In Fiji, the growing prevalence of diabetes mellitus (DM) has become a significant public health concern, with profound implications for individuals and the health care system alike.
Recent surveys and studies that were presented by Doctor Semesa Matanicake at the 30th Fiji College of General Practitioners Annual Conference last weekend, revealed that diabetes-related complications have become an escalating burden in this country.
“Of particularly lower extremity amputations (LEA), paints a stark picture of the challenges faced by both patients and health care providers,” Dr Matanicake said.
“According to the Fiji (STEPS) NCDs survey conducted in 2002, approximately 16 per cent of individuals aged 25-64 were found to have diabetes, with half of them being previously undiagnosed.”
This indicates a substantial portion of the population living with untreated or poorly managed diabetes, placing them at heightened risk for complications such as foot ulcers and infections, ultimately leading to amputations.
He explained how the data further revealed a concerning trend in the number of diabetic-related amputations, with a significant rise observed over the years. For instance, from 2010 to 2012, 938 amputations were performed at the Colonial War Memorial Hospital, averaging 313 annually.
By 2017, this number had surged to 475, with 166 cases involving below-knee amputations (BKA).
The Diabetes Incidence and Projections Survey in Fiji conducted in 2015 highlighted the escalating prevalence of type 2 diabetes mellitus (T2DM) among different demographic groups.
“Over the period of 1980 to 2011, T2DM prevalence exhibited a staggering increase, with rates projected to reach 13.3 per cent by 2020.”
This upward trajectory is particularly pronounced among indigenous iTaukei and Indian populations, both men and women.
“This fact alone highlights the urgency of addressing diabetes prevention and management strategies tailored to diverse cultural contexts.
“One of the most concerning aspects of diabetes-related amputations is the high mortality rates associated with them.
“In Fiji, mortality rates following amputations range from 13 per cent to 80 per cent within one to five years post-surgery.”
