Chronic disease. Good management of chronic disease takes coordination, dedication and understanding on the part of the physician and the patient. It can be frustrating managing chronic disease from the perspective of the healthcare provider, and, I am sure, from the perspective of the patient as well. The disease doesn’t go away. And the healthcare provider can only do so much, the patient must do his or her part. I have noted a problem with medication compliance amongst my patients with chronic disease- for example, sometimes I feel like I’m talking to deaf ears when trying to convince a patient that it is important to take his medication to treat his diabetes EVERY day- not just when he feels bad. It does not resonate with many patients. I recently read an article in a medical journal that estimated a 30- 50% medication non- compliance rate in the United States. What?!?!?!

Type 2 diabetes (adult onset) is a common chronic disease in Haiti. The etiology for the disease is complicated, genetics and various lifestyle factors typically both play a role.  Not very many of my diabetic patients in Haiti are overweight and most of them get plenty of exercise just performing the activities of daily living. My assumption is genetics plays a huge role in the etiology behind diabetes in Haiti. And a high carbohydrate diet doesn’t help. Kidney failure is a common complication of diabetes, as well as retinopathy (can cause blindness) and vascular disease. Treatment availability for these complications is limited in Haiti. So proper and consistent disease management and prevention of complications is paramount.

When a patient is diagnosed with diabetes at our clinic, we provide education regarding the disease and management. And then each time the patient comes for follow up, they are given additional education. But clinic is busy and hectic and not the ideal setting for education. So, we are going to start a diabetes education class on a non-clinic day. There will be ample time to explain and discuss the etiology, management and complications of poorly managed diabetes. The first class will be held this coming Monday, May 21^st. We would greatly appreciate your prayers for this class. I will post a follow up after the class. Thank you for praying!