Diabetes mellitus is a common chronic disease that currently affects 285 million people aged 20-79 worldwide: 6.6% of the adult pop ulation. 1 Upwards of 3 million Canadians are currently affected, which will reach 3.7 million by 2020. 2 Recent research has demonstrated that the prevalence of diagnosed diabetes in Ontario adults over 20 years of age was approximately 8.8% in 2005; 3 extrapolating from this, Hamilton, with a total population of approximately 505 000, yields an estimated 34 000 adults living with diabetes. 4 The sheer magnitude, impact and growth of diabetes and its consequences suggest that diabetes is now a major public health problem. 5,6 Understanding the complexity of diabetes and the resources required for optimal self-manage-ment highlights the need for community-based approaches. Such an approach should enable any motivated individual in the community to gauge his/her diabetes status, engage his/her health care providers as an informed consumer, and actively participate in and monitor his/her own diabetes therapy. By shifting the responsibility of diabetes care from the health care system alone to include individuals with diabetes, and providing community resources designed to assist individuals, such an approach explicitly recognises that diabetes is a growing societal 'public health' problem with a huge potential impact and that interventions at the community level can mitigate this effect. 5,6 The objective of this paper is to describe Diabetes Hamilton (DH), a novel community-based diabetes programme, and to determine the impact of DH on the improvement of selfmanagement behaviours.
Diabetes Hamilton
Diabetes Hamilton is a free, voluntary programme available to people with diabetes and health care providers in the Hamilton area. It was conceived in 1999 after conducting a needs assessment of diabetes stakeholders, including individuals with diabetes, family physicians, pharmacists and other service providers, and has been supported by educational grants. DH is a community-based support programme that includes the
A community-based approach for the self-management of diabetes
The Diabetes Hamilton support programme and registry