THE SILENT DIABETES CRISIS

By Dr Tariq Jagnarine
Fam Med, Endocrinology/Diabetes

Diabetes is one of the fastest-growing health problems in Guyana, yet it remains widely misunderstood. Many people believe diabetes only affects the elderly or that it is caused solely by eating sweet foods. Others assume that if they feel well, their blood sugar must be normal. Diabetes often develops quietly over many years, damaging the body long before a person realises something is wrong.
Diabetes occurs when there is too much sugar in the blood, because the body cannot use insulin properly. Insulin is the hormone that allows sugar to move from the bloodstream into the body’s cells to be used for energy. When insulin does not work as it should, sugar builds up in the blood and slowly damages blood vessels, nerves, and vital organs.

Why diabetes is a growing crisis in Guyana
Diabetes is increasing across Guyana and affecting people at younger ages than ever before. Many families only discover the disease after serious complications appear, such as foot wounds that do not heal, sudden changes in vision, kidney failure requiring dialysis, or the need for amputation. These outcomes are not sudden events; they are the result of diabetes that has gone undetected and untreated for years.
The rising burden of diabetes is placing significant pressure on families, communities, and the national health system. Lost income, long-term disability, and ongoing medical care affect not just individuals but entire households.

What health workers are seeing every day
Doctors and nurses across Guyana regularly treat patients who are shocked to learn they have diabetes only after major health events. Some arrive with severe foot infections or gangrene, others with vision loss or kidney failure. Many report that they felt well and had no reason to suspect illness. This pattern highlights how silently diabetes progresses and how dangerous late diagnosis can be.
Diabetes also significantly increases the risk of heart attack and stroke. Many patients experience these life-threatening events without knowing that diabetes was already damaging their blood vessels.

Causes
Diabetes develops over time and is linked to a combination of lifestyle and genetic factors. Frequent consumption of sugary drinks, sweet snacks, and processed foods increases risk, particularly when combined with physical inactivity. Being overweight, especially carrying excess weight around the waist, places extra strain on the body’s ability to use insulin.
Family history plays a major role, meaning people with parents or siblings who have diabetes are more likely to develop it themselves. High blood pressure, stress, poor sleep, and previous diabetes during pregnancy further increased the risk.

Who is most at risk
Although diabetes can affect anyone, adults over the age of thirty face a higher risk, especially those who are overweight or physically inactive. People with a family history of diabetes, women who had diabetes during pregnancy, and individuals with high blood pressure are also more vulnerable. Increasingly, younger adults are being diagnosed, dispelling the myth that diabetes is only a disease of old age.

Signs and symptoms that are often missed
In its early stages, diabetes may cause no symptoms at all. As blood sugar levels rise, some people experience increased thirst, frequent urination, unexplained tiredness, blurred vision, slow-healing wounds, or repeated infections. Because these symptoms are often mild or gradual, many people ignore them or attribute them to stress or ageing.

Diagnosis
Diagnosing diabetes is simple and widely accessible in Guyana. Blood tests can measure current blood sugar levels or show average sugar levels over several months. These tests are quick, affordable, and available at public health facilities. Early diagnosis allows people to act before irreversible damage occurs.

Living well with diabetes
When diabetes is detected early, it can be effectively managed. Many people control their blood sugar through healthier eating, increased physical activity, and weight management. Others require medication, including tablets or insulin. Taking medication is not a sign of weakness; it is a necessary step to protect the body and prevent complications.
With proper care, regular follow-up, and lifestyle adjustments, people with diabetes can live long, active, and productive lives.

Complications of uncontrolled diabetes
When diabetes is poorly controlled or ignored, it can lead to severe and often permanent complications. These include blindness caused by damage to the eyes, kidney failure requiring dialysis, nerve damage leading to numbness and pain, and foot ulcers that can result in amputation. Diabetes also greatly increases the risk of heart attack and stroke.
Once these complications develop, they are often irreversible and can lead to disability, loss of income, and early death. Many of these outcomes are preventable with early diagnosis and consistent care.

Preventing diabetes and its complications
Although not all cases of diabetes can be prevented, many can be delayed or controlled. Regular blood sugar testing is essential, especially for those at higher risk. Reducing sugary drinks, eating balanced meals with fruits and vegetables, staying physically active, and maintaining a healthy weight significantly lower risk.
People diagnosed with diabetes can prevent complications by taking medication as prescribed, attending follow-up appointments, checking their blood sugar regularly, and caring for their feet. Small, consistent changes make a powerful difference over time.

The role of families and communities
Families play a vital role in preventing diabetes-related complications. Encouraging loved ones to get tested, supporting healthier meals at home, and reminding those with diabetes to take their medication can save limbs and lives. Diabetes affects entire households, not just individuals.
The diabetes crisis in Guyana is real, but it is not inevitable. Diabetes becomes dangerous not because it exists, but because it is ignored. Early testing, informed choices, and proper treatment can prevent most complications.
Do not wait until your vision fades, a wound refuses to heal, or your kidneys fail. A simple blood test today can prevent a lifetime of suffering tomorrow.
Check your sugar. Control your diabetes. Protect your future.