Editorial

How many ways can we thank Dr Dalip 'Diabetes' Ragoobirsingh?

Tuesday, October 29, 2019

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Jamaica woke up yesterday morning to a screaming headline 'Amputation capital of the world!', thanks to a critical alert from the man we like to call “Dr Diabetes”, Professor Dalip Ragoobirsingh.

In our Monday edition, Dr Ragoobirsingh made the rather stunning revelation that the Caribbean region, led by Jamaica, is the amputation capital of the world, due to poor foot care, which he often attributes to backward cultural practices and beliefs.

One in every 1,500 diabetic patients in Jamaica has to get a leg cut off, we are told by Dr Ragoobirsingh whose credentials include director of the Diabetes Education Programme and professor of medical biochemistry and diabetology at The University of the West Indies, Mona.

Putting it starkly, he said: “The Caribbean has attained the infamy of being the 'amputation capital' of the world, losing more lower limbs amongst our diabetics, due to poor foot care, than any other region of the world.”

He says that 90 per cent of diabetes patients worldwide owe their disease to obesity, while the remaining 10 per cent are of autoimmune origin.

The Jamaican figure of one amputee per 1,500 diabetics was comparable to Barbados and Trinidad and Tobago. It is alarming to hear that the prevalence rate for diabetes in the region is eight per cent to 15 per cent.

Broken down, Jamaica's prevalence rate is about eight per cent to 10 per cent. Among Jamaican women the rate is 9.3 per cent, compared with 6.4 per cent for men, not surprising, he says, because 33 per cent of adults and 25 per cent of adolescents in Jamaica are obese. Females are the most affected in both age groups.

In other words, Jamaica and the rest of the Caribbean have a diabetes emergency on its hands, one that calls for urgent action to prevent a big jump in the number of amputees, who would most likely be unable to work, and thereby become a strain on the public purse.

The professor compares, unfavourably, our situation to that of the United States, United Kingdom, and Europe, where the amputation rate is lower, and even less in South India and Indonesia.

Importantly, he notes that already there are visible risk markers for chronic illnesses in the adolescents group, based on a study in 10 high schools in Jamaica in which he collaborated with Florida International University.

All this is tragic, because lifestyle changes can prevent or reduce the incidence of diabetes and amputation. His list of tips to encourage proper foot care includes a simple but interesting matter of wearing shoes bought at mid-morning “when our feet are between sizes, given that they are smallest when we awake in the morning and largest when we retire at night”.

We in this space are pleased to hear that there is a plan to carry out a scientific study of amputations in Jamaica, as much of the information already gleaned is based on anecdotal evidence, even though based on clinical assessments.

We also welcome the diabetes exhibition planned for November 7 - 30, 2019 in the museum on the ground floor of the Faculty of Medical Sciences Teaching and Research complex, Mona. The purpose of the exhibition is to educate health care professionals and impact patient care.

For every foot that is saved, Jamaica will owe Dr Ragoobirsingh a debt of gratitude.


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