Higher Institute of Medical Sciences
Hospital Dr. Salvador Allende
Havana, Cuba

February 2010
Diabetes mellitus is a frequent metabolic disorder seen in Geriatrics at Hospital Dr. Salvador Allende in Havana, Cuba.  In 1999, about 2% of the Cuban population was diabetic and this percentage increased to 3% by 2006.  Suffering from this pathology is a challenge especially in developing countries like Cuba.
Diabetics are at a disadvantage in Cuba.  The Cuban economy is not ideal for those who need to follow a diet.  The high price that diabetics need to pay to get the right food for their diet makes it impossible for them to have a diet.  In this island you eat what is available.  Let us remember that Cuba is a developing country whose economy is affected tremendously by the US Embargo.  The embargo against Cuba has a negative impact on people of all ages.  At the end of the day, following a diet is a luxury which is obviously out of reach to most diabetics in Cuba.    
Maintaining adequate levels of blood glucose helps diabetics lower the risk of long-term complications.  It is important to check the levels of glucose in blood and, to do so, diabetics normally use a glucometer.  In Cuba, however, glucometers are not available to diabetics.  This is very unfortunate because it makes it difficult for diabetics to monitor their blood glucose throughout the day.  Diabetics have to go through the hospital laboratory if they wish to know their blood glucose levels.  Due to the high demand, lab results are not readily available and the patients must wait hours in order to receive the results.  Lab results are only obtained relatively quickly during a medical emergency.  Keep in mind that healthcare in Cuba is free despite all the financial difficulties.  Physicians and patients must work with whatever resources are available.   
Life as a diabetic is tough but not impossible in developing countries.  Despite the obstacles, some diabetics manage to maintain an adequate metabolic control.  My current patient, Luisa, is a vivid example.  Luisa is a loving eighty-year-old grandma who has been diabetic for over fifty years.  She is currently teaching fourth grade in a primary school here in Havana and has no plans to retire.  Over the years she has learned to maintain an adequate metabolic control without the use of a glucometer.  Luisa managed to overcome the obstacles and much of the energy that she has comes from her fourth graders that anxiously wait for her recovery. 
Sincerely,

Alejandro Bernal
Website: www.pnhpwesternwashington.org
Email: alex238209@yahoo.com