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Health systems and the management of chronic diseases: lessons from Type 1 diabetes

David Beran

Type 1 diabetes is a good example of a chronic noncommunicable disease and some have even suggested that it may be used as a ‘tracer’ condition. Chronic noncommunicable diseases are the leading challenge that health systems throughout the world currently face and a shift is needed at different levels of the health system to manage these conditions effectively. However, Type 1 diabetes like most chronic noncommunicable diseases is managed outside the health system, and therefore a larger perspective than purely medical care is needed. This is also required as any chronic disease changes the individual’s perspective and their needs in managing their condition on a daily basis. The purpose of this review is to present a health systems’ perspective on the management of diabetes and chronic conditions. In presenting this perspective the review aims to highlight that although the individual is included in the Innovative Care for Chronic Conditions Framework, current literature fails to address the individual’s experience and how the health system only plays a small role in their overall care.