The PM might have set off the latest public worry-fest on Budget Day with his tenuous assessment that sugar causes diabetes, but medical studies across the region have for fifty years been pointing to the escalating number of cases, health problems and deaths caused by the disease in the Caribbean region.
A 2001 study by the The Barbados Eye Studies Group highlighted the high prevalence of diabetes in the Afro-Caribbean population, with related factors such as eye problems and cardio-vascular disease. Diabetes was reported by 17.5% of black, 12.5% of mixed, and 6.0% of white/other participants of the study. In black participants, diabetes was associated with age, diabetes family history, hypertension, obesity and high waist-hip ratio.
Thirteen years ago the study recommended: “Primary prevention of diabetes by lifestyle interventions, screening for individuals at high risk and prevention of disease complications . . . through non-pharmacological and therapeutic interventions are all needed to reduce the high burden of diabetes and associated mortality in Afro-Caribbean . . . populations.“ Four years ago.
Fast forward to 2010 and a West Indian Medical Journal article on “The epidemiology of diabetes mellitus in Jamaica and the Caribbean” which states that “studies have been conducted in the Caribbean for more than four decades.”
In Jamaica, the estimated prevalence among adults grew from 1.3% in 1960 to a massive 17.9% in 1995. Across the Caribbean, the overall prevalence of diabetes mellitus (in 2010) was estimated at about 9%. The study also showed that while more than 70% of persons with diabetes were aware of the condition, less than 50% were under control.
Four years ago the study recommended: “In light of the expected increase in the number of people with diabetes mellitus, healthcare planners and researchers will need to redouble their efforts to both prevent as well as limit the impact of diabetes mellitus and its complications in Caribbean populations.”
Whether governments are switched on to the impending crisis or not, Diabetes will remain one of the major public health challenges for the Caribbean in the twenty-first century.
A recent paper on diabetes and hypertension in Jamaica, Barbados, Bahamas and Trinidad and Tobago found the annual cost of diabetes in the year 2001 was 27 million US dollars in The Bahamas, 38 million USD in Barbados, 221 million USD in Jamaica and 467 million USD in Trinidad and Tobago. This translated to 0.5% of gross domestic product (GDP) in The Bahamas, 1.83% of GDP in Barbados, 2.66% of GDP in Jamaica and 5.21% of GDP in Trinidad and Tobago.
The Global Burden of Diabetes Study has projected that there by 2025 approximately 300 million people will be living with diabetes, primarily in developing countries where there is expected to be a 170% increase, from 84 million sufferers in 1995 to 228 million in 2025.
For Latin America and the Caribbean, the projection shows 33 million persons living with diabetes by 2030.
According to Caribbean governments, “the response to the very real threat of diabetes must be a coordinated effort both at the individual ‘high risk’ level and population level.
“Measures to reduce high calorie food intake and increase physical activity should be instituted across the region in order to reduce obesity, which remains a major risk factor for diabetes.”
The 2007 Declaration of Port-of-Spain states that “the burdens of non-communicable diseases [including diabetes] can be reduced by comprehensive and integrated preventive and control strategies at the individual, family, community, national and regional levels and through collaborative programmes, partnerships and policies supported by governments, private sectors, NGOsand our other social, regional and international partners.”
To listen to the debate since last week you would think Diabetes is the new lifestyle-related-disease-on-the-block which sneaked up and bit us on the over-sugared butt.
Believe me, Diabetes is not new, and it is not going away any time soon.