 The panel, the discussion, an objective and impartial view of the issues of interest to you. Nation Beat is on now. Welcome to a production of the Ministry of Health in collaboration with the National Television Network and the Government Information Service in the observation of World Diabetes Day. I am here presented today, Sant Justin. We will be discussing World Diabetes Day 2022, annually celebrated on November 14th. This year's theme, Diabetes Education, to protect tomorrow, very specific theme, and with me I have a panel from the Ministry of Health and the SLDHA who is going to help me talk about that theme. We don't want to make it a straightforward discussion. It's going to be very informative, very light, and the representative from the SLDHA is going to take us on a shield. So just to introduce our panel today, Dr. Shana Siru is the senior medical officer with responsibility for chronic diseases with the Ministry of Health. Dr. Siru, just give us a little wave. Nus Yolanda Al-Sidore also from the Ministry of Health is the principal nursing officer. How are you doing today, Nus? I'm good. Wonderful, wonderful. And Mrs. Jacqueline Scott, a very special panel member today. She's a board member of the Saint Lucia Diabetes Hypertension Association and she's also living with the diabetes. So very interested to hearing your story today. Okay, so just to kick off conversation, recently there was a survey held, steps survey, and it was in its second phase, okay? The preliminary results came out with some concerns with our risk for chronic illness, diabetes included. Dr. Siru, we want to start the conversation with you. Can you share with us a little on the current situation in country with diabetes, particularly in reference to the steps survey? Okay, we're very happy. I'm very happy to be here this morning. Very, very good question. So in 2019 and 2020, we embarked upon something called our Behavioral Risk Factor Survey, which is called steps, a step-wise approach actually. And we looked at the risk factors for chronic diseases, including diabetes, but not limited to diabetes. So we looked at things like what the diets were like, whether people were exercising, smoking, alcohol consumption. We also measured persons. We looked at what their waste circumference was, what the weight was, blood pressures. We looked at blood sugars, cholesterol levels, and so on. When the results came out last year, we took a while to get them because they had to go through the external organizations and so on who were helping us with the analysis. When the results came out, we were very concerned about particular things. And one of the things, one of the risk factors for diabetes, a very significant risk factor is obesity. We realized that traditionally women are more obese than men in the Caribbean region, particularly. All of a sudden, when we looked at our results from 2012, when we did that survey and compared 2012 to 2019, the rate of obesity in men had risen by 20%. And that's significant, of course, when you look at the risk factors for diabetes, high blood pressure, cancers, et cetera. So that was concerning. The rate did not increase significantly for women, but for men who traditionally have better weights, that had increased by 20% for our blood pressure, our raised blood pressure, which is a significant risk factor for even diabetes itself, that had gone up by 12.1% between the years where we did the surveys. Our blood sugars had not changed that much, but we only measured blood sugars for about 30% of the respondents for the survey. But like I said, obesity was one of those things. Physical activity, which is also a significant risk factor for diabetes, that was very concerning. Persons had not been engaging in physical activity for like moderate physical activity. We had about 80% of the respondents not doing that at all for the weekend. And of course, that is concerning because it's a significant risk factor for diabetes and for NCDs. So on that same question, when you see concerning, would you say there was a significant downward trend coming from statistics before? Yes. Traditionally, probably around, you know, about half of the respondents would tell you, okay, they're engaging in physical activity. So for this particular round of survey, about 80% of them did not engage in any, you know, what we call moderate physical activity. We're talking about jogging, cycling, that kind of thing. People were not doing that, okay? And our rate of sedentaryism or physical inactivity was a lot higher than it usually is. And of course, that's concerning. So from trends seen through these two surveys and from engagement with people within the clinic and community settings, what do you believe is underpinning the current trends with diabetes? The current trends in terms of just the survey. We did one of our concerns. We did a survey around the end of 2019 and into the beginning of 2020. All right? We can argue that persons were afraid of COVID, et cetera, they were probably not going out as much. Yeah, we can argue that. But remember, we started a survey in 2019, okay? One of the things we've noticed, not only with adults but also with children, is the tendency to be using a lot of gadgets, spend a lot of time doing very sedentary things. You sit at work for eight hours. You go home, you sit in front of the TV or you sit online and you know you're on social media and so on. So we know that that is definitely affecting our levels of physical activity. Okay. Ms. Alcindor, principal nursing officer. Sinusia offers a very robust primary healthcare with health centers in communities island wide. Can you share a little on the services offered for diabetes prevention as well as treatment? Well, the services we offer through the Ministry of Health and primary care for diabetes on chronic diseases generally are that we focus on prevention and then we offer physical activity. There is screening, so persons who are not diagnosed as yet can come in and get their blood pressure, their blood sugar tested. We do weight measurement, weight circumference, all that is part of our screening for chronic conditions. Also, there is treatment available where persons who are living with chronic conditions are medical services available, medications available at the facilities. We offer support for our self-management program which is a weekly program for two hours for a duration of six weeks where persons living with chronic conditions go through that program and develop competence, different skills that they need to cope with their chronic condition. We look at problem solving, decision making, physical activity, healthy eating, all that is part of our chronic disease program. Also, for both persons with diabetes and high blood pressure we do offer eye care where we have our diabetic retinopathy program and all the services through primary health care is free of charge. It's at no cost and it's available to everyone. Now, with all these services available, the statistics coming from the steps of E. Would you say it's surprising or how did you take it? Well, I won't say that it is surprising because there are other factors. Although the services are available, other factors contribute to persons' self-management and healthy lifestyle practices. Like Dr. Sir mentioned before, we were just starting with COVID and also there are changes within society where we have to encourage physical activity. Just the knowledge, the information is insufficient. We have to try to create safe spaces where persons can go out and engage in physical activity. That is one of the areas we really have to focus on if we want to change the trend that we are seeing now. We just want to change up a little bit and bring in Mr. Scott. Mr. Scott, you're here in a dual capacity. First, we want to talk to you as a board member of the Senoshia Diabetes and Hypertension Association and as someone living with diabetes. Can you start by sharing with us your journey with the diabetes diagnosis? How was it going for you? Well, I would say so far so good. But I'm quite aware that I ought not to take it for granted. My journey with diabetes began with my mom having been diagnosed with diabetes some time prior and so we got to see her live with it and I must say kudos to her. She really handled it well. I mean, from the wood go, she did everything she was supposed to do. So she managed her diabetes well but I can say that we also have it throughout our family on both sides. My dad has it as well, very well managed but I got to see my grandmother have it and my aunts having it and we've lost loved ones through diabetes. So I was always at high risk of developing it and so I had, being aware of that, every time I did go to see the doctor for my checkups and so on, of course I got my test done, my urine test and so on and I thought, well everything always came out okay. So I thought that I was alright. I didn't pursue, I didn't study and research more information about it. I just thought if your sugars are okay, then you're alright. Until one day I went to one of my doctors on another matter that was recurring and she said, have you been tested for diabetes and what's the, do you have diabetes in your family? And since I did, she told me, when I explained to her, well I mean I've always been, you know, taking my tests and so on and everything's coming out okay. And she said there's another test. I was sending for that one. And that I did only to find the results showed that I had blown all five parameters of the job. I had full blown diabetes and apparently I'd had it for a while. And so that's where the journey began and I can say that it still didn't quite hit me. So at the start it was a lot. Just to know, oh my goodness, I did get the thing, right? But I was still in denial because there were not many changes to my body. I wasn't feeling sick and all of that. So I think I'm okay. And so I'm not getting back okay. Until I started seeing those changes because now I was more away. So one of the things I found was that I started having fuzzy brain. I just found out I was finding myself slow to respond to questions and just wondering what was going on with me. It's like I used to be able to think quicker than that but what's happening. And also when I started feeling weak and one of those, on one occasion I wrecked my car in the mall in the parking lot and I hit a pillar, I ripped the side of the car. And I just wondered, well, how did that happen? Because in my mind there was no pillar there. You know, and the pillar just came in the way. And what happened was that my sugar was really low and I was getting to a dangerous place at that time and I wasn't even aware that this is what happened. This is what diabetes does when your sugar is low. So I was disoriented in a really bad way at that time and I wasn't aware. And that is where I got to discover this is what diabetes is like. This is what it does. This is how serious it is and you could have really gone down in a bad place at that point. So that is when I began to pay attention to it and start being more aware of the changes in my body. When I eat certain things, how my body changed, how I felt, and then it became real to me. And I began to learn more, research more and start to do the things that I needed to do. Because it became a reality then. Doctor Sir, if somebody has gone through the whole process, the tests, for as far as they consider, and then to end up in a position where a doctor is saying, yes, you have diabetes. After you know you've gone through that process, how is that possible? So for diabetes, we do screening and we recommend screening for particular individuals when it comes to the risk factors for diabetes. So we have things like your age, all right, above 45, whether or not your family has a history of diabetes, which Ms. Scott alluded to, whether you're obese, that's a significant risk factor. Our ethnicity, okay, black people are more prone to having diabetes, whether or not you're somebody who actually exercises, because physical activity would help you with that. Whether or not you've had gestational diabetes, some women have diabetes during pregnancy, later on they can become full-blown diabetics. So we recommend screening for persons like that. And the screening would have to be at intervals. We recommend that at least once every three years you get your screening done. We do a finger stick, right, with a glucometer. However, if that reading is abnormal, once you hit above 100 on 100 milligrams per deciliter, we would start looking at you as possibly having what we call prediabetes. We would send you for another test, which would be our fasting blood sugar, or our HB A1C, or we do an oral glucose tolerance test if we have reason to believe that you need that, too, okay? So traditionally, before we tested people's urine for diabetes, however, the research has shown that urine, that sugar would end up in urine after the blood sugar is pretty high, okay? And so you'll probably be diabetic and not be spilling sugar until you reach a particular level. So that we don't use for diagnosis or screening anymore. We do blood, okay? We have to get your blood either from your finger initially to give us, you know, something to go by. But then we would get blood from your vein and actually test that to see whether or not you have reached a particular level where we can consider you diabetic or prediabetic. And that blood test must be done at a lab. Yes. Okay. So should we stop calling it pisadu, then? I, honestly, we call it pisadu, but we need to be very careful about calling it pisadu because long before your urine becomes sweet, if you want to say it like that, you can already be diabetic because the blood sugars are higher than they should be. Okay. Now you mentioned, Mrs. Scott, you mentioned something very significant, which is changes in your body. I mean, that's something that we don't take note of as individuals, changes in our body. And women normally do it. They would run to the doctor as soon as they see the slightest change, but I guess men take a little longer. So can we talk about noticing changes in your body and maybe when you should, let's say, run to the doctor? Well, like Dr. Sears said, that screening is done. You do not have to wait for changes to get screened to get tested. However, if you're experiencing any change, you should seek medical attention as soon as possible. The health centers are accessible and you do not need money. The services available would provide counseling at the wellness centers and we will direct you to where you can get the services and get it in a timely manner. So we're asking persons, do not wait for change. If you have not been screened for a while, come to go to your nearest wellness center to be screened. Also, persons who are already living with the chronic condition, if you do observe changes, you notice changes, also visit so that we could do further tests because that's a possibility you are developing complications from your chronic condition. Now, as a nurse practitioner, what is your view on how the services are being utilized, both clinical services and education programs offered on diabetes? Well, we would love for more persons to access the service. We would love for more persons to come in because our wellness centers are open from 8 to 4.30. What we find in our culture, a lot of persons come in the morning and the afternoon can be quiet. So we're asking persons, you can call, you can make an appointment, you can walk in to access our services. I want to ask you, Mr. Scott, almost a similar question. In your role with the SLDHA, what would you like to see change as it pertains to current trends with diabetes and so on? Well, one of the things we will be pushing next year in our educational campaign is the need for individuals to seriously consider developing a healthier lifestyle. I mean, off the bat. So once you have that in mind, about from the screening having to always do your checkups and make sure everything is okay, but if we commence living healthier lifestyles in terms of our eating, our exercising, drinking more water and things like that, and we'd like to encourage people to start doing it from young. That's why we have gone to our alma maters to speak to the young ones. We decided to start there, to start passing on the message that you can start, even from now. You can start making the right decisions from now in terms of what it is you eat, how much water you drink in terms of, you know, getting off the gadgets, the devices, the gamers, the games and so on, and engage in play-fit activities where you are being a little more physical and so on. Get out of the house. I encourage them to, you know, be happy about doing their chores because every bit of movement that you give to your body is part of exercise. So just start incorporating it throughout your life and how we eat and so on. So that's one of the things we will be pushing. Let's begin there, like taking care of our body because our bodies are wired a certain way. It's meant to function a certain way. It's meant to absorb nutrients a certain way, process your foods a certain way. There's a purpose for the water and the quantity of water you drink per day. And Dr. Sear referred to living a sedentary lifestyle. I can say that I was guilty of that. Office workers, you spend those hours at your desk per day maybe a bit of movement here if you have to go out for lunch, move about the building or wherever it is. But when you think of the number of hours that are spent at your desk per day, you leave late at the end of the day. There's no time to go out to the gym or to go walking because it gets dark now, especially for a woman. So it has been those issues about feeling safe on the road, you know, and, you know, I'll get to exercise. You start the gyms and then there, you know, you think of the course, can I really sustain that? You know, and then you just put it off. But then that body is not getting the amount of physical exercise. It needs to help with the food and the drinking of water and so on. So if there's anything apart from the services, because we're looking to introduce more programs as the theme for the next years is access to diabetes care. So apart from the care, we want to help educate people to encourage and inspire people to live healthier lifestyles. So as Ministry of Health, we have thought of that. And part of primary care is that we do outreach. We go out to the communities, to the workplace where persons who do not readily access the services at the Wellness Center, we bring the services to them. Also, we have nutritional counseling that's available. And for our Caribbean Wellness Day, we launch St. Lucia Move, encouraging persons to move, engaging physical activity. And we're hoping that the workplaces will come on board and have everybody moving and getting physically active. I want to zoom in a little bit on your journey. Because there are people at home who only went to the same thing that you went through. They didn't know. Maybe they tried, but they didn't know. Like you did. Tell us about some of the changes that you have to make after you were diagnosed. Well, one, I had to go on a diet immediately. Lose a few pounds. My doctor was on my case. I got my diet sheet set so on, yes. So we did that to manage the weight, getting into more physical activity. I'm not on the road. Just making sure that I'm always moving and getting out of the house, running errands and doing so on. I've also had to start reading my labels. Cut on sugar. Change the types of sugar that I use. If I use at all. So getting accustomed to drinking your tea without sugar, reducing on milk or changing your milk to healthier, plant-based milk or reading labels has been big for me. So now I'm aware of reading, checking my carbs, how much sugar and also even fruits. Knowing which fruits are better. Because even if the sugar and fruits are healthier, there are those that have more. So there are those that are better. So I choose more tart fruits and so on. So I do a lot of research. I do my meals. How to combine my foods. What time to eat. Just being on top of it. Time of day to eat. Getting my rest. Sufficient rest that I'm still working on. But these are some of the changes as well as constantly checking my sugar. Making sure that I check several times a day. So I'm getting used to getting my little pricks and so on. So you just have to be on top of it and be aware. Be more conscious of your body. The changes. Because you're moving about. You feel weak but you just think I'm not feeling well today. Or I'm tired. Or I'm just hungry. There is no emptiness. I'm just hungry. But you don't know that your sugar is plummeting so low. You could be in a dangerous place. So you're not just hungry. You find yourself in a coma. Collapse or something. So being more aware of the changes to my body now. And knowing how to interpret that. And that's where I'm at. So far. I think the scary thing about knowing that you're living with diabetes is how the changes that you have to make would affect you. How has these changes how has the effect of these changes been for you? Well I mean I suppose we are creatures of habit and you don't like restrictions. And you've always been accustomed to being able to eat what you want to eat. Do what you want to do. If I feel tired now I will rest. So the fact that you have to change your life as a whole and things you thought were okay because you think well I don't eat bad. I'm not a junk food person. I feel like people would eat a whole chocolate bar. I go crazy over ice cream and this and that and the other. Although I do need to mention I am a cake decorator baker. So I do sweet stuff. But to say that I consume so much of it or whatever. So I thought I was okay. You know. But you have to rethink all of those things and just know that if you are having it you don't indulge. I wouldn't say that I indulge but the fact that I have the disease I know that I have to be all the more careful. And just know what proportion to use and if you choose to indulge now know what else to do. Well for your next meal what not to take so that you don't add to that. So it's just a matter of getting the information. Understanding the disease and understanding how it affects the body. And applying that knowledge on a daily basis. You said some very interesting things. We are going to zoning more on those things when we get back. This is take 30. We will be back in a few. Okay thank you for staying with us on take 30. Today we are talking diabetes. World Diabetes Day celebrated on November 14th and we're still talking about we're still trying to educate the masses on the Dr. Sergio in the break you said you wanted to expand more on changes in the body. You're saying that sometimes there are no changes. So sometimes, most times initially even if you are diabetic and you're not screening you're not checking your blood sugars etc. The changes may be so subtle that you do not pick them up. So you think you're okay but you're actually not okay. The damage is being done in your body. Remember there's only a particular level of blood sugar that should exist within the body to function normally. If your body is running on a higher than normal blood sugar, every part of your body is being affected in essence because the blood flows through every part of your body. So we just want to make sure that the average viewer understands that even if you don't feel anything, at least so you think that there could be changes happening. You can be diabetic especially if you have a few risk factors. So screening is really important. You go and you check. Relatives have diabetes. My mother has diabetes. My sister etc. Go check routinely. It doesn't hurt in the end. That is what I wanted to say specifically. So you're saying even with no reason just pick up. Your reason is that you have risk factors for diabetes as well. We're talking about obesity. Family history of diabetes. You've had a very big baby more than 9 pounds. As a woman you've had a baby more than 9 pounds. You are at risk for diabetes. You're a smoker. Smoking is a significant risk factor for diabetes. You have high blood pressure. High blood pressure can cause you to get diabetes. So once you're hypertensive, you should be checking for diabetes as well. So we're saying don't just go. I don't have diabetes. That's not the way to go. Go screen for diabetes. Minus all these factors. Minus all these factors. You're 40 years old, 45. Routinely do your screening. And screening is available at all the wellness centers. So you can access that service closest to you at your wellness center. If at time when you do the glucose test, the finger break, if it's elevated then you'll be given a form to go to a lab to do another test. Okay. Mrs. Scott said something a little earlier about she's a beaker. As far as I know, I'm not sure if it's a myth. A regular conversation would say, you know, cakes are not good. Don't eat cakes. Don't eat anything with I don't want to say too much sugar, but a certain amount of sugar. Let me ask you first, Mrs. Scott. How is your relationship with your doctor? You being a beaker? Well, she's on top of it. We discuss it thoroughly. She spends time with me. So we go through how much I consume and how I consume. If I do consume, how to manage it thereafter in terms of what do I eat next so that I don't, you know, exacerbate it and so on. The fact is I am in it daily. Everything I do includes sugar and so on. It's just a matter of managing it if that's the business I'm in being aware of my risk and taking care of myself in the process. So the fact that Mrs. Scott is a beaker does this change anything? I mean, people will say don't eat, don't eat, don't eat. What are we doing now? Is there moderation coming in here? Yes, moderation is important, self-discipline moderation and also education on portion. So portion size what amount you're going to have and what it contains. As Mrs. Scott mentioned earlier, she spoke about label reading and all that is part of our self-management program that's available. So we need to know somebody living with, and not only persons living with diabetes, but generally if you're going to consume any food high in sugar or refined flour and so on that it should be in moderation and also you need to substitute because of the conversion after you've consumed that food, that amount of sugar that will be in the blood at the time, you need to know what you're going to consume next so you'll eat less of anything that contains carbohydrates, starch you'll consume more water so your body can get rid of it faster so you do not develop you know, causes any damage or it's not something that should be done on a regular basis that you'll have elevated sugars to move on to complications. So moderation small amount and a balancing act. You've had something that is considered not too healthy then you need to consume more healthier foods. So I just want to self-monitoring not continuously self-monitoring is very important at this point also so I've consumed a slice of cake I need to check what my sugar is for the next meal even before the next meal I need to find out what it is so I know what I can consume for that next meal and persons living with diabetes need to be empowered on how to test their blood sugar on their own half their meters and so on we encourage that although it's not everyone who can afford it and I'm hoping within the health system we'll be able to give some support very soon to persons living with especially diabetes and high blood pressure for self-monitoring So the self-monitoring can you tell us what you do to monitor your well one of the things I try to do is ensure that I have something in my stomach before before I consume cake or cookies or something so try to have proteins or fiber in my stomach so that it slows down the absorption of the sugar in my system and also as she said after you've had that just observe your body after you've had it know how much to have in the first place and also observe the body to see if there are any changes how you feel and know what not to eat so I'll not have another sweet thing in a hurry after I've had a slice of cake and before my next meal just be sure that my sugars are in the right place as a whole you just want to check your sugars know that your sugars are okay before you consume anything I try to do that to get my device check my sugars if I'm okay because I have the diabetes and I need to be sure that I manage it properly that is my beauty something else that's very important when it comes to control is taking your medication in a timely manner and as prescribed so if you're experiencing any difficulties any challenges with the medication you should go back to your doctor come to the wellness center because the medication can be adjusted and also we can give you advice on how best to take the medication to prevent complications so we do have a challenge where persons do not want to take the medication they skip days or they cut on the dosage and so on this is not advisable especially considering you know what Nessar is saying about the medication persons when we look at the myths concerning diabetes you know in the wellness centers patients have come to me and said well you know you're the money piece I do they say I have diabetes but so and so who did me something okay I don't have diabetes okay there can be denial but then because they don't think that they have diabetes then they tell you they're not taking the drugs I've had patients say but the drugs are supposedly going to destroy my kidneys they're going to make me sicker they're going to do this and that but when you look at the effects of not taking the drugs to control your blood sugar blood sugar that is left uncontrolled damages every single part of the body and of course we have the complications that we know you lose your eyesight you can have strokes you know you can have heart issues you can have kidney problems we have quite a bit of problems as a healthcare system because of our prevalence of diabetes we almost at 12% as a country you know and of course the kidney pathologies and people needing dialysis that is something that a country can't afford but that is diabetes so in as much as they probably not feeling that sick and they see a need not to take the meds the complications are coming on and as the complications come on then they're in a worse state than they would have been if they had taken the medication as prescribed okay and as Nassar Asindo said if there's an issue, if you're concerned you come back and sit with the healthcare provider and discuss the issue and one of the complications we must not forget is the feet where persons are losing their toes persons having amputation losing their feet and so on this creates a lot of problems because we are unable to move around as they would like you have lots of income you have a burden for other family members to support and all this can be prevented or even delayed if we start managing well prevention first and start managing effectively as soon as we are diagnosed and the self management program provides that education and support for persons living with chronic condition I want to talk more about the education aspect of managing diabetes and what's been happening within the last month in observance of old diabetes day you mentioned some other things that were being done let's go further into what was being done during the month of November Mrs. Scott mentioned labelling and I know that's something that was being taught during that process so it's not only during the month of November but throughout the year as the year goes by we provide education and support and one of the ways that is done is through the chronic disease self management program and like I said before this program is over duration of six weeks we meet once a week for two and a half hours and every session we look at different areas and topics where we give person skills so they can manage effectively because someone living with chronic condition they only see the healthcare provider maybe once every three months and during that period of time they have to manage and whether they do a good job they do a bad job as a form of management would love everybody to manage good well to avoid complications so one of the good thing about the self management program is that at every session we do what we call action plan each individual within the group just having the group form of support for each other and for the action plan towards the end of our session individuals decide on something that they want to do for themselves before we meet the following week and to be able to do it effectively so they can decide on anything or something we've discussed within that session our sessions like I said before communication how we talk to ourselves the thoughts that we have how we talk with our healthcare provider problem solving when challenges come about how we solve problems or how we have to learn to live with something that we cannot solve but we can manage and all that is part of stress management also we look at healthy eating weight control how we make decisions how we decide whether we'll try a new medication or whether we'll continue our medication and label reading also is part of that program the program is designed in a way that everyone can benefit even if you're not fully literate you can't read and write you can still benefit through the program label reading is very effective because we are able to know what we're taking in when we go to the supermarket we consume or we purchase foods we're able to look at what amount of salt sugar and other nutrients these food contain sometimes we'll be surprised that foods we never thought contained salt has high level of salt and also sugar and that is why Ministry of Health is also working on to front label yes where for persons who are unable to read the small prints they can just look at the label and see the signs and know whether this is high in salt this is high in sugar is that a food I want to consume I think there was a pointing time at least maybe when I was a bit younger where we would think that hypertension and even diabetes only affected a certain age range is that a myth? definitely like I was saying one of the most significant risk factors for things like diabetes even hypertension is obesity and the world is becoming very obese ok the world over there is no exception the Caribbean region actually even in our childhood population we have a serious issue about obesity so when you are looking at obesity being a risk factor for our children we are looking at type 2 diabetes which is the more predominant kind of diabetes there are a few kinds of diabetes but generally we are only talking about diabetes in our setting we are talking about type 2 diabetes which is more lifestyle related in the region and in the world over that younger persons are getting type 2 diabetes traditionally children didn't get type 2 diabetes and we are looking up to 18 they did not get type 2 diabetes so once a child would have had diabetes you were almost sure back in the day that it was the type 1 which couldn't be helped right now you have younger persons 12, 13 getting type 2 diabetes and this is the one that you can prevent being laid on set alright so it is an issue that is no longer a myth that ok well you know what I am 25 I can't be diabetic because I am still young that doesn't exist anymore we are having younger and younger persons becoming diabetic now you said the word I want you to be specific in St. Lucia do we have persons 18 and below in St. Lucia we do who are type 2 diabetics we have type 1 diabetics to children but we have type 2 diabetics to 18 and below yes I just wanted to say that I am also a member of the Diabetes Foundation for Youth which is the youth chapter of the SLDHA and it is a support group for young people youth with diabetes and we have young children 5, 6, 7, 8 teens who are living with diabetes and it is a useful group to be in because there is support, moral support we check on each other what are your sugars this morning and if somebody isn't doing too well we put pressure on you and so on and there are other services available for the youth so that is something I would like the public to be aware of but I would like to mention that we have a member he is 22 now but he has been diagnosed for a few years who unfortunately just lost his second leg so he is now at double amputee and he is only 22 years old so it really goes to show that that is possible that young people can have it and have it in a chronic way and that is why we would like for young people to be aware of that disease and from now they can start making the changes to their lives that is what the diabetes so that can be prevented if you start early you can help delay the onset or avoid getting it at all not all of those in our group have the type too but it just shows you that it is just as real and that you have young people having amputations unfortunately as we close in our professional view what do you think is the most urgent need to reduce the impact of diabetes on our population I want to just go back to what we are saying what we have been saying throughout the program I think education is really really key and we are not looking at education just for the person of diabetes we are looking at education of the general population education as to what diabetes is and what it can do and how it can be managed also education of our healthcare providers sometimes I think we don't take diabetes seriously alright and I think it should be taken so much more seriously than it is and of course education of our patient population diabetes needs to be the kind of thing that is spoken of in a very simple language so for instance understand what it is about their bodies on what they do about it like Ness Ascender was saying most of the diabetes management and any chronic disease management happens outside of the healthcare provider's office so persons need to know about the disease what to do about it and how to manage and Ness Ascender was saying something we need to be empowered we need an enabling environment to manage your disease if you can't even have a sidewalk and physical activity is so important when it comes to managing diabetes weight loss those things need to there needs to be an enabling environment to allow for those things to happen closing statements diabetes is not a death sentence together we can try diabetes Ness Ascender I would like to encourage persons to access the services that's available visit the wellness center closest to you you can get screened and also you can get information on the other services available to help you with prevention if you already diagnosed to help you manage your chronic condition and we are there to serve you so feel free to come visit your wellness center closest to you I just caught in your closing statements I would like to I would like you to reach out to persons who maybe have or have been diagnosed with diabetes and probably sitting at home down and out any support groups that they can come to or just highlight that for us okay well I would like to mention the services that are offered by the SLEH as well the signature diabetes and hypertension association we can walk in any time to our office we offer screenings as well you can get your your glucometers, the strips we offer counseling and we can advise you on portion sizes we sit with you discuss, we check all your your vitals and we also offer food care we have the equipment, everything so you can get full exams okay the signature diabetes association is there for you and you will get the support from us, feel free to walk in any time also the diabetes foundation for you has activities coming up as well we like to encourage the young people to be aware of that association and to inquire you can call the signature diabetes office for information as to how you can join so there is support for members and non-members as well because we don't only have those who are living with it physically but family members and so on who are supporting those living with diabetes so they can get counseling and help us or guidance from us as well okay just to let you know that there is support also at your wellness center feel free to register for the chronic disease self-management program registration can be done at all the wellness centers once you register you will be contacted to participate in the next available group alright, thank you very much panel for joining me on TV Clity for this discussion on diabetes November 14th was World Diabetes Day November is not done yet so we are still continuing with the education process this has been a production of the Ministry of Health in collaboration with the National Television Network and the Government Information Service in observation of World Diabetes Day I am your host Sant just join us right here