The Hungarian writer Frigyes Karinthy theorized that "anyone on the planet can be connected to any other person on the planet through a chain of acquaintances that has no more than five intermediaries." Stanley Milgram in his experiment "The Small World Problem" showed that Karinthy was on to something. His findings led to the now popular term "6 degrees of separation". Unlike the Milgram's "The small World Problem" and "6 degrees of separation", Diabetes is a 'Big World Problem' and it's only a '1 degree of separation'.
Diabetes, Diabetes mellitus, DM2, or SUKA in Tongan is a nasty non-communicable disease (NCD). In the US alone, diabetes affects about 30 millions Americans and an additional 7 millions aren't even aware they have it. According to Diabetes.org, it cost the US approximately 300 billion (yes, with a B) per year. That's $1 in every $5 in healthcare dollars spent in the care of someone with diabetes in one year. Each day, 3800 Americans will be diagnosed with Diabetes for the first time, another 200 will undergo an amputation related to diabetes. Another 136 Americans will start treatment for end-staged renal disease (ESRD) for the first time and it doesn't end there. Another 1,796 will develop retinopathy which lead to vision loss and blindness. These numbers are staggering and regrettably ever growing.
According to a study that was done in 2002 that is now published in the American Diabetic Association, the prevalence of Diabetes in Tonga is 15.1%, 80% of which are undiagnosed, a scary steep increase from 7.5% from 25 years earlier. I do not know, or more accurately, I haven't found the dollar breakdown for diabetic care in Tonga. However, a quick glance and compare of the aforementioned sets of statistics may cause one a brief episode of vertigo. It sure did me. These number suggests many things. One of which is the safe presumption that each of us, within hug-range, knows someone or someones that is/are plagued by Suka. They could be parents, siblings, cousins, uncles, aunties, or grandmas and grandpas. They could be your neighbor, your favorite teacher, or your lest favorite in-laws (I love all of mine, so don't get no ideas now). Hack, they could also be your doctor! If there's one thing that 'mankind vs. alien invasion' movies have taught me it is always "You've got to understand them to defeat them". So, now you know what my next few posts will be. #BeatSuka
Tuesday, June 28, 2016
WRITE!
It is 2:30 am, the house is utterly quite, the wife and kids are sound asleep, and not a single sound from our 16 months old boy (very rare btw). I'm sitting on the couch, the AC and the ceiling fan are tirelessly battling the Phoenix hot summer night (truly grateful). My mind is restless as usual, except tonight, it is with a tinge of uneasiness and I'm unable to diagnose it. We just finished a 4 hour orientation of brand new resident doctors who are starting in a few days and perhaps I am anxious about how they are going to handle the load of residency; Long hours, endless reading and learning, non-compliant patients, unforeseen post surgery complications, middle of the night pages from the floor or the ER, and etc etc. Or may be it was the news I received today that my father called in sick to work (a true rarity) because he's not feeling well. Perhaps it's the reality that I where ever we move to next might be our home and where we will plant some roots for the next few decades. "I have to keep my mind occupied, I have to enervate it". So, I started with reading about world events; from more significant 'Brexit' to not so crucial 'Messi retiring from the National team', and of course Facebook (just being honest here). Unfortunately, none of those did the trick. So, I decided to do work related reading and I came across this frightening piece of statistic from and article titled Causes of death in Tonga: quality of certification and implications for statistics by Carter et al. Popul Health Metr 2012,
By now, I have read the paragraph above over and over and the sting seems to get worse each time. Now, the leash on my mind is shortening and it is zeroing in on a few more scientific articles about the havoc Diabetes is effortlessly wrecking in Tonga. I am not feeling discouraged at all, instead, I am feeling motivated. "What can I do?" Part of the answer came swiftly and clearly; WRITE.
It has been 5 years since I last wrote on this blog. I have, on multiple occasions, thought about writing again but I was so good at finding reasons not to. I shall make the utmost effort to suppress those thoughts and embrace the reasons to write and lovingly discuss these issues not just as a healthcare provider but also as a son, a grandson, a husband, a father, a brother, a cousin, an uncle, a neighbor, and of course a TONGAN. #TongaMaaTonga
"Mortality from diabetes
for 2005 to 2008 is estimated at 94 to 222 deaths per 100,000 population for
males and 98 to 190 for females (based on the range of plausible all-cause
mortality estimates) compared with 2008 estimates from the global burden of
disease study of 40 (males) and 53 (females) deaths per 100,000
population."
It has been 5 years since I last wrote on this blog. I have, on multiple occasions, thought about writing again but I was so good at finding reasons not to. I shall make the utmost effort to suppress those thoughts and embrace the reasons to write and lovingly discuss these issues not just as a healthcare provider but also as a son, a grandson, a husband, a father, a brother, a cousin, an uncle, a neighbor, and of course a TONGAN. #TongaMaaTonga
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