2023-07-28 19:10:39
Diabetes is a major health problem: By 2050 it is estimated that 1.3 billion people will suffer from some form of diabetes. Guyana is no exception to the phenomenon. The Diam group (Diabetes Amazon Metabolism) was set up by Professor Nadia Sabbah, endocrinologist at the Cayenne Hospital Center. This experimental device created in 2020 is supported by the Ministry of Health and Health Insurance.
In France, according to Public health Francethe highest prevalence rates for diabetes are observed in the overseas departments. “With an identical age structure, the prevalence is twice as high in Réunion as in the whole of the territory. It is 1.8 times higher in Guadeloupe and 1.5 times higher in Guyana and Martinique”says this report.
A problem closely monitored in Guyana where in 2020, Professor Sabbah, head of the “endrocrine-diabetes-nutrition” department at the Cayenne Hospital Center responded to a call for projects from the Ministry of Health and Health Insurance aimed at reduce costs around diabetes disease. This gave Diam (Diabetes Amazon Metabolism)an incentive for shared care to reduce patients’ healthcare costs.
There are only two overseas departments that have had their projects valued for this call for projects. Diam is subsidized by the Ministry of Health for 4 years. It will therefore end next year (2040/2024). There will of course be a de facto assessment of the efficiency of the system. And depending on the result, the experiment may be extended or applied to other departments.
Diam is what is called an Ipepan incentive for shared care in the context of diabetes, metabolic pathologies and cardiovascular risk factors.
Vérélène Alcide, dietician and coordinator of Diam:
“This coordinated work is about pooling forces. The observation is that there are not many endocrinologists’ offices in town. It was therefore necessary to create a device to prevent people from showing up, at the end of the day, to the emergency room, for things that can be settled in town. The group is made up of city doctors, liberal nurses, a few ophthalmologists because in the complications of diabetes, there is diabetic retinopathy, nephrologists to respond to diabetic nephropathy and cardiologists. Podiatrists and dieticians are also part of the group. We interact with a secure means of communication called “globule” which allows us to communicate around the patient and to exchange files. The platform was set up by an organization that deals with e-health. This continuous chain of care makes it possible to limit hospitalizations and better coordinate the care pathway. »
All these professionals are committed to the process of continuity of unscheduled care to respond “H24/7” at any time and every day of the week. Diam has made training a strong focus both to harmonize practices and to improve patient care.
Among the factors favoring the appearance of diabetes is obesity “the curve of diabetes and obesity follow each other in the world” and in Guyana 51% of Guyanese are overweight or obese, according to a 2019 INSEE report. Diam has integrated a part-time dietitian into the team to monitor these patients.
Diabetes is a disease that progresses silently, the symptoms are not always detected in time. Also, Diam, the association of diabetic patients, the association Diabète Guyane Obésité work together and organize spontaneous screenings so that no diabetic ignores himself.
The disease of diabetes is constantly increasing in the world. It is urgent that there be more efforts to raise public awareness of this pathology, which affects increasingly young people.
In November, the sixth edition of the Diabetology Congress will be held in Guyana, in which professors from France, Canada, the West Indies and doctors from Guyana will participate.
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