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The Diabetic Reality in Trinidad & Tobago

My grandmother was a diabetic and although she died when I was only 14 months the stories are endless. She used to say “something has to carry me” to justify not sticking to her diet. Some other typical trinbagonian diabetic responses are “my sugar levels low I need to eat something sweet” or “if I have to dead let me dead happy”. My dear grandmother used to have a time during the mango season…that’s how I know that genes are strong cause I’m a big lover of mangoes. Her favourite was starch and I was told she would go under the tree, collect a bucketful and suck her life away. That quantity of sugar and diabetes don’t mix, so the end result was the amputation of one foot and due to the same stubbornness…getting my cousin and neighbour (young children at the time) to purchase sweets for her and her not exercising, lead to the amputation of the next leg by the following year. With amputations depression often sets in and she was no different. These combined factors led to her demise.

We are lovers of our local homemade ice-cream flavours, and to top it off, not one but three foreign companies have joined the club, even creating a casual dining experience in some instances. Our schedules have become crazy and people hardly cook, far less eat home prepared food anymore; so all the salt and trans fat in foods are settling in our systems. We leave home early, get stuck in traffic, eat lunch on the run cause we work long hours, and then the evening traffic takes us into the night with no exercise. Then, it’s basic preparation for the next day, which equals no time to take proper care of our bodies, and in some instances those of young children. This explains the significant rise in obesity.

World Diabetes Day is a global observance held annually on November 14 to raise awareness of diabetes and its complications amongst the general population and the care that people with this condition need. The World Health Organisation (WHO) estimates that more than 220 million people worldwide have diabetes. It is estimated that this number is likely to more than double without intervention by 2030.Diabetesfalls under the chronic disease category and has become one of the most prevalent causes of many problems.

According to the Diabetes Association of Trinidad and Tobago (DATT), in 2008, diabetes was ranked second in the cause of death with an estimated 175,000 persons affected by the condition; this represents approximately 13% of the population – an alarming revelation.

Signs and Symptoms

  • Frequent urination
  • Thirsty
  • Hungry
  • Itching
  • Blurred vision
  • Drowsiness
  • Weight loss

Complications

Hearing about the various complications of diabetes that could directly or indirectly lead to death was also a shocker. These include heart disease, strokes, high blood pressure, blindness via glaucoma and cataract, kidney disease, nervous system disease, erectile dysfunction, dental disease, complications of pregnancy and amputations.

People at Risk of Developing the Condition

People with a family history of type 1 diabetes are at an increased risk of developing the condition.

Risk factors for type 2 diabetes include:

  • Diagnosis of pre-diabetes
  • A family history of diabetes (i.e. mother, father, sister, brother)
  • Heart problems
  • Your race – some races are more prone to it
  • Giving birth to a large baby (more than 9 pounds)
  • Having diabetes during a pregnancy (gestational diabetes)
  • High blood pressure
  • Being overweight or obese (BMI ≥30)- waist circumference is particularly important. A waist size greater than 35in in women and 40in in men has recently been shown to significantly increase the risk of developing diabetes, high blood pressure and heart disease
  • Inactivity

Some Tips

Being diagnosed with diabetes is not a death sentence. You are simply going to have to learn a new lifestyle to fit around your disease. Controlling diabetes will give you a better quality of life, and a longer life with fewer complications as the disease affects your body. Even if you are not diabetic, some of these tips can be used by anyone for a healthier and more satisfying life.

1) Monitor your blood glucose levels closely and keep a log book to take to your health care provider. This will enable them to adjust your diet, medication or insulin accordingly.

2) Visit a nutritionist and stick to the nutrition plan set forth for your type of diabetes. Don’t skip meals knowing that eating isn’t going to hurt anyone but you.

3) Don’t smoke or drink alcohol.

4) Join a support group of other diabetics, (DATT has 24 branches nationwide). It helps to have someone to talk to about the disease, maintenance, and how it’s affecting your life.

5) Stay on medications despite feeling better. It is easy to skip medicines or stop testing sugar levels. Consistency is best in the long run even if it appears to be a bother, or gets expensive.

6) Let others around you know of your condition. Give basic instructions to people around you to let them know the warning signs of both high and low blood sugar levels. You will need breaks to snack and take insulin if needed. Also, you may visit the restroom more regularly than         co-workers. Being diabetic is not something to be ashamed of. Most supervisors are accommodating and understand your needs.

7) Stress increases your sugar levels, find ways to relax.

8) Take care of cuts. Watch them for infections. It’s dangerous for diabetics because wounds could heal slower and infections increase sugar levels. Consult with a doctor/podiatrist/chiropodist/foot health practitioner if you become injured or cut.

9) Use footwear at all times; no walking barefooted. Appropriate foot wear needs to be worn.

10) Do electrical and massage therapy to help deal with nerve related problems such as poor circulation and neuropathy.

11) Exercise is extremely important, but use proper walking/track sneakers. Aim at a minimum to walk 3 times a week for 30 minutes.

12) Although it is believed by many that diabetics can’t do pedicures, you can! Unless your diabetes isn’t under control.

13) Maintain your appointments; see a foot specialist, eye specialist, and dentist periodically. Also, have tests done to ensure all other organs (especially the heart and kidney) are functioning properly.

14) Denial isn’t the way…Depression isn’t an option – accept and fight the disease head on.

Diabetes is a lifestyle change not a death sentence. Taking control of the disease is the first step toward a more satisfying and productive life. Additionally, control will decrease the damage to your body that diabetes can cause especially loss of mobility through amputations. According to DATT, caring for your feet can reduce amputation rates by as much as 45-85%.

This is the first part of a series on Diabetes, related ailments and the relevant care.

Your feet mirror your general health . . . cherish them!

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