People with diabetes in Venezuela: between the high cost of private medicine and the neglect of the public health system – El Diario

  • The hospital crisis and low salaries have alienated specialists from hospitals, so diabetic patients must pay for most of the health services in the country

Care for patients with diabetes in the public health system is almost non-existent in Venezuela, warned the president of the Venezuelan Society of Endocrinology and Metabolism (SVEM), Roald Gómez. People with this diagnosis require at least 200 bolivars ($ 44.6, according to the Central Bank of Venezuela) per month to pay for basic treatment.

Diabetes is a metabolic condition that is associated with an increase in blood sugar or glycemia above normal values. A diagnosis of diabetes occurs when a fasting blood glucose level of 126 milligrams per deciliter (mg / dl) or at any time of the day of 200 mg / dl is recorded.

World Diabetes Day

World Diabetes Day was created in 1991 by the World Health Organization and the International Diabetes Federation in response to increasing concern about the health threat posed by this disease.

It became an official United Nations day in 2006 with the passage of United Nations Resolution 61/225. It is celebrated each year on November 14, the anniversary of the birth of Sir Frederick Banting, who discovered insulin together with Charles Best in 1922.

Although it is a pathology that can be controlled with a good diet, exercise and drug therapy. The chronic form of the disease can cause kidney, visual, neurological or cardiac complications, which is why it is necessary to have a proper medical check-up.

Diabetes is multifactorial, there is a genetic element that we cannot modify: if the person has a direct relative such as a father or brother with diabetes, they will be more likely to develop the condition. But there are also other factors that are modifiable, which basically have to do with lifestyle: being overweight, obesity and uncontrolled hypertension are major risk factors, but they can be changed, ”Gómez explained in an interview for El Diario.

The endocrinologist clarified that these changes should not be radical in principle. He assured that with regard to food, a healthy diet should be consumed and that it contains the three main macronutrients, which are proteins of high biological power, complex carbohydrates, starches and polyunsaturated fats.

The specialist pointed out that the early diagnosis of diabetes is complex, because about 50% of people do not have symptoms. He indicated that when glycemia is not controlled and exceeds 180 mg / dl, symptoms do begin to register.

He added that there are four main indicators that someone with diabetes can recognize: unexplained weight loss, increased urinary volume, increased need for water and increased hunger.

Situation of patients with diabetes in Venezuela

Gómez recalled that Venezuela does not have official figures on chronic diseases such as diabetes since 2013. However, two studies that were published in 2017 give an idea of ​​the prevalence of this pathology in the country.

The World Health Organization (WHO) produced a report on the prevalence of diabetes in several countries. Venezuela, which had provided the information through government entities, appeared in the study with 6% of its population with diabetes.

However, the Venezuelan Society of Internal Medicine also revealed data from a study that was conducted between 2014 and 2017 in seven regions of the country. The results showed a prevalence of 30% of the Venezuelan population with diabetes.

“This is much higher than the report made by the WHO and it is really alarming because it exceeds the normal rates of other nations,” said the doctor.

The president of the SVEM stressed that this population is extremely neglected by the public sector. A person with diabetes depends on their monthly income to access any service or product that maintains their quality of life.

The doctor commented that the State supported people with diabetes through the metabolic program. This service worked in the Regional Health Corporations, but most of these programs have already disappeared.

In the metabolic program there were diabetes clubs where they were assisted from the medical, psychological, physical and recreational activities point of view. They also gave them oral medications and, if necessary, insulin, “he said.

The endocrinologist indicated that the hospital crisis and low salaries have caused specialists to leave the public health system. He warned that it is currently uphill to find an endocrinologist in the network of outpatient clinics and in hospitals of the Ministry of Health.

Photo: EFE

In that sense, a consultation in private clinics is the most viable option. A specialist can charge more than $ 30 per appointment without conducting studies. Gomez added that the patient with diabetes needs periodic examinations and check-ups to prevent possible complications.

“The person with diabetes should see at least once a year a nephrologist, a cardiologist, an ophthalmologist and a neurologist. One of the main problems with diabetic patients with kidney failure is that dialysis units do not work in the public sector, hemodialysis is not done properly and kidney transplants have not been done for four years, so it is a complicated picture ”, He emphasized.

Medications for diabetes: more supply, but at a higher cost

The specialist commented that since 2020 the supply of oral diabetes drugs has been stable in pharmacy chains. However, the costs that they mark make it difficult to acquire.

“A few years ago it was very difficult to get medicines for patients, but since last year it has been, especially metformin, sitagliptin and linagliptin which are the ones that are being used the most, but the costs are really high. The patient needs at least Bs. 200 a month to pay for a treatment, “he said.

The doctor explained that this becomes more complex when the patient must control other aspects of their health such as high blood pressure, cholesterol or some other disease.

The specialist considered that if a patient goes to a public hospital for some complication, he will also have to pay for several of the drugs, supplies and studies, since in most healthcare centers services such as laboratories, X-rays and pharmacies fail.

More prevention

The slogan that WHO promotes for World Diabetes Day is “Access to Diabetes Health Care”. However, this is a difficult slogan to follow in Venezuela given the conditions of the health system.

Taking this into account, the SVEM decided to focus this year on activities more inclined to the prevention of the disease and its complications. The creation of the portal www.muevetecontraladiabetes.com is one of the tools with which society will promote positive changes in the habits of the population.

From November 14 to 28, the public will be able to upload their images of any physical activity they perform as a preventive measure. The first virtual race “Move against diabetes” will take place on the platform. Those who wish to participate can also take walks, swimming or cycling to add kilometers if they are not used to running.

On Thursday, November 18 and 25, the SVEM will carry out Instagram Live on diabetes care and prevention to close the month of activities that they have promoted together with the National Federation of Diabetes Units of Venezuela (Fenadiabetes).

More and more Venezuelan medical societies are trying to tip the balance towards prevention to counteract the effects of the humanitarian crisis and thus prevent patients from exposing themselves to a preventable emergency.

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