The Worst Place to Live if You Have Diabetes (Where is Diabetes Hell?)

Imagine a place that has incredibly beautiful islands, some of which have mountains covered with lush green foliage, surrounded by crystal clear blue/green water, with white sandy beaches lined with palm trees, and beautiful puffy white clouds and spectacular sunsets. That feels like paradise to me. But it's not.

Here are the just plain awful facts about this place.

1. The main crop of this place is sugar.

2. Sixty thousand people who live there remain undiagnosed for their diabetes.

3. Every complication known to be caused by chronically elevated blood sugars affect the diabetic population in huge proportions. Nine hundred cases are identified yearly as needing renal dialysis at a cost of $35 million. Nearly half the population needs eye surgery for cataracts or laser treatment for retinopathy. There is one amputation every twelve hours. According to Professor Eddie McCaig of the country's National University, "40% of the surgery done in this country is done for amputation."

4. To complicate matters even more there has been a shortage of insulin and the majority of this vital medication is only available in hospitals.

5. As if all of the above is not bad enough, here is the coup de grace. It has the highest and worst diabetes death rate in the world. This place must surely be Diabetes Hell.

The worst place to live if you have diabetes is........ Fiji.

Now, I have nothing personal against Fiji. My impression of it has always been as I described it in the opening paragraph....Paradise.

It was only after I learned about the horrific situation there concerning diabetes, I had two thoughts. My first thought was that that situation in Fiji was completely out of control. My second thought was how fortunate most of the world is to have medical providers and some form of health care, diabetes education, nutritional counseling, medication, medical devices, and all of the ancillary services that support prevention.

Having managed the Preservation Amputation Care and Treatment Program (PACT PROGRAM) in two VA hospitals for 12 years and personally treated patients with foot infections, ulcers, and amputations, all of the pedal complications of diabetes, I have had first hand experience with the consequences of chronically elevated blood sugars and non-compliant patients. I have seen too much suffering and too many premature deaths in patients with diabetes, most of which could have been prevented. Knowing all of this, I felt obligated to do something to help address the situation in Fiji, but what could I, one person alone do?

The situation in Fiji reminds me of the patient with diabetes who presents with an infected foot ulcer. It took some time for the foot to get in that condition and it will take some time to heal.

Medical missions frequently visit Fiji and "hubs" similar to the outpatient clinics in the US have been established for better access to care. And while there have been some successes, the root cause issues that predispose Fijians and all Pan Pacific Islanders to diabetes related tragedies are difficult to address and manage. There is sparse organized patient education and nutritional counseling. Unfortunately, there is no proactive evaluation of the foot health of people with diabetes as Scotland has done so successfully. Traditional medicine may have been attempted by some patients before arriving at the hospital when the situation is critical, and some patients are just plainly in denial.

It appears that the complicating factors to this situation are political, social and economic. Could the best strategy to address the problems of the complications of diabetes in Fiji be to take a page out of the play book of the multi-disciplinary medical care teams that successfully treat diabetic foot ulcers? Could it be that this model of care could be applied in a modified form to address the situation in Fiji?

The diabetes related problems in Fiji are the result of multiple and complex issues. Could the the resolution of the issues affecting the diabetic population in Fiji be accomplished by forming a multi-disciplinary group whose membership would include government, business, social, economic, religious, and medical leaders whose mission would be to identify and seek resolution to each of the issues in their area of influence in a coordinated manner with the ultimate goal of promoting prevention in the diabetes community?

I believe it is time for those of us who deal with diabetes and its complications around the world to recognize the tragedy that is happening to the people with diabetes every day in Fiji and the Pan Pacific Islanders and to take action. To that end I would like to propose that that people of every nation who care about what happens to people with diabetes, and the governments, business and organizations that touch the diabetes world work together to come to the aid the people with diabetes in Fiji and the Pan Pacific Islanders by supporting health-care infrastructures, investing in training health professionals and education at the community level with the goal of making prevention the key to resolving the tragedies that are happening every day in Diabetes Hell.

https://theworldnews.net/vu-news/diabetic-amputations-40-percent-of-all-fiji-surgery