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'T&T facing diabetes epidemic'

By Kimberly Castillo

THE burden of diabetes and its complications, including heart disease, stroke, blindness, amputations and end-stage renal disease, will continue to grow in Trinidad and Tobago unless appropriate and effective interventions are implemented.

This warning came yesterday from the Director of the Diabetes Outreach Programme with the Trinidad and Tobago Health Sciences Initiatives (TTHSI), Dr Paul Ladenson.  

Ladenson was speaking at a media conference at the Hyatt Hotel, Port of Spain, during which the results of a new study of diabetes care in Trinidad and Tobago were released. 

The study was the most comprehensive of its kind in almost ten years. A team of experts from the TTHSI analysed data collected between June 2010 and March 2011 from a total of 2,124 patients in 31 of the 33 health centres and clinics connected with the South-West Regional Health Authority (SWRHA).

The data revealed that only one per cent of patients monitor their glucose levels and only one third could recall having the essential hemoglobin A1C test, which Ladenson stressed is an important step in achieving long-term glucose control and minimising the risk of serious complications.

Based on the survey's findings, two-thirds of diabetes patients saw a doctor or a nurse regularly for diabetes care and had received at least some education about their condition.

But only 28 per cent of the patients had seen an eye specialist and only nine per cent had received a foot exam within the previous year.

Ladenson named diabetes as possibly the leading cause of blindness and foot amputations in Trinidad. According to the survey, heart disease was among the most commonly self-reported complications of diabetes. Twenty-four per cent of participants reported having heart disease and seven per cent reported having suffered with a stroke.

Thirteen per cent suffered with foot ulcers and amputations, 13 per cent reported damage to the retina, 67 per cent suffered with hypertension and 51 per cent reported having high cholesterol.

Of those who were assesed by the TTHSI team, five per cent reported damage to the kidneys while 41 per cent suffered with nerve damage.       

Two-thirds of the survey participants were overweight or obese with metabolic control worse in women and children.

The results of the survey represent a clarion call for more aggresive intervention, stressed Ladenson, who is also the Professor of Endocrinology, Medicine, Pathology, Onconology, Radiology and Radiological Science at the Johns Hopkins University School of Medicine in Maryland, USA. He emphasised that this country faces an epidemic that if left unchecked has significant economic, human and health consequences.

There is a significant gap between the acceptable levels of diabetes control and those that are currently being achieved in this country, he said.

President of the Academy of Diabetes Clinicians of T&T, Dr Claude Khan, stressed that there is an explosion of diabetes in this country and called for more resources to be invested in the primary care settings for diabetes care, to prevent serious complications from the disease.

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