– study finds

THE first estimate of diabetes prevalence in Guyana based on actual glycaemic measures estimate that Guyana’s national prevalence in diabetes is higher than previously estimated.
The data for this conclusion was collected by a team of Canadian and Guyanese investigators and presented by Professor at the University of Toronto Department of Surgery, Dr. Brian Ostrow.

His presentation titled, “Estimation of Type 2 Diabetes Prevalence and Validation of new Diabetes Risk Score in Guyana,” was delivered during the 11th Annual Guyana Medical Scientific Research Conference on Sunday.

The findings show that while other research have estimated Guyana’s national diabetes prevalence to stand at 11.2 per cent, research in keeping with the International Diabetes Federation (IDF) have estimated the actual figure to stand at some 17 per cent (ages: 25-65).

The IDF recommends a two-step detection programme, which identifies high-risk individuals via questionnaires, followed by glycaemic measures of these high-risk individuals.

“Prior to this study there was no data on diabetes prevalence in Guyana. Previous estimates in the ‘Diabetes Atlas’ published by the International Diabetes Federation are extrapolated from other countries that are [said to] have similar socio-economic and ethnic diversity. So, this information from Guyana is significant,” Dr. Ostrow explained.
To gather the prevalence data, the Public Health Ministry provided the researchers with the raw data from a 2016 STEPS (Stepwise Approach to Chronic Disease Surveillance).
It was a national study conducted in all 10 regions of Guyana.

Out of the coded responses to STEPS questions and coded results of blood tests received, the team analysed 798 persons with blood tests linked to 36 STEPS questions. It found that there was a 13.7 per cent prevalence of males with Type 2 diabetes and a 19 per cent prevalence in females.

HIGHER THAN PREVIOUS ESTIMATES
“This is the first estimate of diabetes prevalence in Guyana based on actual glycaemic measures and is higher than previous estimates based on extrapolation,” Dr. Ostrow said.
He added: “The actual number of people in Guyana with diabetes is about twice the number currently diagnosed [while the] female to male diabetes ratio is less than previously recorded.”

Dr. Ostrow stated, too, that due to a long asymptomatic pre-clinical phase of Type 2 Diabetes, a significant number of persons may be undiagnosed.
A total of 72 persons were placed in the ‘undiagnosed category,’ meaning that they had been tested positive and had either no previous sugar testing done, or had never been told they have diabetes.

Meanwhile, more than half or 52 per cent of those diagnosed were unaware of their condition.

However, the professor reminded that early diagnosis and treatment has proven to be significantly beneficial in reducing the risk factors of glycaemia and cardiovascular issues.
The STEPS questions also analysed correlated factors to Type 2 Diabetes such as sex, age, ethnic background, smoking habits, Body Mass Index (BMI), history and results of previous blood sugar measurements and more, which could be utilised in the risk score.

Pointing out that the Ministry of Public Health is interested in the development of a Guyana Diabetes Risk Score (GDRS), Dr. Ostrow said: “Risk scores developed in Caucasian populations cannot be applied to other populations of diverse ethnic origins.”

He added: “We recommended a risk score of 10 or more which maximises sensitivity with a reasonable number of false positives; either trigger or biochemical verification of Type 2 diabetes status in any subsequent survey. Thirty-five per cent of the population is ruled out with this score.”

The team’s work was funded by the World Diabetes Foundation and the University of Toronto; its next step in Guyana is to examine the urban and rural distribution of Type 2 Diabetes.