Eldemire-Shearer, Denise A.
Author Affiliation, Ana.
Diabetes in the Older Population: The Jamaican Experience
Date of Publication
Paper presented at the 9th International Diabetes Conference, 2003, Jamaica.
The population has been ageing steadily since the 1970's and so has the prevalence of chronic diseases. Type 2 Diabetes has been increasing in importance as a leading cause of morbidity and mortality since the 1950's. At the same time, the population has been ageing and there are many older persons living longer. Ageing is a multidimensional process influenced by many factors. Older persons have issues specific to their age group such as inadequate incomes and the accepted physical changes, which can increase their risk of disease and complicate their ability to manage their illness. Longer life expectancy translates for some into longer life with chronic disease, added disability and long term care. Many older persons live with families, which raises the increasing awareness of the burden associated with caregiving. The persistent trend of increasing levels of diabetes has accentuated the need for appropriate prevention policies and activities at all ages. Diabetes is also associated with many complications - large and small vessel related complications and neurophathies manifest as heart attacks, strokes, blindness, impotence, kidney failure, amputation and nerve damage, which can reduce the quality of life and place a heavy burden on the health services. Diabetes is also recognised as part of the metabolic syndrome, which predisposes to cardiovascular disease and is characterised by hypertension, obesity, high insulin levels, insulin resistance and high cholesterol. The development of the complications of diabetes is related to the length of time that a person has the disease as well as the level of control. Given that maturity-onset diabetes is mainly an illness of mid-life, much of the burden of the disease is seen in old age. There is evidence that this is already a concern as it was reported that the main reason for hospitalization in middle-aged females at a major hospital in Jamaica was the complication of diabetes. Medical expenditure for people with diabetes has been reported as being two or three times higher than for those without diabetes. Care for a diabetic is estimated at US$750.00 and a non-diabetic US$146.00. Many of the complications can be avoided or minimized by lifestyle changes even after the illness has been diagnosed. Risks for disease and disability increase with age and can be made worse by lifestyle choices - influenced directly by an individual's motivation and attitudes and/or by other behavioural and social factors.....