Bermuda may not have the facilities to cope with the complications associated with an aging population.

Recently, members of the House of Assembly debated the 1996 Health Care Review, released in May 1996, which revealed several shortcomings in the health care industry.

In addition to dealing with the well-publicised lack of beds -- mostly due to elderly patients -- the Island's only hospital will also have to cope with an aging population with a high incidence of diabetes and its associated complication of heart disease.

Last month patients had surgery cancelled because King Edward VII Memorial Hospital was bursting at the seams with elderly patients.

At the time, Chief Medical Officer Dr. John Cann said in the future the pressure of an aging population could affect the hospital.

"The pressures will increase as the population ages if the hospital does not increase with it,'' Dr. Cann said. "It will take some time to develop, we won't see this until some time down the road.'' The Health Care Review showed that the most frequent hospital admissions were for heart disease, asthma and diabetes.

One disease that increases with age is diabetes and the results of the 1996 Bermuda Diabetes Epidemiology Project showed that diabetes was a common health problem in Bermuda.

Diabetes is when the body cannot properly convert sugar and starch. It is due to a deficiency in the production or effectiveness of the hormone insulin. It can lead to severe health problems.

The first-ever epidemiology study on diabetes in Bermuda revealed: 10.7 percent of adult Bermudians or one in nine adults over the age of 18 have diabetes.

In the 65-plus age group, almost one in three females and one in five males have diabetes.

For every two adults in Bermuda with diabetes, there was one who had diabetes and did not know about it.

Those with diabetes weighed more and had higher blood pressure readings than those without diabetes.

Bermudians with diabetes had a higher cardiovascular risk.

Some 1,066 locals were interviewed for the study and 999 completed both an interview and clinic visits under the guise of study director Dr. Meng Hee Tan.

High blood pressure and obesity, according to the study, led to an increased risk of coronary disease and certain cancers.

"Coronary heart disease (CHD) is the leading cause of death in people with diabetes,'' the study reported. "CHD is caused by hardening of the arteries (blood vessels) in the heart itself.'' Last week American physician Dr. John Shigo -- a university lecturer in medicine visiting Bermuda -- said he was not surprised by the high level of diabetes here and the fact that its presence increased as adults aged.

"Diabetes is a progressive disease,'' Dr. Shigo claimed. "We are all going to get it, it's a just a matter of time and how long we live. As you age the insulin produced in the pancreas gradually loses its ability to function.'' Dr. Shigo -- who teaches family medicine at George Washington University in Maryland -- was here to inform local doctors about a new drug, Rezulin.

He predicted that the disease would eat up a bigger slice of the health budget every year as undetected diabetics turn up with medical complications.

"Diabetes takes time to develop,'' he explained. "If it's discovered late, complication factors set in.'' Those complications include blindness, cardiovascular disease and kidney malfunction, he said.

Dr. Shigo also pointed out that the majority of medical expenses were racked up during the last two weeks of life.

The Health Care Review revealed that the Island had no vascular surgeon and that some equipment at the hospital sits dormant waiting for someone to operate it.

Regarding the issue of Bermuda obtaining more specialists, the report stated: "It is generally understood that due to our small size it may not be practical to expect to have several specialists competing with each other by setting up permanent practices here.'' HEALTH HTH