Specificities of the Diabetic Population in French Guiana: The Health Barometer Survey.

AIM: This study aims to identify the epidemiological and social characteristics of the diabetic population in French Guiana. BACKGROUND: The prevalence of diabetes is very high in the French overseas departments. French Guiana is, however, a very atypical territory, closer in the epidemiological field to Latin America than European and French standards. OBJECTIVE: To perform a descriptive analysis of variables related to renouncing medical care, social parameters, and use of healthcare services. METHODS: A two-stage random sample of 1390 individuals aged 30 to 75 years was surveyed by telephone, and screening was initially done for diabetic versus non-diabetic individuals. Logistic regression was fitted on the sample to adjust for potential confounding factors. A Kaplan-Meier analysis showed the risk of diabetes as a function of the age of onset. RESULTS: The prevalence rate of diabetes was 9.3%, particularly among women, for whom 20% had a history of gestational diabetes. Excess weight and obesity were found in 60% of people with diabetes. The diabetic individuals in French Guiana were younger than those in mainland France, and 30% of people with diabetes were on insulin. They often reported sleep problems, and their health status was described as poor. People with diabetes did not regularly consult a doctor and were very rarely followed up by a specialist. CONCLUSIONS: The prevalence rate of diabetes and obesity in French Guiana was one of the highest among the French territories, with specific vulnerabilities requiring to be addressed by local health policies.

Potencialidades e limitações dos instrumentos de mensuração da sustentabilidade / Potentialities and limitations of sustainability measurement instruments

RESUMO A medição da sustentabilidade tem sido tema recorrente nas discussões sobre o meio ambiente. Este artigo trata das potencialidades e limitações de instrumentos de mensuração da sustentabilidade (IMS) por meio de revisão da literatura e pesquisa de campo com especialistas. Os resultados mostram concordância entre as opiniões dos especialistas e as encontradas na literatura no que se refere ao grau de relevância dos resultados da aplicação dos IMS para as dimensões ambiental, social e econômica da sustentabilidade e sobre a concordância ou discordância quanto às potencialidades e às limitações desses instrumentos. Para a dimensão ambiental, a pegada ecológica foi considerada a mais relevante; para a social, o barômetro da sustentabilidade foi apontado como o mais importante; e para a econômica, o Pressão, Estado, Resposta (PER) foi o mais relevante. Os resultados também mostram que todas as potencialidades pesquisadas foram consideradas importantes para os IMS. Ao viabilizarem medidas de sustentabilidade, os IMS colaboram para a conservação do meio ambiente e o desenvolvimento sustentável, contribuindo para a conscientização da sociedade e de gestores e fornecendo subsídios para a realização de ações visando à melhoria da sustentabilidade, porém as limitações dos IMS reforçam a dificuldade de se ter uma ferramenta que reflita a natureza holística da sustentabilidade em toda a sua amplitude.

ABSTRACT Sustainability measurement has been a recurrent theme concerning environmental debates. This article deals with the capabilities and restrictions of sustainability measurement tools (SMT) using technical literature review and field research with experts. The results show consensus amongst expert's positions and those found in the technical literature about both the importance level of the sustainability measurement tools implementation results and the capabilities and restrictions of these tools. The ecological footprint is regarded here as the most significant to the environmental dimension. The barometer of sustainability is regarded here as the most significant to the social dimension, and PER is regarded here as the most important to the economical dimension. Results also show that all researched capabilities are regarded here as relevant to SMT. By the application of sustainability measurement, SMT contribute to the environmental protection and sustainable development, raising managers' and society's awareness and providing sustainability improvements. SMT limitations enhance the obstacles for a tool to reflect the holistic nature of sustainability in its all extent.