Major survey planned to monitor ‘silent killer’

A major survey planned for Bermuda could shed a sobering light on the severity of the diabetes epidemic in Bermuda.

Renowned diabetes expert and epidemiologist Dr Nigel Unwin was recently on the island to discuss with stakeholders the details of the study that could see at least 1,500 locals surveyed at random.

While the Ministry of Health last surveyed islanders in 1996 and found that 11 per cent of the population ha diabetes, the information gathered relied on self-reporting. This is not always as accurate as surveys that include professional examinations which the proposed survey plans to conduct. According to World Health Organization estimates —it is more like 26 per cent of Bermuda’s population.

As in other parts of the world diabetes is a prime cause of coronary artery disease — the leading cause of death in Bermuda. Diabetes is also the leading cause of kidney failure, blindness and lower limb amputations in the island. It is hoped the survey will help to put into place strategies that will help to prevent diabetes — the survey will provide evidence to the government that the island is in need of the necessary policies for prevention.

Today diabetes is a recognized public health problem due to the escalating epidemic of diabetes in the elderly as well as emergence of type 2 diabetes in children.

The number of people with diabetes worldwide is predicted to double in the next 20 years due to the soaring obesity rate as well as the fact that people in the western world are living longer.

The Bermuda survey, which is likely to take place within the next six months, will collect a wide variety of information relating to health. It will look at sugar levels including levels that are high but not up to the level of a diagnosis of diabetes — this will show where there is increased risk of development.

Blood pressure will be monitored as it often goes hand in hand with diabetes and the survey will also look at weight and, in particular, obesity.

Finally, it will measure fats in the blood — cholesterol  — as well as information on smoking and self-care.

“The good news to emphasize if you have type 2 there is an awful lot you can do to decrease the risk of future adverse events,” said Dr Unwin.

The Ministry of Health conducted its last major diabetes survey in 1996. The survey measured blood sugar levels which Dr Unwin said is essential in the upcoming survey: “It is important because at any one time, a high proportion of people have not been diagnosed.

“That is why diabetes — known as the silent killer — it’s a bit like high blood pressure because it is possible to go along with it — you may not have any specific symptoms so it can be doing damage while it is undetected.

“Diabetes has the dubious distinction of being one of the very few conditions that is increasing the world over.”

Dr Unwin has worked closely with the International Diabetes Federation on producing some of their estimates — he has been involved in the past two global estimates of diabetes. He was asked to consult with on Bermuda’s survey by Bermuda Diabetes Association educator Debbie Jones.

Asked what the overall benefits of the survey could be, Dr Unwin said: “We know it is increasing the world over and the causes of it are part of a cluster of things that increase the risk of other chronic diseases such as certain cancers and cardiovascular disease in particular.

“There is a need to have regular timely information in order to know what is happening in order to be able to put in effective preventative activities.

“That is the main message. We know it is important but we need better information to know really how to target it and know if the activities are working.”