PROBLEMS IN CENTRAL AND SOUTH AMERICA
Ramos O1, The GELADNA-ALAD Study Group
1Hospital
General de Niños Pedro de Elizalde, Buenos Aires, Argentina
In Central and South American
countries, physicians and patients face alarming and common problems in
diagnosis, treatment and follow-up of Type 1 Diabetes Mellitus (DM). Even
having declarations such as Kos and Cancun, that expressed the need of a
complete and free coverage from the health authorities, little was
achieved.
In 1996, GELADNA (Latin American
Study Group on Diabetes in Children and Adolescents) presented a study of
the situation in each country and it was repeated in 2001. It is our
objective to compare these two situations and draw conclusions from them.
Our countries are geographically, demographically and ethnically different
but we face common difficulties due to the socioeconomic situation, with a
few exceptions (Costa Rica and Puerto Rico).
We have
studied incidence and ketoacidosis onset, difficulties in diagnosis (lack
of trained health team, of information about the disease and of specialized
centers), in treatment (lack of monitoring material and syringes, of
trained specialists and free consultations with them, of continuous
educational programs, distance to reference centers, no stable diet), and
in follow-up (possibilities of performing HbA1c and microalbuminuria
control tests). The problems persist and are similar throughout the times.
In 1996, we suggested some proposals depending on governmental and
non-governmental organizations (NGO) and they are still valid. The
implementation of complete or practically complete social coverage through
a National Social Health Security has not been fulfilled yet and neither
has the fact of giving more importance to DM in the Pediatric and General
Medicine Programs for children and adolescents. The promotion of National
Diabetes Programs has improved, as well as the promotion of NGO for
protecting the diabetic patients, and the education of the people through
mass media.