Port of Spain, Trinidad and Tobago. 13 November 2022. Diabetes is a leading silent but most preventable killer in the Caribbean. The training of health care providers strengthens and standardises the management of diabetes in primary care settings, which is a cost effective and results intensive way of improving good outcomes in diabetes care region wide. This statement made by Dr Joy St. John, Executive Director of the Caribbean Public Health Agency (CARPHA) in observance of World Diabetes Day 2022.
Crucial to an effective response to the diabetes epidemic is access to high-quality, integrated and people-centred primary healthcare services with the appropriate number of healthcare professionals who are well-trained and equipped to care for persons with diabetes.
In the Americas, diabetes was recorded as the fourth leading cause of death and disability in 2019. According to the IDF Diabetes Atlas, North America and the Caribbean are ranked 4th in the world, with an age-adjusted comparative diabetes prevalence in adults 20-79 years of age of 11.1%. Projected prevalence in 2030 and 2045 are 12.3% and 13.0%, respectively1. In 2019, the country in the Americas with the highest age-standardised mortality (excluding chronic kidney disease) due to diabetes was Guyana, with 82.6 deaths per 100 000 population. Several Caribbean countries were in the top ten, including 3rd Trinidad and Tobago and 4th Haiti at 69.6 and 68.2 per 100,000, respectively2.
This year's observance of World Diabetes Day emphasizes the need for better access to quality diabetes education for health professionals providing care and people living with diabetes. While the high prevalence of diabetes and other NCDs were thought to exacerbate the impact of COVID- 19, it showed the need to improve the prevention, diagnosis and management of NCDs.
Diabetes: Educate to protect tomorrow is one of the key messages for the 2022 World Diabetes Day. It reminds us that education supports diabetes prevention, early diagnosis, and the reduction of diabetes complications. Healthcare providers should know how to detect and diagnose diabetes early and provide the best possible advice and care for people living with diabetes.
Access to diabetes education increases the likelihood that healthcare providers will have productive interactions with informed-activated clients empowered to take charge of their health. Information provided to clients should include:
- The risk factors that increase the risk of developing diabetes and the associated complications
- Signs of diabetes and blood sugar control
- Managing diabetes through healthy lifestyle and nutritional choices such as
- Eating a healthy diet which includes at least five servings of fruits and vegetables each day and reducing intake of fats and sugars
- Remaining physically active – at least 30 minutes of regular moderate-intensity physical activity on most weekdays (for adults); and 60 minutes of moderate to vigorous physical activity everyday (for children)
- Avoiding tobacco use
- Maintaining a normal body weight
CARPHA provides technical support to Member States to improve access to care for persons living with diabetes and minimise the impact of the disease. The CARPHA Guidelines for Diabetes Management in Primary Care in the Caribbean, updated in collaboration with the Organisation of Eastern Caribbean States, offer a framework for the care for persons living with diabetes and are intended to support, strengthen and standardise the management of diabetes and improve outcomes in the care of diabetes in the Member States.
Guidance should also be provided on managing difficult emotions, decision-making skills and setting lifestyle change goals to reach optimal health.
If you are living with diabetes or a caregiver, several of these topics may be found in Module 3: Guidance for Persons with Diabetes (PwD) & Caregivers of the CARPHA Guidelines for the Management of Diabetes in the Caribbean. CARPHA has also produced two general videos What is the state of diabetes in the Caribbean and What is Diabetes.
Member States are encouraged to invest in their health systems to meet the needs of persons living with and affected by NCDs. CARPHA provides technical support to Member States to improve access to care for persons living with diabetes and minimise the impact of the disease. CARPHA has also hosted training for health professionals to support adopting or adapting the guidelines in their respective countries.
Print versions of the guidelines and associated tools are being distributed to CARPHA Member States; the e-versions can be accessed at https://carpha.org/What-We-Do/NCD/Integrated- Disease-Management/CARPHA-Clinical-Guidelines.
World Diabetes Day is observed annually on 14 November. The theme for 2021 to 2023 is Access to Diabetes Care.