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Am. Samoa doctors present picture of diabetes in the Territory

The LBJ Hospital spends $2.6 million, on a yearly basis for the treatment of diabetes, according to Tamasoali’i Dr. Joseph Tufa, who spoke at the Two Samoa’s Health Summit together with Dr. Seakerise Tuato’o and Dr. Richard Ripley.  The summit that ended yesterday (Friday Samoa time) is focusing on the challenge of non-communicable diseases (NCDs) in both countries.


According to Tamasoali’I, American Samoa’s annual budget for LBJ is about $3.3Million, and of that amount, $2.6Million (nearly 80%) is spent on problems associated with diabetes.


Globally, diabetes is one of the most common non-communicable diseases. It is a chronic metabolic disorder, characterized by high levels of glucose (sugar) in the blood and it occurs either because the pancreas stops producing the hormone insulin, or through a combination of the pancreas having reduced ability to produce insulin alongside the body being resistant to its action.


Tamasoali’I presented some statistics on diabetes in American Samoa:


*  in 1980  1-in -7 people were obese, 3000 had diabetes


* in 2013   1-in- 3 are obese, with 8000 known diabetics and 6000 estimated undiagnosed


There are also somewhere around 10,000 pre-diabetics.


This is about 24,000 with diabetes or pre-diabetes— which is more than 1/3 of our population.


He also noted that policy makers should be convinced that NCD is a Public Health issue where action must be taken, not by a few but the whole-of-society.


Lastly he noted that diabetes has a causal relationship to heart disease and stroke, high blood pressure, blindness, kidney disease, nervous system disease and amputation. He also said that in 2011 there were 151 deaths in the territory, of which 85 died of diabetes and its complications. In 2012, with 138 deaths, 72 had diabetes and its complications.


The three doctors discussed three levels of prevention: Primary, Secondary and Tertiary.


Tamasoali’i explained that primary prevention means limiting the occurrence of a health problem, generally by preventing exposure to known risk factors. For example, reducing levels of malnutrition through social and economic reforms that increase access to adequate healthy food; or preventing lung cancer through legislation and education to discourage young people from starting to smoke.


“Secondary prevention involves action to limit the adverse consequences of disease by intervening before symptoms have occurred — or during their early stages.”


This involves action such as early detection (and possibly screening) or curative action like reducing the risk of heart attack by lowering high blood pressure and controlling diabetes.


He said tertiary prevention aims to limit the damage caused by the established disease and to optimize the quality of life of those affected.  An exercise and training program to help a stroke victim regain speech, cognitive, or motor functions would be an example of tertiary prevention.




Dr Tuatoo said diabetes is sometimes diagnosed in children and young adults—this is known as juvenile diabetes, or Type 1 Diabetes—and those who have the disease in their youth must learn early to manage their condition carefully in order to live a long and healthy life.


However with Type 2 Diabetes, which is the most common form of diabetes, and presents itself in adulthood, the body does not use insulin properly and in time, your body is not able to make sufficient insulin to keep blood glucose at normal levels. When glucose builds up in the blood instead of going into cells, it can cause two problems — the first occurs immediately, and your cells starve for energy.


In time, high blood glucose levels damage your body, affecting your eyes, kidneys, nerves and heart.  Symptoms include urinating often, feeling very thirsty, feeling very hungry, even though you are eating, extreme fatigue, blurry vision, cuts/bruises that are slow to heal, weight loss, even though you are eating more, and tingling, pain, or numbness in the hands or feet.


He also pointed out that there is a form of diabetes that occurs in pregnant women called gestational diabetes. This type often has no symptoms, which is why it's important for at-risk women to be tested at the proper time during pregnancy.