Diabetes Association pleads for more government help

The Maltese Diabetes Association is appealing to the government to give people suffering from diabetes more blood glucose strips to monitor their condition, as well as more free syringes.

Diabetes in Malta is reaching alarming proportions - around 10 per cent of the population, or 30,000 Maltese, are diabetics, making it one of the highest percentages worldwide.

There are 150 million diabetics in the world and the International Diabetes Federation expects this figure to double in the next 20 years, meaning that the figure would also be expected to rise in Malta.

Ideally, blood glucose tests are carried out four times a day, but the government only supplies 50 free strips a month until people are 35 years of age, said association president Anna Zammit McKeon. Each strip costs 25 cents. After 35, diabetics do not receive any glucose strips at all even though diabetes is a lifelong condition and does not just disappear at 35.

"What the government forks out today, it would get back in the long run through lower rates of hospitalisation," the association argued. Of course, as diabetics grew older, they would require fewer strips because their condition would be more under control.

Ms Zammit McKeon said the number of free syringes that the government provided - 10 a month - was not sufficient either. Insulin-dependent diabetics inject themselves one to three times a day. While the insulin is free, syringes have to be bought to administer it - an additional burden on low-income earners.

While drug addicts have an unlimited number of syringes at their disposal, "diabetics, who find themselves in these conditions through no fault of their own, are compelled to use the same syringe repeatedly throughout the month".

Between strips, syringes and keeping up a healthy diet and lifestyle, diabetics are burdened with additional expenses, Ms Zammit McKeon pointed out. Patients feel the government is letting them down.

Another problem faced by diabetics is that health and life insurance policies are not available for them, meaning that they have major problems getting a bank loan because a life policy is required as security.

The MDA will be approaching the Malta Insurance Association on this "discriminatory" issue, said Ms Zammit McKeon, adding that such policies existed in Europe and the UK.

The association is working for more government recognition. It also hopes to increase its membership, which currently stands at a mere 1,000 out of the 30,000 sufferers, to create a stronger pressure group that could not be ignored.

Ms Zammit McKeon is the first woman, non-doctor, or diabetologist to occupy the post of association president. Both her husband and her son are diabetics, her son having been diagnosed at eight. She has been researching the condition ever since.

"Diabetes becomes a family concern and everyone gets involved in it," she said.

"I tell my son that no one is going to change their eating habits just to please him, teaching him to adapt to his condition, so as to be able to cope with the outside world and to minimise the trauma and temptation when he sees his school friends eating food he cannot have. His siblings eat sweets in front of him and he has his own."

According to Ms Zammit McKeon, "diabetic children should not be confined to a closed and sheltered environment and then left to go haywire when they hit the outside world".

Diabetes is mostly regarded as a condition affecting elderly, or adults, but a considerable number of children also suffer from it. No exact data on the number of diabetic children in Malta is available yet, and Ms Zammit McKeon is trying to gather it.

As a result of the nationwide lack of knowledge on diabetes - despite the prevalence of the condition - the association's role is primarily educational.

"Diabetics need information about their condition to be able to take care of themselves... They can live with it if they know about it."

Hence, the association organises regular talks by specialists in related fields for adults, parents and teenagers. Its Parent Juvenile Support Group focuses on the parents - an important target.

"The shock of finding out that your child is diabetic is so immense that parents have to sort out their own state of mind first if they are to help their children come to terms with their condition."

At the beginning, the parents need more support than the children diagnosed with diabetes, Ms Zammit McKeon felt. They need to understand that it is not their fault that their children are diabetics.

Apart from the medical complications that arise from diabetes, it is traumatic for a three-year-old to be told he, or she cannot eat sweets any more, Ms Zammit McKeon said. And the children feel worse if their parents fail to accept their condition and continue to take it badly.

The talks for teenagers are considered to be a breakthrough for the association. Youths have enough problems of their own, without having to deal with their condition, Ms Zammit McKeon said. The idea is to go down to their level and meet them in places they frequent to get them to know each other, discuss and share their experiences.

Summer camps are being organised for youths, offering them the opportunity to learn more about diabetes in a fun environment. The camps, which started two years ago for 20 children, are now expected to attract 60.

Ms Zammit McKeon said the summer camps often marked the first time the children left their home environment. Parents of diabetics often tended to be over-protective and worried that something would happen to them.

They complained that many teachers were unable to cope with diabetic students in that when they started feeling the symptoms of hypoglycaemia, a deficiency of glucose in the bloodstream, they would be immediately sent home - even though all they needed was a soft drink. This resulted in a loss of school days for nothing, Ms Zammit McKeon said.

"Diabetes is taboo and parents often hesitate to say that their children are diabetics," said Ms Zammit McKeon. But, she maintained, their friends should be aware of their medical condition. If their sugar levels dropped, diabetics were prone to shiver, faint and could enter a coma if prompt action - such as simply having a soft drink - were not taken.

Unfortunately, few schools have taken up the association's invitation to hold talks by consultant diabetologists.

Ms Zammit McKeon said the association was working on providing smaller identification tags for diabetics - the current ones being too bulky. The tags would include information on the holder's condition and how to handle it.

The president spoke of the importance of eating regularly and following a healthy, sugar-free diet, as well as exercising and paying attention to weight.

Today's lifestyle was more sedentary, with children being stuck to computers and TV, and eating junk food. It was, therefore, more conducive to developing diabetes later on in life.

The association aims to teach children to lead a healthy lifestyle, with regular exercise. If diabetics do not take care of their condition, it could lead to a series of complications over a number of years, affecting eyesight, the heart and circulation.

Ms Zammit McKeon highlighted the importance of regular check-ups, particularly if diabetes runs in the family.

She promoted the idea that patients should learn to take care of themselves and that "doctors should empower them to take control". Many diabetics tended to leave everything in their doctor's hands, but, "at the end of the day, it is the patient's life and condition and it is up to him, or her to manage it".

The Maltese Diabetics Association is based at 111, Melita Street, Valletta. It is open every Wednesday from 8.30 to 11.30 a.m. Those who would like to get in touch with it can do so on tel. 21 221518.