The newspaper of the Lithuanian Diabetes Association
No 4 (40) November 10, 2003

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

Page 1

Diabetes and Kidney Disease: Time to Act

Diabetes is epidemic illness. There were 30 million people with diabetes in 1985, and there are 190 million people who suffer because of this illness at the moment. If the way for this epidemic is not restricted there will be about 330 million people with diabetes in 2025. The 14 of November is The World Diabetes Day. The topic of this day this year is “Diabetes and Kidney Disorders. It is time to take care”. Untreated diabetes can raise hard complications, such as kidney disorders, eyes disorders, nerves disorders or heart disorders. Diabetes is still untreatable but gives way to controlling it. People with diabetes can be capable of working, creative and obey complications while the illness is diagnosed at time; the medicine is used and adjusted to healthy living. Complications of diabetes, such as blindness, kidney disease or heart disease, are a big bother for institutions of heath care. It is supposed to use about 5 – 10 % of national health budget to control diabetes.

More attention to diabetic kidney disease could help avoid insufficiency of kidney activity. Primary and secondary links of diabetes and diabetic kidneys disease prophylactics should be thoroughly discussed in National program. Organized companies for education could incorporate in this activity. Most people with diabetes know nothing about thread of diabetic kidneys complication. Not everyone with this complication is acquainted with insufficiency of kidneys activity. Still, people must become acquainted with the factors of risk for that hard complication. Tools restricting progress of illness must be used.

The ways to diminish risk of kidney disease are: often control of blood glucose, observing and correction of blood pressing, diminished usage of albumens, refusing of harmful habits, such as smoking and alcohol, treating infections of ureters, if the albumens were find in urine, the research should be conducted every year.

The information by International Diabetes Federation was prepared by Dr. Egle Rudinskiene.

Page 2

LDA Is the Member of International Diabetes Federation.

The information about LDA is provided. The usefulness of being the member of LDA is stressed. The information about Diabetes school in LDA is provided. Attention, please, the working hours of Diabetes school is changed. Dr Egle Rudinskiene consults and educates people with diabetes in the office of LDA in Vilnius.

Page 3

Presents from the Life

“Many times I did things other wanted and refused my own desires. (…) That’s way I want to tell about it. I hope to be heard. If you find something useful I’ll be happy to give back a part of my debt for people who loved me, consoled me and did not abandon.” Those are words by Vida Augustiniene, the author of a book “Presents of the Life”. After reading this book you can be enriched with the new thoughts. The book is in sale at all bookshops of Lithuania.

Newspaper “Diabetes”

LDA reminds of subscribing “Diabetes” for 2004 year.

Page 8

14 November – World Diabetes Day

Lithuanian Diabetes Association invites Vilnius citizens to a conference for World Diabetes Day. You can check your blood glucose, acquire a literature, prescribe a newspaper “Diabetes”, meet the representatives of Vilnius diabetes clubs “Beta”, “Diabite plius”, “Dia” during the conference. The time-table and other information of the conference is provided.

Page 9

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

“Nephrology: from expensive haemodialysis to “golden” transplantation

According to Prof. V.Kuzminskis, there are about 800 – 900 people with the haemodialysis need in Lithuania at the moment. About 16 – 17 % of them die every year. There are about 400 people after kidney transplantation in Lithuania. More than 35 thousand of people in Lithuania suffer from different kidney disease. About 270 people wait for kidney transplantation. The price for haemodialysis in Lithuania is 280 Lt. 100 people with diabetes get this procedure. Thus Lithuania pays about 3.8 Lt for this treatment yearly.

The article was prepared by Dr. E.Rudinskiene according to publication in “Gydymo menas”, 2002. No 9.

Page 10

Summer in Druskininkai

Dr. Egle Jakimaviciene tells about her work in a diabetes camp “Dainava” this summer. The blood glucose was conducted at least 4 times per day. Changes in indexes and correction were discussed individually. Filled questionnaires showed lack of children’s knowledge. The most often topic children did not understand was the span of short acting insulin. All mistakes were discussed. While leaving a camp children answered to 98 % of question properly. Their knowledge increased in 9 %.

Thanks!

Gryta from Pasvalys is thankful for ability to participate in a camp in Druskininkai. She is happy for new friends and knowledge.

Page 11

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

Unforgettable days in a camp

Gintare from Anyksciai shares her impressions from a camp in Druskininkai. She says that it was her first time in such a camp, but still she felt like spending a time with a family.

We played and went in for sports

Mindaugas Briedis hopes to return back to Druskininkai next year. The most impressive for him were sport competitions and well organized free time.

Page 12

Diagram. The evaluation of diabetes control knowledge of children participated in diabetes educational camps in 2003

According to diagram, children increased their knowledge by 10 % in Veisiejai camp, 9 % in Druskininkai camp and 21 % in Plateliai camp.

Pages 12 - 13

Children still writing

Nijole Voveraitiene cities the thanks letters from children participated in diabetes educational camps.

Page 14

The way I come to an agreement with my illness

Diabetes is an illness till the end of my life. I know that I can’t get rid of it, that’s way the only way is to come to an agreement with it.

I am 64 years old. I have diabetes for three years or even more. There were 10 – 12 mmol/l of glucose in my blood in the mornings. The smallest wound used to suppurate and did not get well for months. Tablets “Diaprel” prescribed by doctors did not help either. I got 4 of them per day. I was shocked by the illness.

One day I began to visit a diabetes club “Atgaja”. After all literature I got there was studied and the communication with the members of the club was established, the hope appeared.

There are enough literature and articles about nutrition. Still, the way to adjust illness and physical activity is presented only in common phrases. That’s why I want to share my thoughts on this topic. Until now it happens to meet confused and upset patients in health care institutions. They do not know what to do and where to start. My way was confirmed practically, simple and accessible for everyone.

It is very important to check blood glucose often. There are individual glucose measures achievable in diabetes clubs on favorable terms. The tests of HbA1c are necessary as well. They show an average glucose index during last 3 months. It is pity to notice that only 25 % of members of the club do these tests. It is possible for others to know nothing about them at all. Most people with II type diabetes are satisfied with glucose control once per month during visit to clinics and prescribing medicine. There no talks about positive result in that case. The changes in glucose are constant, especially after meal and physical activity. If patient does not know that, he does not control his illness.

For the sake of clearness I present some numbers from my diary:

11 August, 2001, 1.5 hours after lunch. Blood glucose 9.7 mmol/l. After 0.5 hour biking 7 km – 6.7 mmol/l.

6 April, 2002, 2 hours after breakfast I was lazy to move – 10.7 mmol/l. After 0.5 hour biking – 7 mmol/l etc.

That’s the way I learned to come to an agreement with my illness. The result – such a dynamic of HbA1c:

2001 April: HbA1C 9% or 11.6 mmol/l – bad.

2001 November: HbA1C 7.7% or 9.5 mmol/l – satisfied.

2002 March: HbA1C 5.3% or 5.4 mmol/l – normal.

2003 August: HbA1C 4.4% or less than 4 mmol/l – normal.

After regulation of nutrition was established and physical activity was intensified, fat index decreased from 6.3 mmol/l to 4.6 mmol/l (norm is < 5.2). I lost 13 kg, body mass index decreased from 27 to 23 (norm is < 25).

How I achieved that? For the first I bought a bike, because loved it in my youth. My norm of the day was 15 – 25 km. The first results appeared. I lost the weight, though the weight did not decrease during the first months. I suppose, the muscles were strengthened. I walked much during bad days. My weight began decrease constantly (till 1 kg per month). At first I walked when all others came to bed, because after checking the blood at night the result was 9 – 10 mmol/l.

I write a diary constantly. It helps me fix what I eat, how many I move, what are results of blood glucose. I move definitely after eating. I feel no discomfort while living in such a way. The health became better and I felt the joy of sport. At the moment I can eat almost everything. I eat moderately, of course, but I do not dream eat at night. I can guess the blood glucose index even without control. I use 1 tablet “Diaprel” per day, and even refuse it when have big physical charge.

That’s why I say, that everything depends on us. We must only want to be healthy. That’s my with for everyone.

Albinas Pilypas, Druskininkai.

Pages 15 - 16

An advertisement on medicine Diabetiker-VitamineI by Worwag Pharma.

Chronicle of the Lithuanian Diabetes Association

·         During 9-10 August 2003 Mariampole diabetes club “Diabetikas ABC” (chief Genovaite Naidzinaviciene) organized a seminar-practicum in Jurgezeriai. Marijampole, Sakiai and Vilkaviskis diabetes organisations took part in it. The main sponsor was the Council for the Affairs of Disabled at the Government of Lithuania. During 8-12 August LDA organized a diabetes educational camp for people with II type diabetes in Vilnius sanatoria “Pusyno kelias” for the first time. The main sponsor was the Council for the Affairs of Disabled at the Government of Lithuania.

·          During 16-25 August the V diabetes camp for children and youths took place in Plateliai. 23 participants took part in it. The nurse dialectologist of Plunge diabetes club was the chief of the camp.

·         During 21-23 August the chief editor of the newspaper “Diabetes” Vida Augustiniene delivered a speech and managed a workshop “CIS&Eastern Countries:achievements and challenges” in France, Versalis, during the Conference of International Committee of Diabetes Magazines (ICDM). Along with Sharley Murray from Australia she was collected to be co-convenors of the ICDM Steering Committee.

·         During 24-29 August Vida Augustiniene together with Linda Cann  from the American Diabetes Association managed a discussion of round table “The role for improving health care of National diabetes associations” in Paris IDF congress. Vida Augustiniene delivered a speech about an activity of Lithuanian Diabetes Association.the President of LDA was elected to be the member of Europe Region Board of IDF. The delegates of LDA Genovaite Naidzinaviciene and Jelena Simoniene took part in the congress as well. IDF, Eli Lilly and Aventis Pharma International S.A. supported the participants.

·         On 26 August the Minister of Health invited the representatives of the Council of representatives of Lithuanian Patients’ Organizations to discuss on a new list of compensated medicine.

·         On 3 September Council of Representatives of Lithuanian Patients’ Organizations together with Lithuanian Medics’ Union posted writing about offerings for diagnosing invalidity to a Ministry of Social Security and Labour.

·         On 4 September the chief of Council of Representatives of Lithuanian Patients’ Organizations (CRLPO) and the President of LDA discussed on the questions of co-operation with the chief of National Institution of Protection Consumers’ Rights at LR Ministry of Justice.

·         On 9 September the member of CRLPO Gintaras Mazintas took part in the seminar “A modern importance of social health public relations improving children’s health” in Seimas.

·         On 9 September the meeting of CRLPO took place. The topic of health care services’ quality was discussed.

·         On 10 September Vida Augustiniene took part in the meeting of LR Seimas Committee for health matters. The price list of compensated medicine was discussed.

·         On 11 September LDA posted writing about enlisting medicine “Tiochtacid” into a list of compensated medicine. The writing was addressed to Health Ministry, Pharmacy department and State Patients’ Fund.

·         On 15 September during a Health Ministry seminar Vida Augustiniene delivered a speech “Patients’ problems due to the quality of health care services”.

·         On 16 September the representatives of CRLPO met the chiefs of State Patients’ Fund and discussed urgent questions of patients.

·         On 16 September Vida Augustiniene talked about etiquette of medics’ work and the order of services in a broadcast of News Radio.

·         On 17 September the chiefs of Kaunas Grinius nursing hospital visited LDA. The questions of services and medicine compensations were discussed.

·         During 18-20 September the chief of LDA was invited to participate in EASD postgraduate  course to Kaunas.

·         On 23 September the project of Obligatory Health Insurance Fund budget was discussed during the sitting of Council of Obligatory Health Insurance.

·         During 24-26 September the representatives of CRLPO Vida Augustiniene, Egle Kvedaraite and Juozas Bulota took part in World Bank Conference “Technologies of medicine: important factors of health system”.

·         During 25-27 September LDA presented a stand and conducted prophylactic tests of blood glucose and cholesterol during the BaltMedica exposition in Litexpo expositions’ centre. Litexpo expositions’ centre, UAB Abovita, Eksmos MTC, Interlux, Limeta supported participation.

·         On 25 September and on 7, 22 and 29 October the sittings of Health Ministry took part. The topic was “The work groups for preparing a program of health care services quality insurance”. The chief of CRLPO Vida Augustiniene took part there.

·         On 26 September the chief of LDA took part in the conference “Let’s change our attitude. An attitude of society is a base of integration for invalids”.

·         On 26 September National Council of Health at LR Seimas invited the chief of CRLPO Vida Augustiniene to the conference “Technologies of medicine: important factors of health system”.

·         During 1-5 October the President of LDA delivered a speech “Patient’s Experiences and expextations on quality of care” during Europe Health Forum in Austria, Bad Gastein.

·         On 6 October the agreement “Due to co-operation between representatives of medicine producing companies and institutions of health care and medics” was signed in Health Ministry. The chief of CRLPO Vida Augustiniene signed it as well.

·         On 9 October during the sitting of CRLPO the questions of increased prepays to compensated medicine and the quality of health care services were discussed. An appeal to State institutions due to health care financing in 2004 State budget was confirmed.

·         On 9 October the chief of CRLPO answered the questions of journal “Pharmacy and time”.

·         On 10 October the President of LDA delivered a speech “The influence of LDA to the education of people with diabetes” during the Conference of Lithuanian Society of nurses dialectologists.

·         On 14 October the quality of health care services was discussed in Trakai. Vida Augustiniene took part in the seminar.

·         During 17-18 October the seminar for chiefs of collective members of LDA took place in Anyksciai. The tests of blood glucose, cholesterol and HbA1c were conducted to it’s participants as well as the support was passed. The main sponsor was the Council for the Affairs of Disabled at the Government of Lithuania. Other sponsors were Eli Lilly, Novo Nordisk, Abovita, Eksmos MTC, Limeta, Ruta, Anyksciu silelis. LDA and Anyksciai diabetes club “Ateitis” organized the seminar.

·         On 18 October Pagegiai diabetes club “Rambynas” became a collective member of Association during a sitting of Council of LDA. A plan of activity and financial questions were discussed. The information for World Diabetes Day passed to all collective members. “A program of volunteer education for advising people with diabetes” was discussed. The Program was prepared by ass. prof. Janina Edita Janulionyte from VU MF and Master Natalija Gagarina. The program was not confirmed.

·         On 24 October KMU organized the conference. The chief of CRLPO delivered a speech “Co-operation between medics and patients. Patients’ attitude”. The member of CRLPO Daiva Andriuliene delivered a speech “Co-operation between nurses and patients. Patients’ attitude”.

·         On 28 October National Council of Health at LR Seimas invited the representatives of CRLPO to participate in a round table discussion “The way better to maintain Lithuanians with compensated medicine and medical tools”.

·         On 30 October the representatives of LDA were invited to take part in a lecture “Psychological aspects of diabetes” in Low University, Faculty of Social work.

·         During 31 October – 6 November the President of LDA took part in the Meeting of Europe Region Board of IDF. She participated in events of the Europe Diabetes Week at the European Parliament and in the EU Working Group ,,Diabetes and Enlargement”. She made presentations “Diabetes in Baltic States” and ,,Improving Diabetes Care. Case study of a  ,,National Diabetes Programme”.

·         14 November – World Diabetes Day. The topic of 2003 year is “Diabetes and kidney disease: Time to act”.

Page 17

Advertisement on self-control devices HumaPenErgo e by Lilly.

Page 18

In the Congress of International Diabetes Federation

During 24 – 29 August the 18^th congress of International Diabetes Federation took place in Paris Palace of Congresses. Over 16 thousands of scientists, medics, people with diabetes and their family members, representatives of medicine industry took part in it. The President of IDF Congress 2003 Gerard Cathelineau delivered his speech during an opening of IDF Congress. The President of France Diabetes Federation M.Jean Merel was pity for still live facts of people with diabetes death. The vice-president of IDF Bjornar Allgot presented a real situation of self-control. The Vice-president of IDF Jean-Claude Mbanya was very pity, that after 80 years from founding insulin there still are countries were treating by insulin is not achieved. The continuation of this article is planed in “Diabetes” No 1 (41).

Page 19

Thanks for love

The member of Taurage diabetes club “Insula” Jovita Rudyte is thankful for possibility to rest in a camp in Druskininkai this year. She thanks to all supporters and organizers and sincerely hopes to come back there next year.

Joys of a camp

Sigita Pazemeckaite tells her impressions of resting in “Dainava” camp. She was not very exited with the idea to go there at first but still, after all vacation she hopes to meet her friends from Druskininkai again.

Advertisement on substitute of sugars Canderel.

Page 20

It is never too late to study

Vytautas Baltrusaitis from Marijampole gives a short summary about activity in the educational camp for people with II type diabetes.

In the sanatorium “Pusyno kelias”

The participants of educational camp for people with II type diabetes gives their warm impressions about use and friendship communicating with others. They are thankful to organizers and sponsors and look forward to other such possibilities.

Page 21

Advertisement on self-control devices by Eksmos MTC.

Livers of Mariampole united their neighbours

Diabetes club “Diabetikas ABC” executes obligations to St. Vincent Declaration. The chief of the club initiated a seminar “Together We are Stronger”. Members of other clubs participated in the seminar.

Page 22

House-warming in Pagegiai

Livers of Pagegiai founded diabetes club. Laima Juciene was elected as the chief of the club during the constituent assembly. The aim of the club is to unite people with diabetes, solve urgent questions, spend a free time. LDA wishes good luck and creativity.

Unforgettable routes by Taurage livers

Taurage diabetes club “Insula” is one of the most active organizations. The club organized the meeting with members of other clubs near the lake Plateliai. More than 100 people participated in the meeting.

Page 23

Enlivening of plans

Elena Siriuniene from Kursenai is happy for diabetes club to become more active. She is thankful to supporters who helped enlivening some old and necessary projects.

Advertisement on injector FlexPen by Novo Nordisk.

A club “Likimas” is spreading

The chief of Radviliskis diabetes club “Likimas” Jeronimas Dambrauskis stresses the necessity to create filial of the club in villages. He shares his experience working with people in distant places.

Page 24

Latvians visited Plunge

S.Urboniene from Plunge shares her impression about Latvians visit to their town. She tells that guests were impressed with the festival of their town and such a meeting was very useful.

The most important is to keep a hope

Janina Sarpaniene from Pakruojis Diabetes club “Vita” discuss on topic how important is to unit people with diabetes. It make them feel comfortable psychologically and share information.

Blood glucose tests during exposition BaltMedica

During 25 – 27 September LDA tested blood glucose for 538 people visiting exposition BaltMedica.

Page 25

Diabetes educational camp - the use for everyone

Diabetes educational camp for people with II type diabetes took place for the first time in Vilnius sanatorium “Pusyno kelias”. 16 persons with diabetes from different Lithuanian clubs took part in it. The chief of this camp was Juzefa Uleckiene. Nurse diabetologist Aldona Danyliene and Dr. Egle Rudinskiene helped her in this work. The main sponsor was  the Council for the Affairs of Disabled at the Government of Lithuania.   Other sponsors were Lithuanian Diabetes Association, Community of Nurses Diabetologists, sanatorium “Pusyno kelias”, Abovita, Eksmos MTC.

People rested and learned to control diabetes in the camp. Their knowledge and practical abilities to prevent complications were evaluated using questionnaires prepared by LDA and recommended by WHO. While evaluating the knowledge about diabetes, only 84 % of answered questions were positive and 16 % were wrong. While leaving 96 % of answers were correct. Thus all the campers increased their knowledge by 12% The results showed that the Government should know the reasons why education of people with diabetes is so important and why they need self control means.

Pages 26-27

Diabetes in Lithuania

Dr. Rytas Ostrauskas elucidates differences of I and II type diabetes. He presents a real situation of diabetes in Lithuania. The means of medicine and the statistics are provided. Dr. R.Ostrauskas presents a diagram with data about diabetes cases number diagnosed in Lithuanian health institutions from 1966 to 2002 year.

Advertisement on insulin pump Dana Diabecare II by UAB Abovita.

Page 28

Advertisement on medicine by Berlin-chemie Menarini Group.

Advertisement on self-control devices by MediSense.

Thanks

Julija Aleskeviciute and Dovile Esteryte thanks to the chief of Druskininkai diabetes club “Atgaja” for ability to rest in a camp.