– in battle to control the lifestyle disease

AS one of the leading causes of deaths in Guyana, diabetes does not only affect the patient emotionally, psychologically, financially and socially, but puts a strain on the local healthcare system.

Speaking with Guyana Chronicle, Dr. Kumar Sukhraj, head of the Georgetown Public Hospital Corporation (GPHC) Diabetic Foot Centre, said some patients on medications exhibit aggressive behaviour while others suffer from depression.

Yet other patients, he said, believe that the fight is not worth it and this has been a challenge doctors have been battling to change.

“I have seen people lost their rank in the family because of diabetes and its complications. If they don’t see properly, their children do not speak to them well or, if they lose a limb to diabetes they cannot walk. Those are some of the emotional challenges a patient may have with diabetes.”

According to Dr Sukhraj, physically, patients have diabetic complications if they cannot see properly, if they have renal failure, an ulcer on their feet or cannot do regular work due to amputation.

One such patient is Sumitra Gendalall. Gendalall, who was diagnosed with diabetes many years ago, cannot walk on her own due to foot complications.

The 54-year-old, who nowadays is very forgetful, was supported by one of her daughters during a recent visit to the Diabetic Foot Centre.

A toe on her left foot was amputated after an infection was left untreated for some time. Gendalall, who is wheelchair-assisted, also has kidney complications, but she enjoys the care of her family.

Another patient at the clinic, Premkumar Sukhdeo, who was once a rice farmer, can no longer work due to loss of part of a limb.

Sukhdeo said he had a wound to the left foot and did not pay much attention to it until it began to pain him. When he visited the hospital, he was diagnosed with diabetes.

By then, it was too late to save his limb which had to be amputated from the ankle downwards and, within a year, his lifestyle changed completely as he shifted into survival mode.

Ramford Sampson, who also lost a limb to diabetes, related that he cannot work, since he walks with the support of crutches.

Diabetes, Dr Sukhraj said, aside from putting a strain on families, it also puts a strain on the health care system, since the treatment of patients is continuous and in large part, the treatment is Government-funded.

Some patients get free medications from the health care clinics but not all benefit, particularly those who are disabled and cannot walk.

“Some elderly patients usually ask for a longer date to return to clinic simply because they cannot afford to make regular trips, since some live far distances from GPHC. Those are some financial aspects on the patients and household because if they are breadwinners of the household who are diabetic and have emotional problems and cannot do physical things, then what happens to the household? They become deprived.”

Government every year, he said, spends millions of dollars on the treatment of diabetes (counselling, providing medication, etc) as well as to educate patients about the disease.

To effectively control diabetes, Dr Sukhraj said patients will have to change their lifestyle and this will require them to exercise, change their diets and the way they eat.

This approach, he said, is important for patients to remain healthy, have a high self-esteem and to function effectively at work.

“Some of them who are wise enough would say to themselves ‘I want to challenge myself and not let diabetes get me down’ and if you have that mind-set, you are on your way to manage diabetes,” Dr Sukhraj said.

Diabetes, if not managed well, can cause damage to the vital organs of the body, leading to death. This is a challenge the Diabetic Foot Centre has been working to prevent.

“We just don’t see a patient and write medication; we treat the patient as a whole, to ensure diabetes is controlled as well as treating wounds if any. If right treatment isn’t applied, that patient will remain longer in the health care system and that puts a burden on it. Our approach is therefore a multi-disciplinary approach towards diabetic foot management,” Dr Sukhraj said.