Evaluation of a home kit blood glucose monitoring device

A blood glucose monitoring device, the Diascan, is commonly used in Trinidad and Tobago. A prospective study was conducted to examine the accuracy of a Diascan unit in measuring blood glucose levels in or capillary venous blood of patients in a hospital ward. The Diascan measurements were compared to those from two laboratories which independently measured the venous blood or the venous plasma glucose levels. Although there was reasonably good correlation between measurements from the two laboratories (r = 0.85) results from the Diascan showed poor correlations with those from the laboratories, with Pearson's correlation coefficients ranging from 0.32 to 0.64. An error grid analysis showed that the Diascan measurements would have resulted in inappropriate decisions relating to treatment regimens in 26of cases. The results suggest that, when crucial decisions have to be made with respect to patients' blood glucose levels, it may be risky to rely solely on measurements from the Diascan.

Medical practitioners views on the management of hypertension in Trinidad and Tobago

We surveyed 161 medical practitioners in Trinidad and Tobago (124 reporting private sector practice and 37 describing government health centre practice) for their views on blood pressure (BP) management. 96 percent of the respondents agreed that BP should be measured on all adults seen and 90 percent agreed that diastolic pressure should be recorded as the disappearance of sounds. There was disagreement over the level of diastolic BP at which drug treatment should be initiated: 63 percent would treat diastolic BP less than 100 mm Hg, but 35 percent would only treat diastolic BP of 110 mm Hg or higher. In private practice 31 percent preferred angiotensin converting enzyme (ACE) inhibitors as treatment for an African Caribbean man with diastolic BP 110 mm Hg, but in public clinics 41 percent preferred thiazide diuretics. ACE inhibitors wre most often preferred as treatment for an Indo-Caribbean man with diabetes and diastolic BP 110 mm Hg in both public and private practice. Doctors considered that non-compliance (66 percent), lack of education (34 percent) and unhealthy lifestyles (25 percent) were important obstacles to BP control. In private practice doctors considered patients' financial constraint to be an obstacle (58 percent), whereas in the public sector limited availablity of drugs (57 percent) was felt to be more important. Less costly and possibly, more appropriate drugs were used in public clinics.

Use of medicinal plants for diabetes in Trinidad and Tobago / Uso de plantas medicinales para la diabetes en Trinidad y Tabago

Use of herbal remedies from medicinal plants (bush medicines) was studied in 622 people with diabetes mellitus attending 17 government health centers on the island of Trinidad, Trinidad and Tobago. Bush medicines were used by 42% of patients surveyed and were used for diabetes by 24%. Bush medicine use was more frequent in Afro-Trinidadians and in those of mixed ethnicity than in Indo-Trinidadians, and was also more prevalent in those with lower educational attainment. Most patients using bush medicines (214/264, or 81%) reported gathering the plants themselves, and 107/264 (41%) took them more frequently than once a week. Patients taking bush medicines mentioned 103 different plants used in remedies. Among the 12 most frequently mentioned, caraili, aloes, olive-bush, and seed-under-leaf were preferentially used for diabetes. Vervine, chandilay, soursop, fever grass, and orange peel were preferentially used for other indications. Patients who reported burning or numbness in the feet or feelings of tiredness, weakness, giddiness, or dizziness used bush medicines for diabetes more frequently than did patients who reported a range of other diabetes-related symptoms. Insulin-treated patients were less frequent users of bush medicines. It is concluded that bush medicines are taken regularly by many patients with diabetes in Trinidad. Plants most frequently used as remedies for diabetes have recognized hypoglycemic activity. Patients' culture, educational background, type of symptoms, and formal medical treatment may also influence the selection and use of bush medicines

El uso de remedios a base de plantas medicinales (medicinas herbolarias) se estudió en 622 personas con diabetes mellitus que asistían a 17 centros de salud gubernamentales en la isla de Trinidad, en Trinidad y Tabago. Se observó el uso de medicinas herbolarias en 42% de los pacientes encuestados y su utilización para la diabetes se observó en 24%. El empleo de estas medicinas fue más frecuente en habitantes de Trinidad de herencia africana o mixta que en los de ascendencia india oriental. También fue más común en personas de baja escolaridad. La mayoría de los pacientes que usaban medicinas herbolarias (214/264, u 81%) dijeron que ellos mismos recogían las plantas y 107/264 (41%) las consumían más de una vez a la semana. Los pacientes que tomaban estas medicinas mencionaron 103 tipos distintos de plantas que se usaban para hacer remedios. Entre las 12 mencionadas con mayor frecuencia, Momordica charantia ("caraili"), los áloes, Bontia daphnoides ("olive bush") y la planta Phyllantus amarus se usaban específicamente para la diabetes. La verbena, la planta Leonotis nepetifolia ("chandilay"), el guanábano, la hierba Cymbopogan citratus ("fever grass") y la cáscara de naranja se usaban más bien para otros problemas. Los pacientes que se quejaban de una sensación urente o de entumecimiento en los pies, o de cansancio, debilidad, sensación de desmayo o mareo usaban las medicinas herbolarias para la diabetes con más frecuencia que los pacientes que notificaron tener otras manifestaciones de esa enfermedad. Los pacientes tratados con insulina usaban medicamentos herbolarios con menos frecuencia. Se concluye que las medicinas herbolarias son usadas con regularidad por muchos pacientes diabéticos en Trinidad. Las plantas utilizadas con mayor frecuencia para tratar la diabetes tienen actividad hipoglicemiante reconocida. El fondo cultural del paciente, así como su grado de escolaridad, sintomatología y tratamiento médico formal, también pueden ejercer influencia en la selección y uso de los medicamentos herbolarios