An island of diabetes
In 2015, some 34 100 people in Barbados between ages 20 to 79 were known to have diabetes. Figures showed that 335 of them died, but at that time there were still an estimated 9 600 others walking around with the disease without knowing.
These figures from the International Diabetes Federation, of which the Diabetes Association of Barbados is a member, point to a startling reality.
“If I told every fifth person in this room to stand up, you would probably be looking at the [average] number of people over the age of 25 who have diabetes,” Dr Diane Brathwaite, a diabetologist from the Diabetes Centre, told a packed Queen’s Park Steel Shed during a recent symposium.
“That’s nearly one-fifth of the population that you’re talking about.”
The point being made by the doctor, during the inaugural Oscar Jordan Symposium, was that each of us on this island frequently – daily, in some cases – interacts with someone with diabetes, whether it is a spouse, a relative, a friend, or work colleague.
While diabetes does not have a face, the image with which Barbadians most associate the disease is a person who has lost a limb or two.
But besides killing hundreds every year, diabetes can produce various forms of related illnesses that not only put a strain on the national health budget, but also affect family members who are called upon to devote more of their time and energies in caring for the diabetic relative.
Dr Brathwaite explained at the symposium, hosted by Barbados Diabetes Foundation and the Queen Elizabeth Hospital, that this disease is brought on by the body’s resistance to insulin, a hormone produced by the pancreas to enable the body to move sugars that the blood takes from foods into cells.
Of the two types of diabetes, people with Type 1 do not produce insulin, and this condition is most common in children and some young adults. Among the reasons for developing Type 1 is genetics, as the disease can be inherited from parents; ethnicity, with Blacks being more predisposed; and diabetes in pregnancy, called gestational diabetes.
Dr Brathwaite explained that those with the Type 2 strain produce insulin, “but it is like the insulin doesn’t work”.
“So, it is like a key that doesn’t open a door. The door has to open to let the sugar come out from the blood into the cells to be used. So if you can’t unlock that door the sugar builds in the blood system. And once the sugar is high in the blood system, it goes all over the body.
“That’s how diabetes causes most of these problems, because you have these high blood sugars going all over, affecting the vessels, the nerves, all over the body.”
Type 2 diabetics make up the majority of affected Barbadians, and this is the strain that can be avoided by proper attention to diet, physical activity, having low body fat, regular blood pressure, and regular cholesterol.
Unfortunately, the evidence shows that a substantial segment of the population does the opposite of what is recommended for a diabetes-free life.
But, as Dr Brathwaite and other medical professionals explained at the symposium, people with diabetes can still have a normal life once they observe a certain regimen.
Knowing your current status early and having repeated checks are important, so whenever diagnosed with diabetes persons should seek medical assistance and lifestyle guidance immediately.
The feet usually need special early attention because they can become numb, causing diabetics to lose the sense of touch in those limbs.
Dr Margaret O’Shea, a Queen Elizabeth Hospital surgeon who daily sees many Barbadian diabetics, said the numbness is a state of necropathy.
“It means you can’t feel. . . .You can’t feel the rock that scratches your foot, you can’t feel the rubbing on your shoe. So you have to look at your feet every single day. Or, if you can’t see well – because diabetes affects the eyes – get somebody to look at your foot and tell you if there is an injury, because you’re not going to feel it,” she advised.
Cuts and bruises on diabetics do not heal easily, and with the loss of sensation in the foot such injuries may go undetected.
Considering the growing prevalence of this disease among Barbadians, endocrinologist Dr Carlisle Goddard advised that early screening or medical check-ups should become a norm.
“It is better to come, even if you think you are wasting the doctor’s time or the nurse’s time. Let them be the one to tell you to go home and don’t worry,” he said.