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Changing the face of diabetic treatment



There’s a quiet revolution gaining momentum to turn around the care and treatment of diabetes, a disease stripping away the health of Barbadians at a rapid rate.

With the island spending well over two per cent of its Gross Domestic Product (GDP) to provide care and treatment for the more than 25,000 Barbadians grappling with the disease, the Chairman of the Barbados Diabetes Foundation, Dr Oscar Jordan, says the island is facing nothing short of a crisis.

“The diabetes population keeps rising all the time. That’s bad enough in itself, but the thing is, it is not a solitary disease, it is a gateway to a number of other diseases and complications, including heart disease, stroke, kidney disease, damage to the nerves and, perhaps the most feared of all, foot disease and, of course, blindness. So it’s a major problem.

The Warren-based Maria Holder Diabetes Centre and its team of specialists are leading a radical intervention which at its core is changing the face of treatment.

No more is the medical professional at the centre; rather the patient takes charge and manages the disease.

“Do you know that if you are diabetic and you have a foot problem you do not have to lose your foot? If you are diabetic and you develop an eye problem you do not have to be blind; you do not have to end up on dialysis . . . . The thing about it is if you are a diabetic, take control,” says Simone McConnie, a podiatrist at the Centre and chief operating officer of the Barbados Diabetes Foundation.

The Centre, the only multidisciplinary facility in the region, has a full-time team comprising a doctor, a diabetes specialist, nurses, a podiatrist, a nutritionist and an education officer.

“This approach is changing the landscape of treating diabetes across the region,” says McConnie. “It really is down to the patient. The patient is really who dictates the care, it is a total experience. The feedback from our patients so far has been that they are still holding their own and doing well.”

Patients are treated by each member of the medical team and they can also benefit from a support group.

“When a patient presents to the doctor, during the examination of the patient the doctor may realize that the patient has a very suspicious looking thing on their foot, the doctor will either excuse themselves from the patient or pick up the phone and call the podiatrist. The podiatrist will come into the room and have a look
at that person.

At the same time, the specialist nurse will observe everything and also interact with the patient to get a baseline of where that patient is at, so at the end of the day, we’ve taken the professional away from diabetes and put the patient at the centre of their management.”

The two medical professionals underscore that this team approach is critical since more diabetics are often unaware of how to manage their disease and this often leads to bigger problems.

“There are patients who think they are doing all right, but who really are not aware of what is going on in terms of their own blood sugar levels, who really don’t understand the numbers, and therefore have not taken sufficient control of themselves and this is absolutely important if we are to improve the management of those patients, “ says Dr Jordan.

McConnie wholeheartedly agrees, as she adds that “most people diabetic or otherwise, don’t know why they are on a particular medication, they don’t know the name of the medication, they usually say ‘we take a white tablet or yellow tablet’, they don’t know the impact of that medication or when they get the side effects”.

Since opening its doors in February, 15 patients have been treated by the centre and, according to McConnie, the results have been more than satisfactory.

“Thirteen of them have reached the target of where we wanted them to be and it has been wonderful. The management is not just that clinical intervention, we also have an education support group and through the education support group those members were able to build new friends, they started exercising, they started dieting and as result they started to have a change of lifestyle. If we are to fast-forward that success a couple years down the road, my prediction would be that it would have an impact on society.”

Dr Jordan underscores that the centre is open to all Barbadians. Under an arrangement with the Government, diabetics who attend polyclinics but continue to have severe difficulties can be referred to the centre.

“We will see that patient for a period of up to six months to make sure their measurements, their biochemical levels-including sugar, cholesterol are restored to as close as normal as possible. We make sure the patients understand the medication they are taking, the implications, make sure the patient is able to take care of themselves and after that they are referred back to the health clinic.”

Private patients can also receive care at the clinic and McConnie stressed that reasonable packages are available for patients to receive necessary care.

Both McConnie and Dr Jordan are anxious for Barbadians to exploit the benefits of the Center but they are especially urging citizens to take step to avoid getting the disease. Dr Jordan called for strong action to arrest the growing number of children  with Type 2 diabetes which is normally seen in the elderly.

“If you live a relatively healthy lifestyle, if you are involved in activity and eating sensibly, then you can prevent diabetes,” McConnie says. “At the end of the day our health is based on the choices we make, whether you have a chronic disease or not. Ask yourself if what you put into your mouth is good for your body.
Is it a good choice?”



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