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Diabetes Care in Poland
There is good diabetes care in the cities and poor care in the countryside largely due to a lack of supplies.

Staged Diabetes Management Update
Dr. Jan Wilczynski of Poland approached International Diabetes Center in 1994 with a request for SDM training. At the time, treatment for gestational diabetes was restricted to a single hospital in the country—the Polish Mothers Memorial Hospital. Most women with gestational diabetes either had no means to travel to the hospital from their rural homes, or got to the hospital too late to prevent complications. The infant mortality rate for women with gestational diabetes was as high as 10-12 percent.

A half dozen physicians from Poland traveled to International Diabetes Center for 10 days of SDM training. Once back in Poland, this physician team trained a larger group of medical specialists in the use of SDM. The SDM materials were adapted and translated into Polish, and the program was implemented at various healthcare sites.

In 1997, at the International Diabetes Federation conference in Helsinki, Finland, Dr. Wilczynski reported that:

• Infant mortality related to gestational diabetes at the Polish Mothers Memorial Hospital had dropped to zero percent.
• Mothers with gestational diabetes were giving birth to normal-sized babies as opposed to the large babies seen with untreated gestational diabetes.
• HbA1c levels in pediatric patients with Type 1 diabetes and in adults with Type 2 diabetes had been lowered.

Today, Polish Mothers Memorial Hospital continues to train three to five physicians in SDM each week. A program to provide SDM care in rural areas has also been developed.