Good morning,
It is truly an honour to bring remarks at this important occasion, where we gather not only to mark the completion of a training programme, but also to commemorate the beginning of your journey as Diabetes Educators, eager to make a meaningful difference in the lives of others.
As graduates of this joint initiative between the International Diabetes Federation (IDF) and the Diabetes Association of Trinidad and Tobago, you hold the knowledge and practical skills to become messengers of transformation in your communities.
Over the past several months, you have committed yourselves to an intensive and comprehensive programme. You have studied the science of diabetes management, learned practical strategies to support patients and were equipped with the necessary tools to inspire persons towards adopting lifestyle change. That is no small feat and I commend each one of you, as well as the organizers of the programme and the trainers.
The Diabetes Landscape in Trinidad & Tobago
Diabetes is one of several largely preventable Non-Communicable Diseases (NCDs), which significantly increases cardiovascular risk for having cardiac arrest and stroke. Diabetes continues to be a major public health challenge locally as well as globally, with management of its complications accounting for a significant amount of health budgetary expenditure annually.
According to the International Diabetes Federation, as of 2024, it was estimated that 1.12 million people or 12.4 percentage of the adult population in Trinidad and Tobago were estimated to be living with diabetes. More alarmingly, an estimated 50,000 individuals were unaware of their condition, simply because they have never been screened or diagnosed.
This figure corresponds to the Ministry of Health’s National STEPS Survey 2024 Country Report, which offers vital insights into our population’s health status with regards to NCDs and risk factors for NCDs. According to this survey, 15.8% of the adult population in Trinidad and Tobago between the ages 18 and 69 years old have a raised fasting blood glucose, that is, a venous plasma value greater than 126 mg/dL (milligrams per deciliter).
The 2024 STEPS Survey also highlighted a lack of physical activity, poor dietary practices and a high prevalence of obesity as key drivers of NCDs in this country. These statistics reflect the everyday realities in our homes, schools and workplaces.
As you are aware, diabetes is a chronic condition that, if left unmanaged, can lead to further complications such as blindness, kidney failure, lower limb amputation, stroke or even death. For this reason, your role as Diabetes Educators is important. You are the bridge between knowledge and action. You are the ones who will help individuals understand what diabetes is, how it can be managed and how to live healthier, longer, active lives.
Actions of the Ministry of Health
The Ministry of Health recognises the significant impact of Diabetes and continues to prioritise addressing the issue of NCDs via its support through several key initiatives:
- Extended Health Centre hours so that persons, particularly, working members of the public, can access Primary Healthcare Services, screening services and self-management services during more convenient hours.
- Advancing diabetes management within the Primary Healthcare System through the establishment of standardised Diabetes Wellness Clinics (DWCs) across all Regional Health Authorities (RHAs). These clinics serve as an intensive diabetes “boot camp” where patients in the Chronic Disease Clinics based in the health centres can be referred to access targeted multidisciplinary care to reduce HbA1C levels and to establish sustainable lifestyle changes.
- Through a standardised programme, with established admission and discharge criteria, patients are able to achieve control. As of December 2024, 2,147 persons have been admitted to the DWCs and are accessing focused treatment plans to lower their HbA1C levels. Of this total figure, 1,945 persons or 90.6% of patients admitted had uncontrolled Type 2 Diabetes.
- Investing in Diabetes foot care services to reduce Diabetic Foot Complications: such as the introduction of a standardised National Foot Screening Tool into the clinical pathway in all health centres, a simple yet key intervention. This is to improve the efficiency with which patients with diabetes have their feet screened in order to detect early signs of diabetic foot complications.
- Additionally, the distribution of specially designed “Diabetic Offloading Boots” to patients, via the RHA Diabetes Wellness Clinics to reduce the frequency of Major Lower Limb Amputations (MLLA). According to data collected at the Ministry of Health in 2024, 484 MLLA were conducted in the public health care system with 269 of these surgeries being due to Diabetes. As such, we aim to continue investing in the necessary tools and services required for effective prevention, management and control of diabetes and its related complications, especially Major Lower Limb Amputations and kidney disease.
- Access to medication for diabetes treatment through our CDAP Programme, which is currently being reviewed with a view towards strengthening and improving its access and efficiency while still keeping in line with internationally recommended treatment protocols.
- As part of the Ministry’s Diabetes and Hypertension Self- Management Initiative, five (5) NCD Primary Care Symposia were held across all RHAs to train and build capacity in primary health care staff for each respective RHA. Over 500 Primary Care Physicians and Nurses received up to date training on core topics for the management of major NCDs such as Hypertension Management (HEARTS), Diabetes Management and Diabetes Foot care just to name a few.
- Through our national campaigns, the Ministry continues to encourage persons to adopt healthy lifestyle practices such as increasing their daily intake of water, increasing their daily consumption of fruits and vegetables, increasing their levels of physical activity and encouraging persons to “know your numbers” (KYN).
- We firmly recognise that screening and early detection also play a key role in reducing the future burden of NCDs. As such, in collaboration with the RHAs, the Ministry of Health continues to host and support several community outreach activities where individuals can participate in free coordinated fitness activities and access free medical consultations, health screenings and referrals for follow up care where necessary.
The Ministry of Health therefore remains committed to addressing the issue of diabetes and by extension, non-communicable disease.
However, the fight against NCDs and diabetes in particular, requires a multi-stakeholder approach. An issue requires a whole- of-government and a whole-of-society approach. An approach which involves family, caregivers, friends, teachers, neighbours, policymakers and of course, trained educators like yourselves, to all come together do your part towards achieving a healthier Trinidad and Tobago for generations to come.
Conclusion
Today, we applaud your dedication to the cause. To the graduates, never underestimate the ripple effect of your work.
Every person you educate, every life you help manage, contributes to a healthier Trinidad and Tobago.
Let our collective efforts ensure that every citizen has access to knowledge, tools and support needed for early detection and effective care. Together, we will protect Trinidad & Tobago’s tomorrow, one life at a time.
We would like to thank the Diabetes Association of Trinidad and Tobago who continue to raise awareness of diabetes and its complications. We look forward to your ongoing support as we continue to strengthen our response towards addressing not only diabetes, but non-communicable diseases as a whole.
Thank you.