The dilemma of diabetes: health care crisis in the Caribbean

ABSTRACT

The epidemiologic transition in the Caribbean over the last 40 years has produced an epidemic of life-style-related chronic noncommunicable diseases. Among these are obesity, diabetes, and hypertension, along with such complications as stroke, heart disease, and amputations. The World Health Organization projects that the number of adults with diabetes in the Americas will double by 2025, and that most of the increase will occur in Latin America and the Caribbean. Both obesity and diabetes have been been increasing in Barbados (2-4), in Trinidad (5,6), and in Jamaica (7-9). Obesity (body mass index (BMI) > 30 kg/m) already occurs in 30 percent of Barbadian women 25-75 years old, and overweight (BMI >25 kg/m) in 57.8 percent of them. Diabetes occurs in 17 percent of persons over age 25, according to one study, and in 13.4 percent, according to another study. The combination of a rapid increase in calorie intake and a decrease in physical activity, against a background of cultural traditions that favor female obesity, imposes an unmanageable burden on the limited health care resources of these small countries of the Caribbean (AU)