according to worldwide research. In Bermuda, the Diabetes Association is working to protect those persons from the many life threatening complications which can arise from undiagnosed diabetes -- blindness, kidney failure and heart problems, to name but a few. Today, the disease affects some 30 million people in the Americas and by the year 2010 that number is expected to rise to 45 million. Through its epidemiology study now underway, the Bermuda Association along with other countries in that region, hopes to have diabetes recognised as a global epidemic and see that the necessary education follows.

Bermuda does not know how big its diabetes problem is,'' explained Debbie Jones, co-ordinator of the Diabetes Education and Counselling Centre at King Edward VII Memorial Hospital (KEMH). "We had to find out the exact size of the problem we were looking at and what we're doing is slightly different to what other studies have done. We're looking at lipid levels and whether there is a risk of heart attack, whether there is high cholesterol or a blood pressure increase, whether or not the person is overweight. And this way they can make changes and prevent a heart attack somewhere down the line.'' Whether or not people agree to participate in the study, said Mrs. Jones, the idea is to highlight its prevalence and the complications which can arise as a result.

The process, she explained, begins with a letter. "People are asked to contact the Diabetes Centre at the Hospital. It's very important that they call. We do not have their phone numbers. So we're hoping people will phone in even if they don't want to participate. If they have diabetes, we want them to respond as well. They are still a part of the study.'' Mrs. Jones, who founded the Bermuda Diabetes Association in 1979, said that after the call is received, an interview is arranged for a later date, covering aspects such as the person's lifestyle and family medical history. They are then given a lab appointment at KEMH. At that time, they are first given a blood test and a sugar drink, unless they have diabetes. After two hours, they return to the lab for a second blood test, breakfast and a t-shirt. Results are mailed about six weeks later. "The study is costing about $400,000 at a cost of approximately $200 per person and we're hoping to do around 1,500,'' added Mrs. Jones. "One idea we have is that all the people found to have impaired glucose tolerance, those at risk of developing diabetes later, will be asked whether they would like to be involved in a ten year trial of exercise, meal planning and a yearly blood test hoping that if, by changing their lifestyles, we can show how it prevented diabetes. We're not just going to let the study die and the statistics fade away.'' Persons could only benefit from responding favourably, said George Smith, president of the Bermuda Diabetes Association.

Especially those persons who agree to participate and find out they are diabetic. "Diabetes can cause high blood pressure, heart disease, blindness and amputation of one's lower extremities. And the danger of diabetes is that you don't feel it damaging you until it's too late. You might wake up one morning with a pain in your foot and the next week find out you have to have it amputated. "Finding out early can help people pay more attention to their diet and their lifestyle, which they should do anyway. Diabetes can create a huge burden. Forty two percent of all people who go into the hospital with heart disease are diabetics; 48 percent of people on dialysis are diabetics and it's the third leading cause of death by disease in the world. So people lose a lot of time and insurance companies are spending a lot of unnecessary money on diabetes care, all which wouldn't be necessary if the victims had looked after themselves.'' PHOTO When there is enough insulin in the blood to fill the insulin receptors, they open the sugar entrances. Sugar enters the cell, is used for energy and the blood sugar level drops.

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