DR. THE HONOURABLE DAVID ESTWICK, MINISTER OF HEALTH, NATIONAL INSURANCE AND SOCIAL SECURITY,
Today Barbados joins the global community in observing November 14 as “World Diabetes Day”.
The day has been established by the World Diabetes Federation, so people worldwide may focus their attention on the serious threat to public health that is caused by diabetes mellitus. It presents another challenge to nations, to develop public policies for prevention, targeting people at risk of developing diabetes, and to ensure that the highest standards of treatment and care are made available to persons living with diabetes.
This year’s theme “Diabetes in Adolescents and Children,” highlights the fact that although diabetes is mostly associated with adulthood, it can affect people at any age. Worrying trends are also showing increasing numbers of infants, children, and younger adults, affected by diabetes.
The World Health Organisation estimates that more than 200 million persons worldwide are currently living with diabetes. This figure is expected to rise to more than 300 million by the year 2030, with the highest growth rates being projected for middle and low income countries. In keeping with this trend, the rates in Latin America and the Caribbean are likely to double over the coming decades.
In Barbados, this increasing number of affected persons indicates a major cause for concern. Research has confirmed higher than average rates in our population, with as much as 17 % of adults over the age of 40 being diabetic, with the figure rising to 22% among those 65 years and older.
Treatment for diabetes contributes significantly to our growing health care expenditure. At the same time, the condition may result in illness, disability, and premature deaths, which can effectively reduce the productive capacity of our country. These factors all point to a pressing need for Barbadians to become personally involved in addressing this spiralling epidemic.
At the individual level our primary focus must therefore be on prevention, through engaging in regular exercise and consuming nutritionally adequate diets. At the institutional level, it is imperative that we create a supportive environment, which makes it easy for our citizens to practise health-seeking behaviours. The National Chronic Non Communicable Diseases Commission in establishing its strategic response is currently exploring options to facilitate the achievement of these goals.
While most diabetes in children is type 1 diabetes which is not considered to be preventable, it is vital to ensure timely diagnosis and appropriate treatment of this potentially life threatening condition. It is also troubling that a small but increasing number of children, particularly at the adolescent stage, have been developing type 2 diabetes which is linked to lifestyle factors such as obesity and physical inactivity. This presents an opportunity to emphasise prevention-focussed lifestyles from the earliest stages and to develop and implement population-based prevention strategies throughout the lifecycle.
The Port of Spain Declaration challenges CARICOM Member States to adopt national strategies designed to reduce the ongoing social, health and economic burdens of chronic diseases.
The Ministry of Health in reaffirming its commitment to addressing these challenging situations has undertaken a number of responses that include the provision of training to members of the health care team in the use of the Caribbean protocols for diabetes management. This was designed to assist our practitioners in primary care in meeting current and international best practices in diabetes care. The Behaviour Risk Factor Survey undertaken in 2007 represents another achievement by the Ministry of Health, in an effort to support ongoing surveillance, monitoring and evaluation of chronic diseases.
In recognising the need to apply new approaches to the management of diabetes, two interventions will be conducted in partnership with the Diabetes Association of Barbados. The first is an intense 10-step programme of therapeutic education, which will combine practical sessions in meal preparation, physical activity and psychological support. This programme will be offered primarily to diabetics who have difficulty controlling their condition. A second project will be geared towards primary prevention and will comprise nutrition education targeting nursery school children, their parents, and teachers, through the establishment of home and community-based kitchen gardens.
One of the goals of this component is to stimulate interest in the production and consumption of local fruits and vegetables from an early age.
In celebrating World Diabetes Day we acknowledge that a problem as pervasive as diabetes will necessitate broad based solutions that involve the whole society. We therefore invite all members of the public to use this day to take positive steps towards the prevention of diabetes.
Plant a fruit tree; start a kitchen garden; make a commitment to yourself to exercise for at least thirty minutes a day, three days a week. Let us strive to live a healthy lifestyle and prevent or delay the onset of diabetes.