Elvira, José Manuel, and Omar, face living with diabetes mellitus and receive ambulatory attention, including educational information about the disease, at Havana’s Diabetic Treatment Center, where patients from abroad and their family members are also served.
Elvira was referred to the Center by her family doctor to re-adjust her insulin dose and learn to inject herself. José Manuel recently experienced a diabetic crisis, and after receiving treatment here, was encouraged to return for more personalized studies of his condition. Omar was diagnosed while undergoing preliminary tests prior to an unrelated surgery, and was directed to stabilize his parameters.
The three are among the 25 patients who participate in a therapeutic-instructional session at the Center every week, while having their glucose levels tested and complications checked. Treatments are adjusted, updated information is provided, and self-management strategies developed, for patients to better handle the disease, according to the institution’s Director and expert endocrinologist, Dr. Ana Ibis Conesa González, who spoke with Granma International.
Dr. Conesa commented that the Diabetic Treatment Center is affiliated with the Ministry of Public Health’s National Endocrinology Institute, and its principal function is education related to diabetes, adding, “We also conduct a program for children and adolescents with the disease.”
During school recesses, the Center organizes educational weeks attended by children and their families. They offer talks that incorporate games, make trips to the beach, have parties, and promote physical exercise outdoors, to teach young patients how to live with diabetes, a chronic disease caused by poor functioning of the pancreas.
During the daily ambulatory sessions, a work schedule has been established based on experience gained since 1972, when the institution was founded. Laboratory analyses are conducted to identifycomorbidities and study possible complications, on the basis of individualized strategies.
“At all times, patients receive educational talks as they rotate through evaluative consultations with specialists, and in the afternoon hours, lectures are given on the symptoms of diabetes, foot care, nutritional habits, complications, and associated diseases, the use of medications, and other issues of interest,” Dr. Conesa explained.
By the end of the week, every patient has a detailed clinical history recorded, and leaves with precise advice to better manage their disease, including lifestyle changes that improve quality of life through a more appropriate diet, in accordance with their weight and height, with specific quantities of food at the right times.
Nineteen similar institutions exist around the country, linked to provincial hospitals but methodologically supported by the Havana Center that shares its learning with all across the island. Patients are referred to these sites by local clinics or general hospitals, and their closest family members are encouraged to participate, to accompany and help with the diabetes.
Professionals here are constantly conducting research to generate information that can be useful in any society, principally in the area of prevention for those at risk of developing the disease, given physical characteristics and lifestyles patterns that may lead to diabetes.
“Our investigations seek (to identify) immediate interventions for patients that can lengthen their lives. We also look into possible links between the illness and other associated pathologies. Plus we conduct clinical trials with monoclonal antibodies and other medications,” Dr. Conesa explained.
This knowledge is shared with Cuban and international professionals and experts in clinics, community centers, intensive care facilities, and others, during national and international events, courses, workshops, and others. Also trained in endocrinology here are resident doctors aspiring to focus on the comprehensive management of diabetes.
Every year they celebrate important dates with scientific days, including the Center’s anniversary, May 26, and November 14, declared World Diabetes Day by the International Diabetes Federation, which identifies a target area of focus annually. Last year’s events were devoted to women, with a view toward highlighting the risks of diabetes during pregnancy.
In fact, one of the special consultations offered by the institution addresses the reproductive risks faced by women with diabetes, during which young women often seek to speak with a doctor about the best time for a pregnancy. This allows steps to be taken to address risk factors to avoid fetal, neonatal, or maternal deaths, and ensure a favorable outcome for pregnant women with diabetes.
Ophthalmologists are also among the most important specialists at the institution, according to Dr. Emoe Pérez Muñoz, who noted, “We assess the diabetic patient and insist on their learning about the disease. We check their retinas to determine if any sign of diabetic retinopathy exists, one of the disease’s complications that can cause irreversible blindness.”
Patients with no lesions, or minimal ones, are encouraged to control their metabolic indicators, and keep their glucose levels low, and to have an annual eye exam. Those with deeper lesions are often offered treatment with novel techniques such as laser surgery.
The institution has the equipment needed to treat these ocular pathologies, but in cases where problems are detected at an advanced stage, patients are referred to the Pando Ferrer Ophthalmology Hospital, part of the country’s third level of specialized care, for the most complicated cases.
All of this was confirmed by Dr. Isleydis Iglesias Marichal, endocrinologist, professor, researcher, and director of the National Endocrinology Institute, who emphasized the Center’s recognition as a national reference according to the World and Pan American Health Organizations’ standards.
Statistical data shows that 62 million people have diabetes around the world, and this is expected to increase 40% by 2040. In Cuba, records indicate that 636,231 persons have been diagnosed, while experts say 30% of the population is suffering from the disease, although they remain unaware of it.
“Our main goal is ensuring that 100% of those living with this condition are attended to, supplied, registered, and diagnosed, so they can be treated in a timely fashion, because our diabetes network allows for full coverage and special attention throughout their lives,” said Dr. Isleydis Iglesias. All of which, no doubt, means better quality of life.
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