Diabetes in Jamaica

 

How common is it?

It affects over 20% of the adult population (ie >25yrs); but 50% of them don’t know they have it. The figures you’ll see quoted of ~12% with diabetes only speaks to those who have been diagnosed. It is the 2nd most common non communicable disease following behind hypertension.

It is increasingly being seen amongst children and adolescents and this could be associated with the increase in obesity being seen in this population. The story of overweight and obesity requires another forum for discussion.

How is it being managed?

Approximately 50% of patients are seen in the public health system and the other 50% privately, hence data from the government does not completely reflect the true picture of the condition and its management.

Medications and monitoring devices are available through public and private pharmacies and the National Health Fund of the Ministry of Health and Wellness assists in the costs. A major challenge for those living especially in remote areas is access to clinics and pharmacies and the long queues and waiting time.

What are the major complications being seen ?

Heart attacks, poor circulation especially in the feet, strokes, kidney failure, blindness and chronic ulcers.

Is there help for those complications?

Both public and private centres offer remedial services and have specialist expertise in all the areas. However, the government system is hopelessly overwhelmed whilst the private facilities may prove too costly. There is especially a crying need for assistance in obtaining kidney dialysis  equipment and supplies.

What can be done to assist the most vulnerable?

The Ministry of Health and Wellness  has a push to intervene in the occurrence and management of non communicable diseases, of which, diabetes is a major component. A direct approach can be to NGOs which assist in this area, in particular the Diabetes Association, the Heart Foundation and several community groups spread around the island and which could be approached on a parish by parish basis. Assistance is best in supplies, literature and even in healthcare team visits which can be arranged as mentioned earlier via direct approach to relevant groups.

What is the outlook for containing this problem?

Predictions are that over the next few decades there will be significant increases in the numbers affected with an increased burden on the public health system, the public purse and productive man-hours. There is no indication of the condition slowing down and as far as intervention methods can go, it is a matter of reinforcing lifestyle…balanced  meals(quality and quantity), physical activity(at least half an hour walk or its equivalent daily) and regular medical check ups, especially for those predisposed… such as with a positive family history for the disease.

Guest Writer: Prof the Hon E Y St A Morrison OJ, MD, PhD

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