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Diabetes Care in Aruba

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Aruba. II PAHO-DOTA Workshop on Quality of Diabetes Care ... of Aruba. 6.6% of all deaths related to Diabetes ... Aruba Diabetes Foundation. Elderly homes ... – PowerPoint PPT presentation

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Title: Diabetes Care in Aruba


1
Diabetes Care in Aruba
II PAHO-DOTA Workshop on Quality of Diabetes
CareDiabetes Research Institute, University of
Miami, 1416 2003
2
Aruba Information
  • Population 100,000
  • 4 languages Papiamento, Dutch, English and
    Spanish
  • We know we.
  • A general misconception about diabetes.
  • We are not the only one.

3
Diabetes in Aruba is mainly due to
  • Obesity problem
  • 57.5 BMI 27
  • Poor lifestyle
  • Eating habits
  • Physical activity

4
Overview of AvailableDiabetes Data
  • Census
  • Public Health Department
  • Home-Care Service
  • GP Survey
  • Hospital

5
Census
  • Diabetes
  • 4.5 of the population (self-report)
  • 60 women
  • 27 in the age group 64 years and older

6
Public Health Department of Aruba
  • 6.6 of all deaths related to Diabetes Mellitus
    (DM).
  • Division of Epidemiology (Health Investigation
    2001) Target group 20 years and older
  • 13.2 has diabetes
  • 9.6 is glucose intolerant
  • Elderly ( 65 years)
  • 42 blood-sugar level, 13 glucose intolerant
  • Obesity
  • 38 with a BMI of 27 has diabetes

7
Home-Care Service
  • Survey 2002
  • Results Clients want to be
  • Checked every 3 months during the general health
    test.
  • Regular monitored by the diabetes nurse.
  • Informed about diabetes and other chronic
    diseases.

8
General Practitioners(family doctors)
  • Survey 2002
  • Results
  • Response rate 84.
  • Average 15 diabetic patient per week, one third
    didnt know they had diabetes.
  • 11 DM Type I, 68 DM Type II (of which 40.7 in
    the age group 40-70 years.
  • 60 of GP no protocol.

9
General Practitioners(continued)
  • Results
  • GPs give information to patient
  • 96 verbally
  • 44 via handouts
  • Topics
  • General information on diabetes mellitus
  • Eye complications
  • Neuropathy 90-100
  • Hypo- and hyperglycemia
  • Diabetes and foot care
  • Poor lifestyle consequences 50

10
General Practitioners(continued)
  • Results
  • GP prescription

11
General Practitioners(continued)
  • Results
  • Specific need indicated by GPs
  • 88 Improve diabetic care in general
  • 48 Need more/better medical and/or
    nutritional information.
  • 37 Need more/better information
    concerning regulation of blood-sugar level.
  • 70 see no need to register diabetic patients.

12
Dr. H. Oduber Hospital
  • Yearly Report 2001
  • Due to diabetes
  • Average Hospital stay (3-16 days)
  • Short-term hospital stay (1- 2 days)
  • Long-term hospital stay (17 days)
  • Wound Care Outreach Clinic

13
Diabetes Care Partners
  • Dept. of Public Health
  • Home-Care Service
  • Hospital Wound-Care clinic
  • GPs and specialists
  • Aruba Diabetes Foundation
  • Elderly homes

14
Dept. of Public Health of Aruba
  • No division that monitors CNCD
  • Health promotion in general
  • 2 Public Health Nutritionists

15
Home-Care Service(White Yellow Cross)
  • No diabetes clinic (yet!)
  • Diabetes Consultation practice
  • 1 diabetes nurse
  • 1 nutritionist
  • 2 wound-care nurse
  • 200 diabetic patients are getting care
  • Diabetes information and weight control
  • Blood sugar
  • Blood pressure
  • Blood cholesterol
  • Wound treatment

16
Hospital and Wound-Care Clinic
  • Capacity 255 beds (short stays stimulated)
  • Wound-Care Outreach Clinic
  • 4 wound-care nurse
  • 1 surgeon
  • Short hospital stays if
  • Home-Care Service is optimal.
  • There are increased visits to the Wound-Care
    Clinic.

17
General Practitioners and Specialists
  • 32 GPs
  • 9 specialists in internal medicine
  • General insurance (a costly affair!)

18
Aruba Diabetes Foundation
  • Founded in 1975
  • Mission
  • Regular information sessions with
  • Diabetic person
  • Family members
  • Caregivers/partners
  • Stimulation of diabetes self-management support
  • National registration system
  • Newsletter

19
Actual state of Diabetes Care in Aruba
                                 
                     
 
20
Conclusion
  • Diabetes Care in Aruba
  • We have to and we can give better diabetes care.
  • A clear-cut approach is essential.

21
Planned Diabetes Approach
  • Short-term goals
  • Reach a consensus in care.
  • Educate caregivers, e.g. nursing personnel.
  • Have a Diabetes Health-Promotion Campaign.
  • Information
  • Instruction

22
Planned Diabetes Approach
  • Long-term goals
  • Monitor the diabetes care.
  • Diabetes networking
  • Protocol
  • Find the right person for the right job.
  • Work setting
  • Provide a diabetes passport.

23
Masha danki (Papiamento)Dank u wel (Dutch)Thank
you (English)Gracias (Spanish)
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