Last Friday Laura Welschen defended her thesis in which she describes a series of studies based on the Diabetes Care system employed in the Hoorn region in the Netherlands. This Diabetes Care system organised by the Diabetes Care Centre West Friesland (http://www.diabetes-zorg.nl/) is an integrated approach including evidence-based efforts to promote patient empowerment to support self-management.
Laura’s thesis is a well written series of scientific papers, including a Cochrane review on the effects of self-monitoring of blood glucose in type 2 diabetes patients (see http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD005060/frame.html).
The main risk factor for diabetes type 2 is obesity. Presently there is much to do about the ‘food crises’, i.e. the sharply rising prices of staple foods world-wide, leading to food riots by people in poorer countries that can not afford to buy enough food, and to hunger. The first of the UN millennium development goals reads (http://www.un.org/millenniumgoals/): Eradicate extreme poverty and hunger:
- Halve, between 1990 and 2015, the proportion of people whose income is less than one dollar a day
- Achieve full and productive employment and decent work for all, including women and young people
- Halve, between 1990 and 2015, the proportion of people who suffer from hunger
The present food crisis makes reaching the hunger eradication goal even more difficult to reach. The fact that on the one hand we face an enormous epidemic of obesity and related diseases such as diabetes, cardiovascular problems as well as certain cancers (http://www.dietandcancerreport.org/), and on the other food shortages and hunger is and remains one of the worlds serious scandals. The present increase in food shortages in poorer countries is repeatedly attributed to the fact that certain foods, like corn, sugar cane, and palm oil are now more often used to produce ‘biofuel’ (http://en.wikipedia.org/wiki/Biofuel). However, only a very small percentages of the total production of these crops is indeed used to produce biofuel. A much larger proportion of agricultural land and staple foods is, for example, used to produce meats, dairy and other animal food products.
In an opinion article in one of the main Ducth national newspapers, NRC-Handelsblad (http://www.nrc.nl/opinie/), professor Jan Douwe van der Ploeg (http://www.rso.wur.nl/UK/People/Staff/vdPloeg/), professor of transition studies at Wageningen University and Research Center, argues that the production of biofuel is only a small contributor to the present food crisis, and he sees the (1) ongoing transition from farmer-based, smaller-scale agriculture to large-scale but less productive corporate agriculture; (2) the development of a world food market in stead of more regional food markets that leads to production of foods further away from consumers, and foods exported from countries where local people already have a lack of food; and (3) the domination of the food market by a few what he calls food-imperia that use food to produce processed food products, which is good for making money, but not so much for feeding the hungry.