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Insulin for Life has helped screen thousands of people with diabetes in prisons all over the Philippines. IFLs work has been actively supporting lower income people with diabetes in the Philippines since 2012.  We provide clinics with in-date and unopened insulin, syringes, blood glucose test meters, and strips and lancets.  In 2018, IFL was invited to help run diabetes screening programs, based on finger-prick blood glucose levels, in the Philippine prison system.

It is important to note that adults who are incarcerated usually have restricted options for exercise and food choices in prison.   The risk  for gaining weight and developing type 2 diabetes is high, particularly if other risk factors are present such as a family history of diabetes. People from certain ethnicities are also at a higher risk.  These include Indigenous people, Pacific Islanders, Asian, and Hispanics.

Many media reports, especially from the USA, highlight examples of inadequate care for people with diabetes in prison.  Even denial of needed treatment has occurred including deaths associated with diabetic ketoacidosis (DKA) or hypoglycaemia. For many people, the ability for self-care is poor and  can lead to complications. Appropriate training and resources to enable good quality care of incarcerated people with diabetes is essential as well as routine screening.

Appropriate training and resources to enable good quality care of incarcerated people with diabetes is essential as well as routine screening.

In 2017, there were over 3.721.900 cases of diabetes in Philippines.  Approximately, 95% are people with type 2 diabetes.  In addition, about 2.5 million people do not know they have diabetes in the Philippines, and the IDF Atlas (2017) estimates that 3.7 million people have impaired glucose tolerance or prediabetes.

In order to continue to prioritize IFLs advocacy assistance program for people with diabetes in the Philippines, IFL Australia helped facilitate a free diabetes screening program conducted by 16 diabetes educators at the Talisay prison in Cebu, Philippines (December 2018).  Led by Marieta Naanos from the Association of Diabetes Educators of the Philippines (ADEP), the team gave fasting blood glucose tests to 1,035 prisoners (also known as ‘People Deprived of Liberty’ or PDL).  Volunteers for the screening included 898 men and 137 women, aged 18-71 years old.  The team found glucose levels consistent with diabetes in 51 men and 23 women, or about 7% of the total.   The people who were found to have developed diabetes will also receive additional testing to verify the diagnosis. One prison guard, known to have type 2 diabetes, also requested testing. His blood glucose was 500 mg/dl (28 mmol/L).  After consultation with the doctor, a diabetes educator administered insulin to the guard and follow-up was recommended.

Due to the success of this first program, other prisons in the Philippines requested the screening program.  In May 2019, IFL Australia has organised a team of local diabetes educators and doctors to conduct blood glucose and blood pressure screening programs in the Magsaysay and Handunaman prisons located in the Philippines city of Bacolod. Four hundred inmates volunteered for the free screening.  Many of the volunteers were identified with high blood glucose or high blood pressure readings.  The prison medical team took our results.

All screening days were very well-run with grateful PDL participants.  It is hoped that the people who have developed diabetes will receive the necessary care and treatment.

In February 2020, a program is planned for Lapu-Lapu City prison in Cebu, for an estimated 2,500 PDLs.

The photos show ‘de-identified’ participants in the Talisay Prison program.

 

Neil Donelan is a Member of the Board of Insulin for Life


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