World Diabetes Day – Mexico City 2011
We arrived in the early morning to set up the booth in Alameda Park – offering education and free testing with supplies provided by Johnson & Johnson. Hosted by the Mexico City government, the event was organized to bring attention to World Diabetes Day, as diabetes affects 14% of the Mexican population (increasing to 1 in 3 over age 50!). In Mexico, diabetes is the leading cause of death nationwide – due largely to late diagnosis and poor control, as high, uncontrolled sugar levels are toxic and damage the body from head to toe. I was accompanied by Gilberta Pelaez, a peer educator dedicated to promoting early of diabetes and prediabetes, in order to reduce the risk of complications and increase quality of life. Gilberta works for Project HOPE for over 5 years, and oversees a community screening project, diagnosing at least one person every day they offer services.
Around 9:00 a.m., Lucia Hernández (34) and her boyfriend Octavio Manzano (38) came up to the booth to be screened. They seemed to be young and in-love. Both hadn’t yet eaten and Lucia’s test was 84 mg/dL. We showed her how to interpret her reading, using a traffic light that indicates healthy, elevated (prediabetes) and dangerous (diabetes) levels of blood sugar – made intuitively understandable when designated, “green," “yellow” or ”red.” Gilberta and I congratulated Lucia for her healthy test result. But then Octavio’s result was 148 mg/dL and, as educators, we knew it was important to tell him clearly that he had diabetes and would need to begin to actively manage his condition to improve his health – now and for the long term.
Octavio nodded, but was quiet, while Lucia insisted we provide additional orientation. As a doctor, I decided it was timely to prescribe medication. “Octavio,” I said, “Go to the pharmacy and buy Metformin, 250 mg. Take a pill right away and come back to re-measure your blood sugar in one hour.” Honestly, I wasn’t sure if he would return, as it can take people a long time – even years – to accept a diagnosis of diabetes. I hoped he would, but was quickly distracted by the line of people waiting to be screened.
I was pleasantly surprised when Lucia and Octavio returned 30 minutes later. They explained that the pharmacy only had 500 mg tablets, so I told them to break the pill in half to make it a 250 mg dose. I reminded Octavio to come back one hour after taking the pill to recheck his blood sugar, and as he was clearly motivated to begin treatment, also recommended he walk for an hour to help his body process the excess sugar in his blood.
The couple returned an hour later. Gilberta checked Octavio’s blood sugar again, using the glucometer. We were all very interested when the result was 98 mg/dL. Lucia and Octavio smiled and were reassured to see their actions caused his blood sugar to drop from “red” to “green” on the traffic light – falling from a dangerous to a healthy level. They promised to visit the diabetes clinic we partner with the following week to learn more.
I share this story to encourage people to help expand access to diabetes screening, so people can check their blood sugar regularly – in community spaces. Diabetes deaths can be prevented. By providing early diagnosis and education, we can reduce complications and help people to live longer, higher quality lives.
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