Aims/hypothesis. The Cost of Diabetes in EuropeType II study is the first large coordinated attempt to measure the current standard of care and determine the costs of managing patients with Type II (non-insulin-dependent) diabetes mellitus. Methods. The study evaluated glycaemic control, blood lipid levels and blood pressure, all of which are risk factors for complications. Records of these clinical characteristics were collected from over 7000 patients during the 6-month study period. Results. The mean HbA 1c value for the entire study population was 7.5%, ranging from 7.0% in Sweden to 7.8% in the United Kingdom. Only 31 % of individuals achieved good glycaemic control (HbA 1c s=6.5%) according to current European guidelines. Only 64% of the total study population were tested for HbA 1c values at least once within the 6-month study period (ranging from 49% in Spain to 71 % in the UK), although HbA 1c testing every 3 months is recommended for all patients, by European Diabetes Policy Group guidelines. The maJonty of patients had borderline total cholesterol values, with a mean value of 5.7 mmol/l. Overall, 21 % of patients were classified as having low risk cholesterol levels «4.8 mmol/l). Good triglyceride levels «1.7 mmolll) were achieved by 47% of the total study population. During the study period, 81 % of patients had their blood pressure measured, with 35% and 53.3% of the patients reaching the recommended targets for systolic and diastolic blood pressure, respectively. Conclusion/interpretation. This study showed that a high proportion of patients with risk factors for diabetes-related complications are not adequately controlled. Improvements in disease management and monitoring are therefore required to ensure that guideline targets are met, thus reducing the long-term complications of Type II diabetes. [Diabetologia (2002) 45:S23-S28]

This paper describes an acculturative integration approach that stresses the contribution of liberation psychology. Immigrant integration is a challenge for receiving countries in the Western world due to the frequent asymmetrical and oppressive conditions suffered by newcomers in their new settlements. The cross-cultural perspective connects integration with psychological acculturation, emphasizing harmony between acquisitions of the new culture while maintaining cultural heritage, and creating opportunities for intergroup relationships. In turn, liberation psychology permits an understanding of the acculturative transition as an empowerment and self-construction process by which immigrants acquire a new vision of the world and of themselves, transforming both structural conditions and themselves. From this perspective we conceptualize acculturative integration as the process by which newcomers become an accepted part of the new society through a reflexive and evaluative process, changing their social references and position, rebuilding their social and personal resources, and achieving a new agency in coherence with their new challenges and goals. In this process, they acquire critical thinking about unequal conditions, gain capacities to respond to the inequalities, and take effective actions to confront them. We illustrate this process using the narratives of nine Moroccan women who are living in asymmetrical and oppressive local contexts in Andalusia, the southern-most region of Spain.

Because of the high cost of treating type 2 diabetes and its complications, preventive measures should be implemented and control of the disease should be improved to reduce the costs associated with chronic complications.

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