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1
Type 2 diabetes in adults
National Institute for Communicable Disease (NICE)
National Institute for Communicable Disease (NICE)
(2023)
CC2
The document provides the NICE Quality Standard for managing Type 2 diabetes in adults (QS209). It outlines evidence-based recommendations for preventing Type 2 diabetes, structured education, continuous glucose monitoring (CGM), medication such as SGLT2 inhibitors, and regular care processes to mon
...
itor complications. The guidelines emphasize individualized care, addressing health inequalities, and improving patient outcomes. They are intended to support healthcare professionals and services in delivering high-quality, equitable diabetes care.
more
The document "Management of Type 2 Diabetes Mellitus" provides comprehensive guidelines for the diagnosis, prevention, and treatment of type 2 diabetes in adults. It emphasizes the importance of individualized glycemic targets, lifestyle interventions like diet and exercise, and the use of medicatio
...
ns such as metformin, SGLT2 inhibitors, and GLP1 receptor agonists to manage blood sugar levels and reduce long-term complications. The document also discusses the screening and management of comorbidities such as hypertension, hyperlipidemia, and diabetic complications like retinopathy, neuropathy, and nephropathy. It highlights the role of diabetes self-management education and support in improving adherence to treatment and patient outcomes. The guidelines are evidence-based and aim to reduce morbidity and mortality associated with type 2 diabetes.
more
The documents focus on promoting healthier nutrition by addressing issues like sugar, salt, and fat intake, emphasizing their role in non-communicable diseases such as obesity, diabetes, and heart diseases. They include educational tools for children and adults to support balanced diets and public h
...
ealth strategies to reform food systems and improve dietary habits globally.
more
Diabetes is a significant public health issue that affects approximately one in 10 adults globally, with type 2 diabetes accounting for 90–95% of cases. This chronic condition causes considerable morbidity and mortality and is growing in impact, with cases projected to rise from 537 million in 202
...
1 to 784 million by 2045. As cases rise, it is imperative to ensure the healthcare workforce is prepared to care for affected individuals. However, there is a growing global shortage of healthcare workers, which was estimated, pre pandemic, to reach 15 million by 2030. Therefore, all of the healthcare workforce will need to be utilised to their fullest potential in order to address the growing global burden of diabetes. Pharmacists will continue to be essential in this endeavour.
more
Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. However, consolidation of CHVs position within formal health systems has proved to be complex and continue
...
s to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health
service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and
the community health team. Our analysis identified key challenges that may impede the strategy’s implementation:
(1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs
from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
more
The workshop aimed to support countries in the prioritization and acceleration of NCD prevention and management with a specific focus on accelerating the prevention and control of hypertension and diabetes, identifying the most impactful NCD interventions within their context, closing the gaps in ca
...
ncer care services through regional collaboration and integrating NCD services in when responding to emergencies.
more
This fourth annual report monitors global progress towards the 2023 target for global elimination of industrially produced trans-fatty acids (TFA), highlighting achievements during the past year (October 2021 – September 2022). Countries are responding to the World Health Organization (WHO) call t
...
o action by putting into place best-practice TFA policies. Mandatory TFA policies are currently in effect for 3.4 billion people in 60 countries (43% of the world population); of these, 43 countries have best-practice policies in effect, covering 2.8 billion people (36% of the world population).
Over the past year, several additional countries took action to eliminate industrially produced TFA: best-practice policies came into effect in India in January 2022, Uruguay in May 2022 and Oman in July 2022. Best-practice policies were passed in Bangladesh in November 2021 (to come into effect in December 2022) and in Ukraine in September 2020 (to come into effect in October 2023), best-practice TFA policies are projected to pass soon in Mexico, Nigeria and Sri Lanka.
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Adolescence is a critical stage in life for physical, cognitive and emotional development, shaping future health and well-being. Comprehensive measurement of adolescent health is essential to prioritize health issues, guide interventions and track progress. However, global, regional and national ado
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lescent health measurement has historically been inconsistent and incomplete.
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The WHO document "Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes: implementation guidance" provides a framework for integrating noncommunicable diseases (NCDs) into existing health programs for HIV/AIDS, tub
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erculosis (TB), and sexual and reproductive health (SRH). It emphasizes the importance of a people-centered approach to enhance healthcare accessibility and efficiency, especially in low-resource settings. The document outlines strategies for strengthening policy, financing, capacity building, and health system infrastructure. It offers actionable steps, tools, and case studies to support countries in reducing the burden of NCDs through integrated, holistic care within primary health services.
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Chronic kidney disease (CKD) is an important contributor to mortality from noncommunicable diseases. No decrease has been seen for CKD mortality contrary to many other important non-communicable diseases (e.g., cardiovascular disease). The prevalence of CKD and kidney failure are increasing all over
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the world – and thereby also the need for dialysis. Unfortunately, the prevalence increases most rapidly in lowand middle-income countries. Globally, there are great inequities in access and quality of management of kidney failure. Many low- and middle-income countries cannot meet the increased need for dialysis. If the patients receive dialysis, it might only be for a limited period due to the out-of-pocket expenses. There are global disparities in CKD mortality reflecting the disparities in access to care. Lack of access to dialysis is an important cause of the increased CKD mortality in low- and middle-income countries.
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The article "Barriers and determinants of asthma control in children and adolescents in Africa: a systematic review" analyzes factors contributing to poor asthma control in African youth. Based on studies conducted between 2014 and 2019 in Nigeria, Uganda, and South Africa, the review identifies key
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challenges such as limited access to asthma diagnosis, inadequate use of inhaled corticosteroids, and environmental and socio-economic factors. It finds that urban living, older age, and concurrent allergic conditions significantly affect asthma management. The study emphasizes the need for improved diagnostic tools, better access to treatment, and tailored public health interventions to enhance asthma outcomes in African children.
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The document "Chronic Respiratory Diseases: A Handbook for Pharmacists" outlines the significant role pharmacists play in managing asthma and COPD, emphasizing patient education, disease prevention, medication management, and promoting healthy lifestyles. It highlights the importance of pharmacists
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in supporting early detection, adherence to treatment, smoking cessation, and interprofessional collaboration to enhance respiratory care and outcomes.
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The goal of asthma treatment is to obtain clinical control and reduce future risks to the patient. To reach this goal in children with asthma, ongoing monitoring is essential. While all components of asthma, such as symptoms, lung function, bronchial hyperresponsiveness and inflammation, may exist i
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n various combinations in different individuals, to date there is limited evidence on how to integrate these for optimal monitoring of children with asthma. The aims of this ERS Task Force were to describe the current practise and give an overview of the best available evidence on how to monitor children with asthma.
22 clinical and research experts reviewed the literature. A modified Delphi method and four Task Force meetings were used to reach a consensus.
This statement summarises the literature on monitoring children with asthma. Available tools for monitoring children with asthma, such as clinical tools, lung function, bronchial responsiveness and inflammatory markers, are described as are the ways in which they may be used in children with asthma. Management-related issues, comorbidities and environmental factors are summarised.
Despite considerable interest in monitoring asthma in children, for many aspects of monitoring asthma in children there is a substantial lack of evidence.
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The Global Asthma Report (GAR) 2022, prepared by the Global Asthma Network (GAN), is the fourth such report (others 2011, 2014, 2018). GAN builds upon the work of the International Study of Asthma and Allergies in Childhood (ISAAC) and The International Union Against Tuberculosis and Lung Disease (T
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he Union) to monitor asthma and improve asthma care, particularly in low- and middle-income countries (LMICs).
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Over the past 20 years, the Global Initiative for Asthma (GINA) has regularly published and annually updated a global strategy for asthma management and prevention that has formed the basis for many national guidelines. However, uptake of existing guidelines is poor. A major revision of the GINA r
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eport was published in 2014, and updated in 2015, reflecting an evolving understanding of heterogeneous airways disease, a broader evidence base, increasing interest in targeted treatment, and evidence about effective implementation approaches. During development of the report, the clinical utility of recommendations and strategies for their practical implementation were considered in parallel with the scientific evidence.
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Asthma is the most common noncommunicable disease in children, and among the most common in adults. According to the most recent estimates from the Global Asthma Network Phase I study, around one in 10 children and adults have symptoms of asthma and one in 20 school-aged children have severe asthma
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symptoms, with marked variations in prevalence and in prevalence trends between countries and regions of the world. The Global Burden of Disease Study estimated that asthma caused the loss of 21.6 million healthy years of life (disability-adjusted life years) and 461 069 deaths in 2019. Approximately 90% of the asthma burden of disease is borne by people living low and middle income countries (LMICs). Some countries report very high (up to 90%) rates of uncontrolled asthma. While the prevalence of asthma is highest in countries with a high Socio-Demographic Index (SDI), death rates from asthma are highest in countries with low and lower middle incomes.
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Asthma is the most common chronic condition in children worldwide. It affects daytime activities, sleep and school attendance and causes anxiety to parents, families and other carers. The quality of asthma diagnosis and management globally still needs substantial improvement. From infancy to the tee
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nage years, there are age-specific challenges, including both underdiagnosis and overdiagnosis with stigma-related barriers to treatment in some cultures and in adolescents. The Paediatric Asthma Project Plan has been initiated to strengthen diagnosis and management of asthma. This encompasses a vision for the next 10–15 years, building on the knowledge and experience from previous educational projects. It will take into account the educational needs of patients, carers and healthcare professionals as well as the accessibility and affordability of medication, particularly in low and middle-income countries where the prevalence of asthma is rising more rapidly. This overview presents a first step for those involved in the diagnosis and management of childhood asthma to strengthen care for children globally.
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The guidance document provides a set of indicators for assessing the status of development, implementation and monitoring of key policy interventions for prevention and control of NCDs and injuries. It promotes city-level evidence based decision-making processes to identify gaps and take appropriate
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s actions to strengthen responses. Additionally, using the standardized indicators can facilitate cross-city learning, sharing best practices and lessons learnt in implementing various policy interventions.
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The ‘jigsaw puzzle’ approach to building a diagnostic picture of asthma in primary care over time
Ryan, D.; Kocks, J.; Correia de Sousa, J. et al.
International Primary Care Respiratory Group
(2023)
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Since there is no single objective diagnostic test for asthma this study suggests an approach of collecting and assembling pieces of clinical information to create a diagnostic picture, like making a jigsaw puzzle. These pieces should include demonstration of symptom and airway variability and/or br
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onchodilator responsiveness over time, to support a clinical diagnosis.
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The Global Action Plan on Antimicrobial Resistance (AMR) calls for making AMR a core component of professional education and training. In 2018, the World Health Organization (WHO) published Competency framework for health workers’ education and training on AMR to ensure that academic institutions
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and regulatory agencies provided pre-service and in-service training to equip health workers with the adequate competencies to address AMR. This was followed by Health workers’ training and education on AMR: curricula guide, which outlines the learning objectives and expected outcomes of pre-service training of health workers to improve curricula. These tools were designed to strengthen the capacity of health workers in various settings to address the growing challenge of AMR.
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