There is an explosion of diabetes in Trinidad and Tobago and the Caribbean and it is now the second leading cause of death in T&T. Diabetes, which is now being described as an epidemic in the medical world, is also the leading cause of adult blindness in T&T. The alarming news was disclosed at a news conference at the Hyatt Regency Trinidad yesterday to launch a White Paper titled "The State of Individuals with Diabetes and their Healthcare in the South-West Region of Trinidad and Tobago". The study found that there are shortfalls in the public health care system in the treatment of people with diabetes. Further, people with diabetes themselves have not been adequately responding to the system, it was revealed. According to the White Paper, diabetes affects an estimated 150,000 people in T&T and the numbers are growing, with 1,000 new cases every year. "T&T has been severely affected by the epidemic of diabetes. It is, arguably, among the countries with the greatest burden of this disease," the White Paper stated.
It disclosed that the numbers affected with the disease in T&T represent an adult diabetes prevalence of around 12-13 per cent. According to Dr Claude Khan, president of the Academy of Diabetes Clinicians of T&T, who spoke at the conference yesterday, this country's figures triple those in the United Kingdom and almost double those in the United States. He said the adult diabetes prevalence in the UK is between three and four per cent and between seven and eight per cent in the United States. The White Paper was prepared and launched by the Diabetes Outreach Programme of the T&T Health Sciences Initiative (TTHSI). TTHSI is an umbrella programme representing a collaboration among the Ministry of Science, Technology & Tertiary Education, the University of T&T (UTT), the Ministry of Health and Johns Hopkins Medicine International (JHI). In fact, diabetes has seen such accelerated growth worldwide, especially among developing countries, that it is termed a pandemic. In T&T the disease now crosses ethnic lines with Afro and Indo-Trinidadians, T&T's two largest ethnic groups being equally affected. Dr Paul Ladeson of JHI, said the genetic predispositions of Afro and Indo-Trinidadians make them more vulnerable to diabetes.
The White Paper said, "Reasons for the high prevalence of diabetes in T&T include the genetic predispositions of its predominant ethnic groups, as individuals of both East Indian and African descent are known to have high rates of diabetes." Other important factors contributing to the high prevalence of the disease in T&T are increased calorie intake and more sedentary behaviour which comes with increasing affluence, the study stated. The secondary complications of diabetes include heart disease, stroke, blindness, amputations and end-stage renal failure. "For heart disease, a leading cause of mortality in the country, approximately 65 per cent is attributable to pre-existing diabetes," the White Paper said. In July 2008, the UTT contracted with JHI to develop the outreach programme designed to collect detailed data on diabetes that would assist regional health authorities in allocating resources.
Dr Ladeson said it would have been difficult to conduct the programme throughout the country and the SWRHA was an enthusiastic and effective partner. He said there are plans to take the programme to the rest of T&T. In the SWRHA, the programme delivered a rotating service model of care to 31 of the authority's health centres. The outreach team evaluated 2,124 patients and assessed each one's level of diabetes care. Some of the results were that the majority of patients were female East Indian and current smokers. Half of the patients rated their health as fair or poor and only 28 per cent had seen an eye specialist and a mere nine per cent had received a foot examination. Further, only one per cent monitored their blood/urine glucose. The White Paper said the outreach team proposes to conduct several interventions, including continuing medical education of doctors and nurses expansion of a national diabetes programme to improve health clinics.