Most of us know someone with diabetes and know that it can be difficult to manage. Unfortunately, as we’ve been working with people in the medical clinics and just around our home town, it’s become obvious that diabetes is incredibly prevalent here. Why is that and how can we help?
I should preface this with the disclaimer that I am not a doctor or research scientist. I’ve based my information on my personal interactions with diabetics in the area of Guatemala that I live and translate in, and on studies done by others. I’ve linked to the studies where used and will indicate what is my own observation.
Causes of Diabetes in Guatemala
Diabetes is a health condition where the pancreas do not produce enough insulin to process sugar in the body. This results in higher levels of sugar in the blood and that can cause all sorts of issues, including damage to the blood vessels, heart, kidneys, eyes, and nerves. According to research by the Penn Center for Global Health, over 25% of indigenous Guatemalans have either pre-diabetes or Type 2 diabetes (which develops later in life). Indigenous people make up roughly 60% of the population here.
The general population throughout Guatemala has a prevalence of 13% for those between 20-79 years of age. That is ridiculously high for people who live and eat locally for the most part. So why is this such a big problem here?
Lack of Healthcare
This isn’t just a lack of availability of health care, since you can go to the public hospitals or health centers in Guatemala, which are free. Unfortunately, the care at these places ranges broadly and many Guatemalans avoid going if they aren’t severely ill. This means, if they’re suffering from diabetic symptoms, they may not put enough importance on them and simply ignore the issue or go to a local curer for advice.
In the clinics where I translate, we often have people come in and tell us that they have diabetes. They are not on medication and if you ask why . . . they explain that they simply don’t have the money for it. This is particularly true when they’re taking oral medication instead of insulin. I suspect this is because once they need insulin, they realize how dangerous it is to leave their blood sugar uncontrolled.
Another very big problem is checking their blood sugar. A glucometer is far too expensive for the vast majority of people and even if they get one, they need to continue buying the testing strips. This costs more than many people can afford. If you have to choose between feeding your children and buying test strips, you’re going to pick your kids, right?
There are alternatives. You can test your blood sugar at a doctor’s office, but that will cost a lot more money. Most pharmacies also offer this option for Q12-15, or $1.50-2 USD. Obviously, this is not something people do very often.
Without frequent testing, diabetics have no idea if their medicine is working or if their dietary changes are making a difference. It’s SO important to get that regular feedback. In the medical clinics that I translate for, we are in a new place each day of the week and people come in to check their blood sugar because they know it’s free. However, most of them haven’t checked it in months and are shocked when it comes back high.
Changes in Lifestyle
Life in Guatemala, as with every country, has changed drastically over the past 50 years. People are more sedentary in some cases, as infrastructure has made it easier to get what they need. However, possibly one of the biggest adjustments is the availability of processed foods and higher-fat foods that are now available.
The changes in lifestyle result in more obesity, particularly in poorer areas. As we know, obesity is one of the risk factors in diabetes. However, there’s something else that we’ve seen frequently here . . . the high amount of sodas that are ingested.
Tap water is rarely safe in Guatemala, so you risk getting sick from drinking it. While it’s possible to boil water, that tastes gross and let’s face it, it uses a lot of firewood, which has to be collected daily, or gas, which costs money. However, sodas are cheap and taste good. I can’t tell you how often we meet people who drink maybe one glass of water in a day, but several glasses of Pepsi.
Before you shake your head at this, remember that sodas give a boost in energy, they make you feel fuller, and best of all, they don’t give you amoebas! There’s a reason they are so popular here.
Did you know that Hispanics are more likely to develop diabetes than Caucasians? It’s actually in their DNA. That could easily be one of the reasons that diabetes has grown so much here.
In 1970, the average life expectancy of a Guatemalan was just 52 years. People often died before they started to get the diseases that become more common with old age. Now, the average life expectancy in Guatemala is 72 years. There is an aging population that is facing more and more health issues. Of course, diabetes is not the only problem, but it’s one that we are working on right now.
What to Do About It
Now that we know why diabetes keeps increasing in Guatemala, what can we do about it? There are several ways to help people with diabetes and those who are at risk for it.
Health education is so very important. Sadly, the vast majority of diabetics are told not to eat sugar and to stop eating tortillas, rice, and bread. That’s the extent of most health teaching at the health clinic, usually because doctors and nurses are tired of trying to educate people who may not follow their advice and end up sicker.
Personally, I like to show people what they CAN eat. Rather than block all the foods they usually consume, we preach moderation and focus on increasing fresh vegetables and protein. Not only that, but we look at what types of protein may be available to those who have limited funds. Beans, eggs, and similar options are far more likely to be consumed than beef or chicken.
Blood Sugar Monitoring
It’s very easy to ignore the fact you have diabetes when you don’t know what your blood sugar is. Providing frequent monitoring is an important part of getting diabetes under control. This is something we offer free of charge at Healing Hearts. At the moment, we just do this out of our house, but will eventually provide blood sugar checks at the Healing Hearts clinic.
Clean Water Access
If people have better access to clean water, there’s more motivation to drink water instead of sodas, especially once they know how much damage those drinks do. They also have the ability to make frescos from hibiscus flowers, limes, etc. which are far healthier.
At the moment, many organizations provide water filters to help families have clean water in their homes. However, this does require followup, since the filters need to be replaced at regular intervals.
Consistent Access to Medications
To help people control their blood sugar, access to their medication is a must. We provide metformin to those who have been prescribed it, which helps ensure they can stay on their medication, even when they are low on funds. Spikes in blood sugar can create more damage in the body, so we want to avoid that as much as possible!
What You Can Do to Help
We are just two people at the moment, which means we can only do so much. For now, we’re focused on mostly helping diabetics and we deal with other issues as needed. If you would like to help out by sponsoring the necessary medical supplies, you can donate here.
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