The second leading TT killer

This percentage of diabetes-related deaths is way above the world average. This is because, according to Basdeo Benson Rampersad, who is chairman of the Couva Branch of the Diabetics Association of Trinidad and Tobago (DATT), Trinidad and Tobago ranks fifth in the world in diabetes cases. Speaking at a prize-giving function last Wednesday to mark World Diabetes Day, Mr Rampersad listed the other four countries: Papua New Guinea, Maritius, Bahrain, and Mexico.

That list in itself suggests why diabetes has remained an incurable disease. There are no clear genetic, dietary, or environmental factors which might help pinpoint the cause or causes of the disease. Studies of twins do imply a genetic factor, but research also suggests that viral infections during childhood can bring it on. Adult-onset diabetes (the kind you don’t need insulin injections for) has skyrocketed in the United States over the past 15 years, with this type becoming even more common among children than juvenile diabetes (the kind you do need insulin for, which is probably genetic and viral in origin). An over-rich diet and lack of exercise are two main factors that cause adult-onset diabetes and, as people in developing countries get exposed to westernised diets, they develop diabetes at an even faster rate than people in developed nations.

The silver lining on this diabetic cloud is that the individual can take effective action to manage the disease. Technology related to diabetes, such as human insulin and blood glucose monitors, enables patients to take much better care of themselves now.

But it is self-care which is the key to managing diabetes. There are several diets which, when adhered to, let patients reach and maintain a proper body weight. Modern dietary prescriptions emphasize weight reduction for obese patients and recommend a generous carbohydrate intake. This is because Western diabetics are now more likely to die of atherosclerotic diseases, like coronary heart disease, than of uncontrolled diabetes. A high-fat diet is therefore harmful. Additionally, research in Asian countries shows that diabetics can manage relatively well and have fewer complications on high-carbohydrate diets, such as rice. While all carbohydrates raise blood sugar levels, the elevation is higher with foods like bread and potatoes, and lower with legumes, pasta, and many fruits and dairy products. So diabetics in Trinidad and Tobago need to cut down on the french fries.

Regular exercise also aids in restricting symptoms, since exercise apparently helps keep blood sugar levels within normal parameters. But, since one symptom of diabetes is numbness in the extremities, diabetics need to be especially careful about damaging their feet since wounds do not heal properly and amputation can be the result of even small cuts. This is bad enough in itself, but the stress of a surgical operation and losing a limb can itself worsen the condition.

Persons with diabetes must bear in mind, however, that this is not a fatal disease. With care and commitment, people with diabetes can live quite normal lives. However, the statistics suggest that this is not happening in Trinidad and Tobago, so a public education programme is clearly necessary if we are to reduce unnecessary deaths from this disease.