Morbidity from diabetes mellitus in Trinidad: identification of vulnerable groups

ABSTRACT

To evaluate health problems experienced by people with diabetes mellitus in Trinidad we conducted an interview survey of 622 randomly selected patients attending 17 government health centres. We enquired after typical symptoms of diabetes mellitus and combined the responses into a score which was used as the dependent variable in multiple regression analyses. Itching was reported by 215 (35 percent), polyuria 315 (51 percent), burning or numbness in the feet 350 (56 percent) history of foot ulcer 69 (11 percent) previous minor amputation 29 (5 percent), major amputation 10(2 percent), difficulty with eyesight 397 (64 percent), vision reduced to light perception only in both eyes 32 (5 percent). A past stroke was reported by 55 (9 percent), heart attack by 54 (9), and other heart trouble 103 (17 percent). Increasing burden of illness was associated with increasing age, Indo-Trinidadian ethnic background, environmental factors such as absence of piped water supply and social factors, e.g., not being employed in full-time work. Hyperglycaemic symptoms were more strongly associated with lower socio-economic status while foot and eye symptoms were associated with lower socio-economic status and increasing duration of diabetes. Cardiovascular disease was associated with increasing age and Indo-Trinidadian ethnic-origin. We concluded that people with diabetes mellitus in Trinidad experience high levels of symptoms and illness. The elderly, those with longer duration of disease, the unemployed and persons of Indo-Trinidadian ethnic background were more vulnerable to the above complications of diabetes mellitus (AU)