The newspaper of the Lithuanian Diabetes Association
No 3 (43) August 10, 2004

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.

Pages 1 - 2

Who impoverishes the State?

Diabetes spreads in a threatening manner. The chronic and lasting all the life illness troubles children, workable age people. Rottenly it troubles aim seeking and embitters daily life.

Statistics is cruel. About 8700 people dye because diabetes every day in the world. ¾ of people with diabetes do not live longer than 35 years. Indexes of death rate because of diabetes are almost equal to HIV and Aids indexes. An epidemic is spreading according to geometrical progress: there were 30 million people with diabetes in 1985 in the world and 190 million in 2003. Supposedly in 2030 to have 366 people touched by this bother in the planet. Presented data is very inaccurate. An illness is not diagnosed for more than a half of patients and they are already injured by one of its complications.

People from developing countries are most often touched by this illness. ¼ of them are less than 44 years old and others are till 65, while more than a half of people with diabetes in developed countries are over 65 and only 8 percent of them are till 44.

As many other countries Lithuania does not have a National Diabetes Program. While elaborate strategy is absent, decisions are made elementally. That’s why some years ago started work of funding diabetic foot care and teaching cabinets was destroyed. The price for teaching and foot care services is not confirmed until now. Since 1997 the quantity of compensated diagnostic sticks for blood glucose tests is the same, tests of glycolic hemoglobin and microalbuminuria are not compensated at all. Things were worsted when patients were transferred to doctors of common practice. Endocrinologists and other health specialists became difficult to achieve. Number of invalidity cases is increasing. People do not get health repairing treatment. An additional payment for some kinds of insulin was confirmed recently. Lithuanian Diabetes Association constantly encourages politics and Government to discuss on strategic questions of diabetes prevention and treatment, since no budget is foreseen to prevention of this illness and its complications. Prescribing of compensated medicine and tests is limited. Representatives of Government do not consider the fact, that saving in expense of people’s health they impoverish all the State.

While filling piles of papers doctors do not have proper conditions and time for communication with patients. Medics are paid poorly and this fact does not initiate them.

State Patients’ Fund and Health Ministry do not present exact data about budgeting diabetes treatment to Lithuanian Diabetes Association and talks abstractly: “Diabetes eats the biggest part of health budget”. Lithuanian Diabetes Association cares for rational usage of State money to diabetes care, preventing complications, teaching patients and specialists. Only complex of self-control and prevention can save budget money.

People with diabetes suffer because different sight disorders already 15 years (2 percent of them blinds, 10 percent become invalids). Almost 1/3 of patients get nephropathy because of diabetes. 40 percent of people with diabetes since yearly age are bothered by different kidney illnesses over 50 and need even transplantation or dialysis. About 70 percent of patient suffers because of diabetic nephropathy. It is the main reason of men impotence. Nephropathy is the common reason of foot sores: even 50 percent of no traumatic foot amputations are made because of diabetes.

Good News

Scientists approved the fact that we can avoid diabetes complications or further them by maintaining blood glucoses, blood pressure and lipids as close to norms as possible. To seek this aim we must teach our patients to control their illness. The main tools for improving patients’ state are healthy diets and living physical activity and denying harmful habits. There is no need for expensive treatment and medicine to health care prevention. An example of cheap prophylactics is teaching of proper foot care. Health systems for optimal care must be created according to needs of patients. People cares for themselves, still they must know how to do it. The main factor for diminishing treating budget and increasing life quality is diabetes teaching.

What to do?

While the science of medicine is improving, probably we can avoid I type diabetes in the future. We must diminish a thread of II type diabetes already now. Changes of life style very often are more effective then medicine. Efforts of patients and society are necessary. Offering and low prices of healthy food can diminish the risk of illness in a very great manner. While eating fruits and vegetables 3-5 times per week, avoiding sugar and concentrated fat, body weight is diminishing as well as the thread of II type diabetes. About 60 percent of people in the world are immobile. According to scientists, daily middle level physical training (30 minutes) maintains good health as well as prevents II type diabetes. It was calculated that about a half of II type diabetes cases could be avoided by diminishing body weight. Most of patients have too high index of body mass. Diabetes and overweight is a problem for all the State and society.

A New Project

A new program “Diabetes action now” was presented in this spring by IDF and WHO. The aim of it was to encourage and support effective diabetes prevention and control projects in states with low and middle revenues.

During tree years propagation of diabetes knowledge and preventing complications are going to be made better. It is important to service providers as well as politics. A program is going to initiate those projects spreading new knowledge about illness and its’ influence for state economics. It is going to prepare reviews about health state and propagate contemporary achievements of science. A practice manual about content, structure and enlivening of diabetes programs is going to be prepared for politics. Information will be presented with the help of internet. In such way diabetes teachers will be able to achieve knowledge as well as advises of experts. The most important presentations are going to be published as separate publications.

Web sites

Much information on diabetes questions one can find in www.idf.org. Scientific reviews from Diabetes congresses and conferences’ work groups are presented; an activity of IDF committees participating in new program “Diabetes action now” is enlightened. Information about activity of Lithuanian Diabetes Association and diabetes news could be found in our web site www.is.lt/diabetas.

International Diabetes Federation unites 185 associations from 145 countries and 7 regions. Lithuanian Diabetes Association, a member of IDF since 1994, appeals to the best practice of the world, spreads it and seeks for increase of diabetes control in our country and strengthening peoples’ health.

DAWN Science Research

Science Research DAWN (Diabetes Attitudes Wishes and Needs) is conducted in the world. An information is presented in journal “Diabetes Voice” (2004, No 5) and www.dawnstudy.com.

Vida Augustiniene

The President of LDA

The member of IDF European Region board

Photo: The President of LDA Vida Augustiniene

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LDA is a 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. Dr Egle Rudinskiene consults and educates people with diabetes in the office of LDA in Vilnius.

Pages 4 - 5

Chronicle of Lithuanian Diabetes Association

• On 12, 27 May and 11 June, 2004, the President of LDA V.Augustiniene took

part in the sittings of the work group “Due to preparation of the project of compensated medicine strategy”, initiated by Health Minister.

·         During 14 May ─ 10 June V.Augustiniene as a candidate t European

Parliament, took part in the meetings with society, people with different illnesses, medics and representatives of mass media in Vilnius, Ukmerge, Moletai, Anyksciai, Raseiniai, Kelme, Akmene Mazeikiai, Palanga, Plunge, Telsiai, Silute, Tuarage, Telsiai,Vilkaviskis and Kaunas and their districts. During the meetings people met an activity of the Council of Lithuanian patients’ organizations representatives and Lithuanian Diabetes Association s well.

• On 14 May Vida Augustniene on urgencies of children with diabetes during the

health broadcast on TV 4.

• On 18 May the President of LDA shared the news on diabetes and the activity

of LDA during the courses for common practice nurses in Central Hospital of University Santariskes clinics.

• During 21 ─ 23 May the representatives of 8 new countries entered to EU took

part in the work group of Diabetes experts sitting initiated by IDF European region in Brussels. Prof. Antanas Norkus and Vida augustiniene represented Lithuanian Republic. Novo Nordisk supported ene event.

·         On 26 May the sitting of obligatory health insurance took place in National

Health Fund.

• On 27 May the project “Strengthening Patients’ Organizations and integrating

them to EU” was presented during the sitting of CRLPO as well as other questions urgent to people with diabetes.

• On 7 June the President of LDA took part to the conference of National Health

Politics in Palace of Government.

• On 11 June Ukmerge diabetes club “Vilkmerge” celebrated it’s 10 ─ year

jubilee. The members of this club, medics, representatives of medics and local government ant the President of LDA took part in this event.

• During 15 ─ 16 June Vida Augustiniene shared her news about diabetes and

diet with Vilnius college students.

• On 16 June the delegation of Raadviliskis diabetes club visited LDA office. Dr.

Egle Rudinskiene and other staff of LDA answered urgent questions.

• On 17 June the chief of CRLPO Vida Augustiniene and members Daiva

Andriuliene and Ona Telyciene met the President Valdas Adamkus.

• On 18 June Vida Augustiniene took part in a sitting of work group “Due to

preparation of the program ensuring health services quality” initiated by health Ministry.

• On 22 June the chief of CRLPO Vida Augustiniene supported a picket “Due to

enlarging financing of health care” initiated by Lithuanian Fisitians’ Union.

• Durirng 23 June ─ 2 July and 22 ─ 31 July the camps of diabetes learning for

children and youths took place in Druskininkai. The chief of the camps was the member of the council and board of LDA and the chief of Druskininkai diabetes club “Atgaja” Jelena Simoniene. The doctors of the camps were Margarita Valuniene and Egle Jakimaviciene. Dainara Kartheiser, Dalia Augustinaite and Tomas Kaulakys helped them. The main sponsor was Lithuanian Council for invalid matters at LR Government.

• On 28 June during the meeting of LDA and the Community of Lithuanian

Invalides urgent questions for people with diabetes and invalidity were discussed as well as a paper to State Patients Fund on a strategy of compensated medicine.

• On 29 June Vida Augustiniene discussed on questions of cooperation along

with representatives of Pfizer Company.

• On 7 July LDA appeal on self-control tools and support to parents of children

with diabetes was discussed in health committee in Lithuanian Parliament. Vida Augustiniene and Egle Jakimaviciene took part in it.

• On 10 July the Conference of Marijampole district diabetes organizations took

place in Sakiai Zypliai Palace.

• On 15 July the chief of the Committee to support Lithuanian children with

diabetes and Germany Wiesbaden town diabetes club “Lion” met children and youth with diabetes in LDA office. Quests gifted to children with diabetes diagnostically sticks for 1200 Euro and sweets.

• On 24 July the Confrence for youth with diabetes took place in Druskininkai.
• During 31 July ─ 1 August the member of the board of IDF European Region

and the President of LDA took part in the International sport event in Riga as well as representatives of Lithuanian diabetes organizations. The event was initiated by Latvian Diabetes Federation.

• During 12 ─ 21 August the diabetes teaching camp for children and youth

takes place in Plateliai, Morta Mikasauskiene country tourism house. The chief of the camp is the member of Federation of European Nurses Diabetes Teachers, Community of Lithuanian Nurses Diabetologists and Plunge diabetes club Aldona Danyliene.

• During 22 ─ 26 August the teaching camp for people with II type diabetes is

going to work at the same place. The chief of the camp is Aldona danyliene, the doctor is Galina Apanel.

• During 27 ─ 28 August the seminar on teaching chiefs of collective members

of LDA on an urgent diabetes questions is going to take place in Plunge.

• During 5 ─ 9 September the Conferences of European Diabetes Studies

Association are going to take place in Minchin. The representatives of LDA and Lituanian medics are going to take part in them.

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Newspaper “Diabetes”

LDA reminds of subscribing “Diabetes” for the II half year.

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About calcium, healthy bones and tooth

Prepared by Dr. Jurate Orlauskiene

An advertisement on calcium preparation “Calci Strong” by Vitabalans oy

Page7

Gaining the “Happiness light”

Nijole Voveraitiene presents a new poetry book by doctor and teacher Prof. Juozas Steponas Danilevicius. It is wondering that this person devotes long lasting hours to its patients and still finds time to admire nature and environment. We met J.S.Danilevicius as the author of scientific publications and now it is worth meet him as a great patriot of his grand land.

Oral medicine for people with II type diabetes

Information about medicine types, activity durations, daily doses and working mechanism is presented.

Page 8

Diabetes lesson

Body mass index

An instruction to gain your body mass index is given. Dr. Egle Rudinskiene prepared an interpretation of your gained results.

Pages 8 – 9

Thoughts from the letters

The President of LDA Vida Augustiniene is happy for people appealing to LDA with the help of letters, phone and directly. Main questions bothering people are the unjust activity of diabetes club “Dia”, possibilities to provide some information in newspaper “Diabetes”, shades of low for people with diabetes and their relatives, abilities to get more information. She says, that LDA mission is to improve a life quality of people with diabetes. With a help of LDA different changes are achieved every year.

LDA is educational organization. Its’ activity is educational as well. To get its’ publication one can appeal to his local diabetes club, community or directly to Lithuanian Diabetes Association. Budget limits a frequency and amount of newspaper “Diabetes”. While preparing articles we pay attention to wishes of our readership but we can’t advertise compensated medicine. You can appeal to you local offices of Social insurance and Taxes inspection on the questions about work probation, vacation and taxes privileges. A department of social care at your local government can consult you on questions about support and care.

Vida Augustiniene thanks doctors for articles, supporters for sponsoring information publishing for people with diabetes.

Page 9

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

Congratulations to Laimute Juciene in case of her 70-year jubilee.

Pages 10 – 11

Letters

The treatment of patients – a bother of their own

The member of Taurage diabetes community “Insula” Jonas Liorancas tells about troubles of people with diabetes, who finds their illness to be chronic and helpless, devoted to them for all the life. What helps to survive for such patient? Jonas Liorancas thinks that uniting into clubs and communities takes an ability to get more useful information. Medic has an important role in patients’ life. It a pity that sometimes even the best doctor is dependant on State institutions and can not treat patients properly. State institutions preclude a proper medical care for patients with long lasting illnesses. In thus a way we create an image of a state that cares for patients, but stay in a position, that the best patient is dead.

Photo: the chief of Pagegiai diabetes club “Rambynas” Laima Juciene is interested in ability for endocrinologist to visit Pagegiai at least once a month

Big hopes of little ones

A mother of the member of Marijampole diabetes club “Diabetikas ABC” Skaidre Matlauskiene tells about an appeal to Mariampole social affaires deprtment to help acquiring blood glucose diagnostic sticks. During the World Diabetes Day in Marijampole a program devoted to children year was announced. Many actions were made to get money for acquiring diagnostic sticks for children during all the year. These actions gave a little hope for better life. Thanks to A.Rimas and administration of Marijampole local government.

A wonderful weekend in “Zvorune”

Agne Gulbinskyte from Kuliai thanks to Dr Sigita Vainiene, nurses and new friends from diabetes teaching camp in “Zvorune”

Feast of St. John in Plunge

A member of Plunge diabetes club Stanislava Urboniene tells about well organized feast of St. John. She was happy to participate in sport competitions, to get presents for remembering and to spend some time in a wonderful nature.

Seminar in Zypliai

A chief of Sakiai diabetes club “Linelis” Birute Jancaitiene is happy to present the sixth yearly seminar by district “We are stronger together”. Sakiai, Vilkaviskis and Marijampole diabetes clubs organize it for six year constantly. Many people from different institutions and representatives of sponsors took part there and gave much important and useful information.

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Substitute of chief of Vilnius diabetes club “Diabite plius” Dainara Kartheiser and Dr. Egle Rudinskiene provides information about diabetes teaching summer camp. 22 youth took part in a camp, and their results were sequent:

Page 13

An advertisement on self-control tool Accu-Chek by Roche Diagnostics

Pages 13 – 14

Is children’s diabetes is being controlled properly?

A questionnaire of children and youth with diabetes was conducted during fall and winter periods. Elaboration of self-control quality and activeness for that patient was the main aim of it. Questionnaires were delivered with the help of diabetes clubs and endocrinologists.

Conclusions:

1. An amount of compensated self-control sticks (150) is not enough for children and youth with diabetes.
2. The proper level of self-control is limited by finances of patients.
3. The main part of patients knows the theory about checking blood glucose several times per day thus they are eager to check it more often.
4. The main part of participants would like to use insulin pump, but can not acquire and maintain it.
5. Patients are positive about diabetes teaching camps and want to take part in them more often.
6. Glucagon is achievable for less than 1/3 of respondents. The main reason of such situation is finances.

Thanks to all respondents.

Egle Marija Jakimaviciene

Jelena Simoniene

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Weekend at Bebrusai Lake

The chief of Vilnius diabetes club “Diabite plius” Egle Marija Jakimaviciene presents a trip to nature with children with diabetes and their parents. The topic discussed during a trip was “Diabetes influence to family psychosocial life”. A trip was a part of social initiative program “Diabetes as life stile and free-complication future”.

An advertisement on vitamins Diabetiker-Vitamine by Worwag Pharma

Pages 16 – 18

Glucose influence on people with diabetes life style

Prepared by Dr. Egle Rudinskiene

An advertisement on glucose by UAB Medicata Filia

Page 19

An advertisement by www.potencialis.lt

Letters

Days were as the moment

Dalia Augustinaite tells about her social practice in children and youth diabetes teaching camp. She helped a chief of a camp and found much new information about threat of this illness despite her mother have diabetes. She stresses that such camps are useful not only for such news but for the great rest, friends and wonderful time as well.

Pages 20 – 21

Foot fungal is not only a cosmetic vice

Prepared by Dr. Loreta Muraliene

Page 21

An advertisement on preparation “Terbisil”

Paying pensions set till 1995-01-01 and paid till 2004-04-01

A low due to pensions is presented.

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Treating II type diabetes by combinations of oral medicine and long lasting insulin

Prepared by Dr. R.Juskiene according to foreign press

Pages 24 – 26

The sun and it’s influence to the skin

Prepared by Dr. Egle Rudinskiene according to foreign press

Page 25

An advertisement on insulin pen “FlexPen” by Novo Nordisk

Pages 26 – 27

Psychologist information in “Zibute”

Psychologist Jolanta Zilinskiene tells about children sanatorium “Zibute” were much attention is paid to monitoring stress situations in families with diabetes. Some information about stress, its’ reasons and coping it is provided.

An advertisement by Abovita

Page 28

An advertisement on preparation Mezym

An advertisement on self-control tool Optium by MediSense

Thanks for a book

The chief of diabetes community “Insula” Algirdas Ardinskas thanks to Vida Augustiniene and Dr. Egle Rudinskiene for a book “Healthy nourishment”.