Early Management of Diabetes Allows Seafarers to Remain Employed

Dr Marcus Brauer, a General Practitioner from one of UK P&I Club’s PEME[1] approved clinics in South Africa, provides valuable medical insight into one of the industry’s most concerning medical issues.

“Diabetes affects 382 million people worldwide, and that number is expected to grow to 592 million by 2035[2]. The early detection and effective early management of diabetes is one of the most satisfying parts of our work as PEME doctors, as we are able to not only preserve and maintain the health of the seafarer, but we are also able to assist them in understanding and managing their condition.

“Diabetes is a progressive, non-communicable disease, which is caused primarily by a sedentary lifestyle and an increasing consumption of sugars and starches in our diets, which lead to obesity and an increasing difficulty in controlling blood sugar levels. It is one of the most significant underlying risk factors for developing premature cardiovascular complications, followed by smoking and hypertension.

“The PEME examination is the perfect time to screen for the risk factors for diabetes as well as the presence of early signs of diabetes. This allows for early recognition of seafarers at risk, and then careful monitoring and treatment. Treatment involves seafarers taking the following steps:

• Minimizing the intake of sugar in sweetened foods (typically all packaged and processed foods, fruit juices, fizzy drinks and sauces).
• Minimizing the intake of starches – the main culprits being bread, potatoes, pasta and rice.
• Exercising at least three times a week for 30 minutes, aiming to achieve an exercise heart rate of 75% of maximum.
• Monitoring blood sugar levels with tests such as urine glucose tests, blood sugar tests and a diabetes control measuring test, an HBA1C, which provides a measure of diabetes control over the last six weeks. The seafarer must also keep a log-book of their diabetes control to enable them to understand their health condition, and to take responsibility for its management.
• Using the medication prescribed by their doctor regularly and notifying their doctor of any change in their diabetes control, so that appropriate adjustments to their treatment regime can be made.

“The treatment is aimed at correcting lifestyle measures and allows seafarers to remain gainfully employed in the careers to which they have often devoted their lives.”