Amputations among male diabetics in Cayman are 2.5 times higher than the estimated global rate, attendees at a national healthcare conference heard this week.
National epidemiologist Rachel Corbett, delivering diabetes surveillance data collected at the Health Services Authority between 2016 and 2021, stated that 76 diabetics – both male and female – required amputations during that six-year period.
Even though there are more female than male diabetics on island, males are more likely to need an amputation relating to their disease.
Far more diabetic men than women underwent amputations, Corbett said, noting that in 2021, 4.7 men in every 1,000 had amputations, compared to one in every 1,000 women.
Comparing Cayman’s diabetes-related amputation rate among men, with the global numbers, Corbett noted it was 2.5 time higher. Between 2010 and 2020 worldwide, there were 0.83 annual amputations per 1,000 women with diabetes, and 1.78 per 1,000 among men with diabetes.
In the six-year period examined by the Public Health Department, 5,711 individual cases had been identified as being treated within the islands’ public healthcare system.
Corbett noted that the data collated by the Public Health Department related to HSA figures, and were not national statistics.
Corbett said the number of people being treated for diabetes was increasing each year, and that the ratio of cases within the HSA was 1.5 females to one male with the disease.
Data was also collated about the ages of amputees – the average age for females was 67 to 82, while the average age for males was 63 to 70.
However, Corbett pointed out that one factor that the researchers had been unable to determine so far was at what age the diabetics had first been diagnosed.
“That’s a really important aspect to be able to understand their care pathway, where along the process maybe they have not been able to get the right care they needed and ended up requiring amputation,” she said.
She added that without the full picture, the research team was limited in what could deduce, but hypotheses that could be proposed from the existing data were that there may be undiagnosed and/or undertreated diabetes among males, and that men may be undergoing treatment later in the progression of their disease, hence the need for amputations.
Behaviour relating to controlling a person’s diabetes is also likely to be a factor in the issue, she added, noting that changing people’s behaviour can be “quite challenging”.
In a separate data-collecting exercise, in the STEPS national healthcare survey carried out earlier this year, researchers found that 7.7% of Cayman adults had high blood sugar levels.
For more on the STEPS survey and the healthcare conference, check caymancompass.com on Monday.
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Is this an issue that needs a national cross-service task force? Cayman has one for children. There are many factors that influence patient outcomes and the quality of their health with or recovering from type 2 diabetes. Not only is lifestyle medicine key but so also is timely care and treatment and referrals where helpful. At present the number of endocrinologists (doctors who specialize in diagnosing and treating the various kinds of diabetes) in the Cayman Islands is very low. Those with potential and late stage issues – e.g. those with amputation related concerns would be well served being monitored closely by such specialist or care team to avert such complications. Cayman can do much much better than the global average. A task force could aim to zero out amputations. By doing so it will reduce total stroke incidents and improve wellness. Cayman’s population evidently needs a task force urgently.