Diabetes Mellitus Fifth Leading Cause of Death in The Bahamas
By Llonella Gilbert
Nov 19, 2018 - 4:51:38 PM
Minister of Health, Dr. the Hon. Duane Sands presents on the incidence of diabetes and its effects, November 16, 2018 at University of The Bahamas. (BIS Photo/Patrick Hanna)
NASSAU, Bahamas – Minister of Health, Dr. the Hon. Duane Sands said Diabetes mellitus is a devastating and costly chronic, non-communicable disease, which is now the fifth leading cause of death in The Bahamas.
“We have seen the prevalence of diabetes increase from 6.7 per cent to 9.2 per cent in 2005 now to epidemic proportions of 13.6 per cent in 2017,” Dr. Sands said at the Bahamas Podiatric Medical Association 2018 Conference, ‘New Hope for Diabetic Feet,’ at The University of The Bahamas, Friday, November 16, 2018.
He added that in The Bahamas, 37.9 deaths per 100,000 persons are due to diabetes.
The Health Minister said foot complications are the source of major patient suffering, high emotion and financial costs to the individual and healthcare system.
He said the frequency and severity of foot problems vary from region to region, largely because of difference in socio-economic conditions, type of footwear, and standards of foot care. Foot ulcers are the most prevalent problem, with a yearly incidence of around two – four per cent and a lifetime incidence between 15 and 25 per cent.
Dr. Sands explained that the most important factors underlying the development of foot ulcers are peripheral sensory neuropathy, foot deformities related to motor neuropathy, minor foot trauma, and peripheral artery disease.
“Once the skin is ulcerated, it is susceptible to becoming infected, an urgent medical problem that can result in amputation or even death. Only two thirds of foot ulcers eventually heal, and up to 40 per cent can recur and 28 per cent may result in some forms of lower extremity amputation.”
He noted that every year, more than one million people with diabetes lose at least a part of their leg, translating to a lower limb being lost to diabetes, every 20 seconds somewhere in the world.
The Health Minister said the five-year death rate following a diabetic foot ulcer or amputation is 50 per cent and higher than in persons with prostate cancer and breast cancer. Prevention of foot ulcers is of paramount importance and has long been recognized as a priority.
He explained that a large number of diabetics are experiencing lower extremity complications therefore the practice of podiatry medicine should be intertwined with their care.
“A multidisciplinary team approach is most effective in providing care and encouraging compliance and reinforcement of foot care practices by all specialties in the diabetes care team. It has been shown that establishing multidisciplinary foot care teams are associated with a drop in the number of diabetes related to lower extremity amputations.”
Dr. Sands added that podiatric medical care is a vital and increasingly valued addition to this multidisciplinary team.
He said the American Diabetes Association’s position statement of Prevention Foot Care in People with Diabetes, recommends that all persons with diabetes receive at least one foot examination annually. The Health Minister said the Department of Public Health, Diabetes Management Protocol also mandates that every diabetic receive at least an annual comprehensive lower extremity examination.
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