Caribbean lifestyles contribute to diseases

Countries in the Caribbean are coming to terms with health issues caused by obesity and weight gain as more and more people are affected by these conditions.
This was the view of Dr Rita Kalyani, Assistant Professor of Medicine at Johns Hopkins School of Medicine, which she expressed to Cayman Net News in an exclusive interview, following her presentation of a paper at the recent Caribbean Health Research Council Conference held in Grand Cayman.
“We know the epidemiological reasons, which can also be found in the Cayman Islands. These include lifestyle, prevalence of fast food restaurants, high caloric intake and increased sedentary behaviour. All these factors lead to weight gain, which can lead to people developing diabetes, high blood pressure and high cholesterol,” she stated.
Although Dr Kalyani did her research in Trinidad and Tobago, she said the results can be extrapolated throughout the Caribbean region because of similarities in lifestyle and population composition. She said this in the context of high blood pressure being identified as the most prevailing illness in the Cayman Islands, according to the 2010 population census.
Her research focused on 2,000 individuals in the southwest area of Trinidad.
“The research’s goal was twofold – examining the metabolic rate and determining where the Caribbean Health Research Council targets were being met, noting that up to 50 per cent of people with diabetes in the region do not know they have it,” she explained.
She noted that people of East Indian and African descent were likely to develop diabetes because of their ethnicity, although genetic reasons could not be ascertained.
“So people in the Cayman Islands are at risk of developing diabetes,” she said.
She noted that diabetes does not only affect high-risk population groups. By 2020 the number of persons affected by the disease will almost double and 80 per cent of that risk will be in the developing world.
“We also wanted to identify potential gaps in care and to ensure that limited resources from government were optimally allocated to improve the general wellbeing of people with diabetes,” Dr Kalyani said.
She noted that the research found that on the whole, targets set by the CHRC were not being met. More than half of the research group tested negative for the recommended glucose level and more than half did not have the recommended cholesterol levels.
Two thirds were overweight or obese and were likely to suffer from high blood pressure, which was also over the targets, placing them at high risk of heart disease.
In defending the science behind her research, Dr Kalyani said the research team assessed each patient’s level of diabetes care using a questionnaire, focussed examination and point-of-care testing.
In reporting about the results it was found that between 2010 and 20ll, the study evaluated 2,129 patients. The majority were female (63 per cent), East Indian (64 per cent), current smokers (69 per cent), and had completed primary school (90 per cent).
The paper noted that one-half self-rated their health as fair or poor. The average age at diagnosis was 38.3 ± 13 years; 68 per cent saw a doctor/nurse regularly for diabetes care and 70 per cent received education.
Dr Kalyani noted also that only 28 per cent had seen an eye specialist and nine per cent received a foot exam in the last year. Only one per cent self-monitored blood/urine glucose and one-third recalled ever having an HbA Ie’ (test for glucose). The prevalence of self-reported complications was: heart disease (24 per cent), stroke (seven per cent), neuropathy (41 per cent), foot ulcer or amputation (13 per cent), retinopathy (13 per cent), nephropathy (five per cent), hypertension (67 per cent) and dyslipidaemia (51 per cent). Two-thirds were overweight or obese and 16 per cent had a high-risk foot examination. Overall, few patients met CHRC guidelines.
Dr Kalyani noted that the government should allocate more resources to fighting diabetes people who were predisposed to the disease because of ethnicity should regularly have their numbers done, because it is highly likely the disease will affect more and more people in the Caribbean region.
She also noted that Caribbean governments should facilitate education symposiums every few months.
“Point of care machines should be increased so that people can get the results that the physicians need to ensure proper care is taken,” she stated.