Considered a worldwide health catastrophe and suffered by more than 422 million people on the planet, diabetes reflects a complex situation in Latin America and the Caribbean, with elevated prevalence rates.
Lisbet Rodríguez Candelaria
The majority of countries in the region have an unfavourable prognosis for this illness – which is growing at an alarming rate – with indications of premature death.
Factors such as genetic predisposition, high blood pressure, lipid disorders, but fundamentally a sedentary lifestyle and obesity, constitute a risk for this chronic condition which, the World Health Organisation considers, will rank as the seventh highest cause of death by 2030.
Mexico occupies first place worldwide for child obesity for children aged between six and twelve; in the case of adults it is in second place, as almost seven out of ten people have these characteristics. Around 35% of the country’s population are overweight and obese.
According to Maria Luisa Ponce, researcher at the National Autonomous University of Mexico, the obesogenic environment strengthens insulin resistance in 95% of cases, a risk factor for the development of diabetes type 2 and cardio-vascular diseases.
The high prevalence of the illness (also in children) is due to a diet which is high in sugary products and saturated fats, in combination with a lack of physical activity, the medical-surgical specialist emphasised.
It is a problem which begins at the pre-conception stage, as any changes in the mother affect the formation of important organs such as the pancreas and the liver: the sensitivity of some of these organs’ receptors is reduced and manifests later on as chronic illnesses in the postnatal stage.
Cuba and diabetes
Cuba is one Caribbean country that has high levels of obesity, mainly in women: because of this the island has many programmes for addressing diabetes during pregnancy, with multidisciplinary teams in gynaecological and obstetric hospitals.
At the end of 2018, diabetes on the Caribbean island showed a prevalence of 64.3 per thousand inhabitants, which translates to 747,466 diabetics registered by the Primary Health Care system, a prevalence which is on the rise precisely because of the growth of sedentary lifestyles and obesity, explained Ileydis Iglesias, director of the National Institute of Endocrinology.
Despite the limitations that Cuba faces such as not having blood glucose continuous monitoring devices or insulin infusion pumps (because they are devices made with North American technology) for patients whose condition does not clear up with multiple injections, it is the most successful country at managing its patients’ blood sugar levels, according to reports from the Pan American Health Organisation.
Hence, of note is the attempt to make insulin treatments more humane, a project involving 20,000 patients which seeks to replace the traditional treatment using vials and syringes with a more convenient and discreet device, which improves the treatment and reduces pain to the minimum with the use of thin needles.
Called NovoPen 4 and made by the Danish company Novo Nordisk, a worldwide leader in diabetic products, the device has been made available as a priority in Cuba to children under 19, young people under 25 and people with visual impairment or suffering chronic renal illness, although in the medium term the majority of diabetics will be able to access this technology.
Without a doubt, the advantages of a national programme that dates back to 1975 and has a network of diabetic care centres throughout the country that now stands at 18, makes Cuba a global model for the prevention and treatment of diabetes. Heberprot – P, a unique medicine that has succeeded in reducing the risk of amputations in the country by more than 70%, also stands out as one of the successes of the Cuban healthcare system. (PL)
(Translated by Carol M Byrne) – Photos: Pixabay