Janauray 2011

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Metabolic Syndrome is a widespread syndrome with a prevalence of 25% in the developed world and a surprisingly higher (and increasing) prevalence in developing countries. In 2007, the Diabetes Education Research and Prevention Institute (DERPi), was established through a $5million grant from Helen Bhagwansingh, to research the disease and determine early preventative measures. The results of the DERPi Project research were presented on Tuesday 18th January at the Daaga Auditorium, UWI.

Obesity, said Professor Surujpal Teelucksingh, is the common factor in a range of diseases linked to the Metabolic Syndrome. Obesity underlies most cases of diabetes, high blood pressure, high cholesterol, cardio-vascular diseases – part of the Chronic Non-Communicable Diseases for which the Caribbean has some of the highest incidences in the world. Indeed, said Prof Teelucksingh, we lead the regional figures for diabetics. Citing pioneering work done by Dr Theo Poon King more than 50 years ago, Prof Teelucksingh established the relationship between unhealthy lifestyles, urban living, and childhood obesity with the onset of what was once adult diabetes in the local population of youngsters.

This project was aimed at providing information about diabetes in children and adolescents in primary and secondary schools in Trinidad and Tobago. This is the first study of this nature and magnitude to be conducted in Trinidad and Tobago and the Caribbean. Many of the deaths caused by the Metabolic Syndrome can be prevented by improving early detection, and prevention of diabetes in childhood is likely to be more cost effective than treating complications that accrue from the undiagnosed or under-treated disease. Earlier recognition will add many years of quality of life.

The cross-sectional survey was performed among 67,000 school children aged 5-17 years in Trinidad during 2009 for urine glucose. It was determined that in testing every 100,000 children, 10 children with type 2 diabetes and 19 children with difficulty in handling ingested glucose, were detected. As many of these children signalled undiagnosed type 2 diabetes in the family, DERPi proposed to intervene on all family members in the household, who were willing to participate in a family-oriented, school/community-based intervention.

DERPi’s intervention focused on the promotion of healthy eating behaviour, physical activity, diabetic education and the creation of a suitable environment for the acquisition of the knowledge, skills and attitudes to understand and address chronic disease.

Under the supervision of Prof Teelucksingh and Dr Brian Cockburn, PhD candidate, Ms Yvonne Batson, has been integral to this work, moving the project from the initial survey to working with schools to address lifestyle changes.

Speaking to an audience which included the Minister of Education, Dr Tim Gopeesingh, Mrs Helen Bhagwansingh, Prof Teelucksingh made the case for funds to be allocated towards prevention and early detection of diabetes, as this was roughly a third of the cost of treatment.

He also predicted that depression (a feature of the Metabolic Syndrome) was going to assume epidemic-like proportions in the near future, and that this further underscored the urgency with which attention and funds must be directed towards these diseases.

The members of the Board of Directors of this collaboration between The UWI and the private sector are Professor Surujpal Teelucksingh, Dr. Rohan Maharaj, Dr. David Rampersad (Secretary) Mr. Vishnu Ramlogan (Chairman, Finance), Dr. Brian Cockburn (Treasurer), Dr. Bhoendradatt Tewarie (Chairman), and a representative of the Medical Board of Trinidad and Tobago

The DERPi Trust was established to “operationalize” existing knowledge on the treatment and prevention of diabetes into effective, immediate interventions. It is expected that this will help prevent the potentially exponential increase in cases of Diabetes in Trinidad and Tobago through a series of interventions and projects aimed at education and prevention, most of which will be community based. The idea to use the funding for a school-based diabetes screening project actually came from Dr Cockburn, a keen researcher himself.

The Trust supports research to increase knowledge about the disease in the local context. The research agenda has been built upon work by researchers in several Faculties at The UWI as well as by those operating in the field who have already made significant inroads and discoveries on their own such as the identification of the “Slippery Slipper Syndrome” the “Ticking Thumbtack Sign” and a new subtype of Diabetes, MODY Type 4.