Nov. 30, 2005 — General risk factors for diabetes are high in the territory, that's why the disease is the fifth leading cause of death in the V.I., according to Anne Thurland, head of the Virgin Islands Diabetes Prevention and Control Program.
Diabetes is prevalent in individuals who are black or Hispanic, low income, physically inactive, smoke, or have a family history of the disease — factors that describe many people in the Virgin Islands, Thurland said. A lack of diabetes education in the territory, coupled with a small number of people actually trained as diabetes educators, also contributes "greatly" to the increasing number of local cases, she said.
"Sometimes I see cases where a person who is diagnosed with diabetes does not go regularly to get screened, or receive checkups," Thurland said. "No one told them that's what they have to do — so the disease just gets worse."
That's why this November — proclaimed Diabetes Awareness Month by Gov. Charles W. Turnbull — is so important, she said.
"It is imperative that we do everything we can to let people know what they can do, that they have a higher risk of contracting the disease if they don't eat right or exercise regularly," Thurland said.
In a press release sent from Government House, Turnbull said 15,000 Virgin Islanders live with the disease, while "6,000 residents have the disease but don't know it." Furthermore, there is an increase in cases seen in children and young adults, he wrote, mostly due to inactivity, obesity, or poor eating habits.
"These statements are absolutely true," Thurland said.
However, a large percentage of children's cases are Type II diabetes, which is usually seen in adults who are inactive and eat poorly.
"There is a need to worry because of the great obesity trend we're seeing nation-wide," Thurland said. "Quite a lot more cases will pop up in children here over the next few years — diabetes will get worse before it gets better."
She explained that many residents have pre-diabetes, a condition where blood glucose levels are higher than normal. However, a slightly higher blood glucose level is not enough to raise the red flag for diabetes and may take up to ten years to manifest into the full blown disease. Other ambiguous symptoms, such as thirst, hunger, fatigue, dry or itchy skin, or blurring vision, can also be attributed to other conditions, and don't help with an accurate diagnosis.
"That's why we don't know about many cases in the territory," Thurland said. "These individuals don't know they have it, and in the cases where a doctor may tell a patient about the chance of pre-diabetes, they don't follow up with screenings or tests, so the diabetes progresses."
This is significant, because according to the V.I. Diabetes Prevention and Control Program's Web site, individuals with diabetes are three times more likely to die from flu and pneumonia, and are at high risk for premature death.
"The disease is much easier to manage if you do the things you're supposed to do," Thurland said.
In its full-blown state, diabetes has a host of other possible effects including heart disease, stroke, hypertension, and gum disease. Kidney failure is also prevalent, and generally leads to lower limb amputations in people who have diabetes, Thurland said.
"Nerve damage and poor blood circulation is caused when the kidney fails, and when this occurs, there are individuals who can sustain a cut and never even feel it," she explained.
Because of this, a great many individuals with the disease have to get arms or legs amputated, she added.
Diabetes may further affect blood vessels in the eyes, causing blindness.
"Most of my clients have lost their vision because of diabetes," said Felecia Brownlow head of the Center for Independent Living on St. Thomas.
Brownlow said she works everyday to help these individuals continue living productive lives, with minimal help from others.
"It's hard for someone to live knowing that they'll never be able to see again," she said. "I see a lot of people who just want to give up, who feel like there's no way they can continue doing the things they were doing before they got diabetes."
Brownlow added that at the Center for Independent Living, the patients have been helping each other, forming peer groups to discuss their emotions, their concerns, and their problems relating to diabetes induced blindness.
"Sometimes it is very tragic for an individual to cope with," she said. "But sometimes, people show you that they really can get through it."
Gestational diabetes — another form of the disease that develops only in pregnant women — causes complications with birth, according to Thurland.
"This type of diabetes causes stillbirths, and malformations," Thurland said. "People with gestational diabetes have to be monitored over time, as well as their offspring."
While Thurland and Brownlow hope to see increased funding for diabetes education in the territory, individuals who wish to learn more about the disease can go to the Virgin Islands Diabetes Prevention and Control Program's Web site, or visit Department of Health clinics and fairs.
"We also encourage individuals to speak to their nurse or physician about where they can get screening for diabetes or regular checkups," Thurland said.
She added that she is also spearheading a Family Health Initiative through the Department of Health, which asks local residents to sit down with relatives to discuss which disease may be prevalent in a family's own circle.
"For example, if a mom and dad both have diabetes, then there's an increased risk of their children having diabetes," she said. "This initiative allows families to share this kind of information so everyone knows what they're at risk for."
The holidays are a perfect time to do that, Thurland added.
"Everyone's getting together, and they can share this information and register it to our Web site familyhistory.hhs.gov/ This gives us [the Health Department] another tool that we can use to improve our health and the health of others. There are too many dying of diabetes in the territory and we have to do what we can to stop it," she said.
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