Improving the diabetes care in Belarus

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Diabetes has become a significant medical and economic problem in Belarus. The direct expenses on diabetes are estimated to be about 10% of the total budget of the Ministry of Health. The incidence of type 2 diabetes has increased 2.5-fold during the past 10 years, which reflects the growing prevalence of obesity in the adult population, especially in urban areas. The incidence of type 1 diabetes in children and adolescents has been increasing slowly over the past years with a current incidence rate of about 10 in 100 000. The National Diabetes Programme called ‘The Complex Programme Diabetes Mellitus’ was launched in 1999. It created the general goals and targets for improvement in diabetes care in Belarus. As part of the implementation of this programme, all people with diabetes have free access to insulin, syringes and oral glucose-lowering medications. A decrease in the rate of blindness and end-stage nephropathy during the last 10 years has been registered. As a result of the Diabetes and Pregnancy Centre activities the data on pregnancy have been improved with a higher number of deliveries in diabetic women and a significant decrease in perinatal child mortality. Unfortunately, the desired reduction in amputations has not been achieved so far, but the percentage of high level amputations has been lowered significantly.The system of diabetes education in Belarus was established in 1987. Since then, diabetes schools have emerged throughout the country. However, recently we have faced the problem of decreased effectiveness of most diabetes schools as they fail to provide an optimal educational process because of lack of testing equipment and teaching materials. There is a great need to change education from the form of lectures to more practical-directed programmes created for groups of patients with different needs and of different ages. Intensive and repeated education is the major priority for diabetes teams and the Belarusian Diabetes Association in the coming years. Only in cooperation with highly motivated and educated individuals with diabetes will the diabetes teams be able to achieve control over diabetes and decrease its medical and social burden. Copyright © 2006 John Wiley & Sons.

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