

·         During 17 – 18 December V.Augustiniene shared her experience about healthy nutrition with diet students in Vilnius College.

·         On 19 December doctor E.Rudinskiene and V.Augustiniene met the members of Skuodas diabetes club.

·         On 20 December the president of LDA participated in the Forum of non governmental organisations in Vilnius.

·         On 23 December V.Augustiniene, D.Andriuliene, D.Kasubiene, L.Bartkeviciene, I.Juknys, M.Chmeliauskiene, U.Sakuniene,O.Telyceniene, E.Kvedaraite met the President of Lithuania Valdas Adamkus. The troubles of health reform were discussed and the suggestions for improving situation were reported. The decision about the meeting of Health ministry and representatives of Patients’ organisations in the nearest time was determined.

·         On 17 January the work group of State diabetes programme met in KMU clinic of endocrinology.

·         On 22 January during the meeting of LDA council an activity of 2002 was evaluated and the work plan for 2003 was confirmed.

 

Page 14

We still wanted to be together

Lithuanian Diabetes Association mourns for a loss. On 9 January 2003 an illness cut Dr. Antanas Vytautas Stepanas’ life. He was prominent personality and shared his experience with LDA. He visited Lithuania once a 2 year and when could not communicated by letters. Let stay him in our memories.

 

Page 15

Advertisement on substitute of sugars Canderel.

 

Pages 15 – 16

Child care in a family

Prepared by Dr. Egle Jakimaviciene according to foreign press.

 

Pages 17 – 18

An appeal

To the President of Lithuania Valdas Adamkus

We turn your attention to the rising disappointment by people with different illnesses because of hurried health system decisions by institutions of the Government. We save money instead of people health. We define suggestions about necessary means which are urgent in our opinion in this situation:

1.       Prevention

1.1.             It is necessary to improve prophylactic and ambulance medicine. It is necessary to acquire contemporary diagnostic tools in state medical institutions as far as private are not accessible for most of patients.

1.2.             It is important to improve good and accessible diagnostic of early stages of chronic illnesses. After limits for compensated medicine were established new facts of illnesses are avoided to diagnose.

1.3.             Avoiding amputations and other complications the valuations for nurses diabetologists and foot care specialists posts must be established. Cabinets of diabetes education and foot care in local clinics must be renewed or funded.

2.       Compensation of medicine and health care services

2.1.             After the order of Health Minister No. 85 due to limits of compensations of health care services and medicine was confirmed, qualified and effective healing is no more accessible to patients:

a)       The medicine is changed by other cheaper and even having other effect uses.

b)       The quantity of compensated medicine is limited. If two sorts of medicine is prescribed other sorts of medicine are offered for money.

c)       People are sent from one doctor to other.

d)       To obtain a specialist at a time is impossible.

2.2.             We offer to keep maximal compensation of medicine for people with mortally dangerous illnesses and aim contemporary medicine. The increasing of money for patients’ hospitalisation and social compensation would be avoided in such a way.

2.3.             We offer gradually to include medicine of new generation for hard illnesses which medicine was not compensated till now.

2.4.             Maintenance with necessary medicine must be quarantined for people with chronic illnesses.

2.5.             Medicine for people with chronic illnesses must be compensated 100% and not after complications arise.

2.6.             A social research must be conducted to find out patients’ possibility to pay additionally for a medicine.

2.7.             A possibility for patients with hard chronic illnesses must be found to get prescriptions for illness and complication medicine from specialist and not to go from one doctor to another.

2.8.             Doctors must be able to prescribe medicine for a time span till 3 months if a state of patients is stable. Thus the rows near doctors’ cabinets would be diminished and doctors could spend more time consulting patients.

2.9.             The possibility to prescribe medicine that is lacked in-patient clinics must be found for patients.

2.10.          Indications for rehabilitation and health repairing healing must be broadened for patients with chronic illnesses. The possibility of rehabilitation without hospitalisation must be discussed.

2.11.          We should renew and use old net of sanatorium and work of specialists in the first place. Only after this we should fund expensive new rehabilitation centres near medical institutions.

2.12.          It is necessary to fund specialised hospitals and warship institutions in the communities for people who can not live at home because of their physical, psychological or social disability.

2.13.          The partial compensation of stomatology services in private cabinets must be confirmed. People must have a possibility only to pay additionally for more expensive services.

2.14.          In the order of Lithuania Health order’s change is stated, that basic price of compensated medicine must be calculated from producers’ price that must be lower than lowest price in European countries or excel it in 5 %.The danger of confirming this order is that accessibility of medicine can decrease because a part of medicine will disappear from Lithuanian market or patient will have to pay huge additional prices.

3. The participation of representatives of Patients’ organisations in health system decisions

3.1.             Change the lows of National council of health and to involve into council a representative of Patients’ organisations.

3.2.             The representatives of Lithuanian Patients’ Organisations must have a possibility to participate in the meetings of Committee of compensated medicine with a voice of advice.

3.3.             The representatives of Patients’ organisations must have a possibility to declare their opinion about urgent patients’ questions during the meetings of the Council of obligatory health insurance.

3.4.             Strategic questions of health care must be discussed according to separate illnesses but in complex while all sides in interest are participating.

3.5.             The low of obligatory health insurance states that the Council of obligatory health insurance is advisory institution. We offer not to confirm this statement the other way the usage of health insurance fund depends on one person and the control of this usage is lost.

3.6.             Health politics must be bright and officers must not collectively but directly be responsible for harmful decisions.

3.7.             Not only maintenance of life, but improvement of life quality must be took into account in decision making.

3.8.             The Council of representatives of Lithuania Patients’ organisations must be equivalent partner in health decision making.

The problems of patients and their suggestions were discussed and confirmed during the meeting of the Lithuanian Council of representatives of patients’ organisations in Vilnius, 16 December 2002. The council unites representatives of 14 different illness organisations.

 

Page 19

Advertisement on insulin injectors Lilly.

 

Page 20

Christmas of “Diabite Plius”

After traditional trip in 2002 members of “Dia - Bite” noticed that many of them grew up. They did not want to separate, so decided to reorganise a club into Vilnius children and youth’ diabetes club “Diabite Plius”. At the end of December this club traditionally celebrated Christmas, met Santa Clause.

 

We seek for knowledge about healthy nutrition

The chief of Radviliskis diabetes club “Likimas” Jeronimas Dambrauskas tells about meeting with representatives of “Korys” laboratory.

 

Page 21

Advertisement on self-control devices Accu-Chek Active by Eksmos MTC.

 

Pages 21 – 22

Valuation of organisation’s activity

The readerships of a newspaper are invited to answer the questions. Your answers will help us to evaluate the activity of LDA in Lithuania areas.

 

Page 22

Advertisement on vitamins Diabetiker by Worwag Pharma GmbH& Co.

 

Page 23

Eyes and diabetes

The answers to quiz published in “Diabetes” No. 4 (36) are provided.

 

Pages 24 – 25

Inform others about yourself

KMU Endocrinology Institute Dr. Rytas Ostrauskas presents information about diabetes. He asks all people with diabetes fill in the questionnaire published in the page 24. It will help scientists to evaluate the real state of patients in our country better. Personal data you provide are important only to scientific evaluation of diabetes situation in Lithuania and they are not passed on to any other organisation. We offer you to keep your personal secrets as well as Lithuanian lows do.

 

Page 25

Advertisement on injector FlexPen by Novo Nordisk.

 

Page 26 – 27

News from a conference of EASD

An information of 2002 from EASD is provided.

 

Page 28

Advertisement on medicine by Berlin-chemie Menarini Group.

 

Advertisement on self-control devices by MediSense.