-Presidential Commission on non-communicable diseases
The state must improve its efforts in relation to the mental health of diabetics.
This is one of the assertions of the Presidential Commission on the Prevention and Control of the NCDs (Non Communicable Diseases).
World Diabetes Day 2024 was observed on Thursday under the theme “Breaking Barriers, Bridging Gaps” and the Commission in a statement urged a more wholistic approach to managing the lives of diabetics while lamenting that many health centres are still not equipped for the task and drugs are sometimes in short supply.
“The health sector must up its game when it comes to Mental Health for Diabetics. Guyana’s NCD Commission wants to ensure that all persons living with diabetes must have access to social workers, counselors, psychologist(s) and other mental health providers. The MOH (Ministry of Health) must articulate within the Diabetes Care Guidelines a Mental Health Care and Treatment component.
“The Commission is of the view that the mental health component of the National Guideline is woefully weak. We urge the Minister to personally ensure that this weakness in the national programme is remedied without delay”, the statement said.
It added that the call for a more comprehensive approach to deal with the mental health crisis among diabetics in no way diminishes the other serious life-threatening diabetes-related complications such as kidney and renal failure, retinopathy, atherosclerotic cardiovascular disease, strokes and other microvascular complications.
The Commission acknowledged investments and improvements in national efforts to deal with nutrition support for people living with diabetes, with the efforts to ensure people have full access to blood sugar and HBA1c testing, consistent and reliable access to medicines, including insulin, programmes to reduce complications, such as diabetes food care access across the country and access to routine testing to pick up early kidney complications.
“However, we would be dishonest if we do not express concerns with obvious weaknesses in these efforts. Many health centres still do not have reliable capacity for blood-sugar and HBAIc testing. No hospital – Levels 3, 4 or 5 – should ever not be able to test for blood sugar and HBA1c every single time for every single person. We are disappointed that primary care is still not making routine the availability of albumin, creatinine and bun testing.
“We question why every hospital does not have a footcare programme in place. We urge also that more efforts be put in place to ensure regular oral and dental health care are available for diabetics. We also urge that a special programme to diagnose COPD (Chronic Obstructive Pulmonary Disease) and other respiratory problems be put in place for diabetics”, the statement asserted.
The Commission commended the Ministry’s Oral and Dental Health Department for beginning to roll out special programmes for diabetics and also praised the TB Programme for including in its 2025 budget a new type of portable x-ray system that could be taken into remote areas to screen people for respiratory deficiencies.
“We acknowledge the continued efforts to ensure that children with Type 1 diabetes have all the diagnostic and medicine needs, including pen insulin administration systems. Still the supply chain sometimes experiences shortages. This must end once and for all. We also continue to be dismayed that the children and parent annual diabetes camps have not yet been resuscitated. In addition, we need to resuscitate the expert patient programme both with children and adults”, the Commission said.
Routine
It noted that last year it urged the public health sector to consider introduction of new medicines that have become routine in developed countries and that have made a major difference in diabetes management, including in the management of diabetes complications.
It cited two medicines.
Glucagon-like peptide-1 receptor agonists, or GLP-1s, are a type of medicine for people with diabetes. They lower blood sugar levels, can help with weight loss, and protect the heart and kidneys.
Sodium-glucose cotransporter-2 inhibitors, or SGLT-2s are a type of medicine for people with diabetes. Similar to GLP-1s, they lower blood sugar levels, can help with weight loss, and protect the heart and kidneys. Because GLP1s and SGLT-2s work in different ways, they can be taken together.
“These are expensive medicines, and Guyana might not be in a position to provide every diabetic patient with these kinds of medicines. But a strategy must begin now for the introduction for some patients”, the Commission said.
Stating that the Ministry of Health and the Government are making a “valiant” effort to combat the scourge of diabetes, the Commission said it continues to push for further improvements to ensure that the global trend of increasing morbidity and mortality associated with diabetes is not Guyana’s reality.
The statement was issued by the Chairperson of the Commission, Dr. Leslie Ramsammy. He is also Guyana’s Ambassador to Switzerland and Permanent Representative to the United Nations in Geneva.
In its push to address diabetes, the Ministry of Health on Thursday said that it has adopted a host of measures including expanded access to diabetic retinal examinations and greater accessibility of key therapeutics such as insulin.
In a statement to mark World Diabetes Day, the ministry said it has implemented HbA1C testing as a standard tool for diagnosing and monitoring diabetes, especially for patients needing precise blood sugar management. HbA1C tests provide a three-month average of blood glucose levels, offering a more comprehensive view of blood sugar control over time than traditional glucose tests. The statement said that this advanced screening tool is now accessible in 82 health facilities nationwide.
To prevent and manage one of the leading complications of diabetes, the Ministry said it has also expanded access to diabetic retinal examinations. Patients can now receive regular eye exams to detect and address retinopathy, a serious complication of diabetes that can lead to blindness if left untreated. Equipped with specialised diagnostic tools, ophthalmology clinics are now available in four health facilities, providing vital eye care services to at-risk patients.
In response to the high risk of kidney disease associated with diabetes, the Health Ministry has also expanded nephrology services across regional hospitals, allowing diabetic patients to receive regular kidney function tests and specialised nephrology care. By improving access to kidney health services, the Ministry says it aims to reduce the incidence of diabetic nephropathy and support early intervention.
The number of foot clinics nationwide has also been increased to reduce the risk of diabetic foot complications, such as infections and ulcers that can lead to amputation. These clinics offer regular foot examinations, wound care, preventive services, and education on proper foot care to help patients avoid injury and infection, the ministry’s statement said. The foot clinics provide essential care and support for diabetic patients, especially those with reduced sensation or blood circulation in their lower limbs, the statement said.
Availability of medications for patients living with diabetes is vital, hence the Ministry says it has secured a steady supply of diabetes medications, ensuring that patients throughout Guyana can access essential treatments for managing their condition.
“Insulin and other drugs are now more accessible at public health facilities, reducing the financial burden on patients”, the ministry said.
