CHILDHOOD diabetes is emerging as a critical public health threat worldwide, and Jamaica is no exception. The rising cases of type 1 diabetes (T1D) and type 2 diabetes (T2D) among children signal an impending health crisis that demands urgent, sustained attention. Although global data outlines the broader implications, the situation in Jamaica has reached alarming levels. At the same time, policies like the National School Nutrition Policy seem to have met a stalemate. Such policies would address nutrition and physical activity within one of our most vulnerable populations. A more robust and coordinated national response is needed to combat the epidemic of childhood diabetes.

The strain on Jamaica’s health system

The economic burden of diabetes on Jamaica’s healthcare system is immense. With the growing number of children diagnosed with T1D and T2D, the demand for insulin, glucose monitoring devices, and specialised medical care is soaring. The country spends approximately 3.08 per cent of its gross domestic product on out-of-pocket health costs for NCDs, amounting to about $33.8 billion (US$452 million) and with costs related to treatment and productivity loss projected to reach around $77 billion over 15 years, as stated by the Ministry of Health of Health and Wellness. While the Jamaican government provides free insulin for children under 19, this is only part of the solution. Families still face the financial burden of purchasing blood glucose monitors, test strips, and frequent visits to specialists such as endocrinologists and dietitians. Managing diabetes is a lifelong endeavour, and without proper support and education, many families struggle to cope with the disease’s demands.

Jamaica’s health infrastructure is already under strain due to other NCDs, and it is ill-prepared for the rising tide of childhood diabetes. The “free” healthcare concept does not necessarily translate to accessible or high-quality care, particularly in public facilities. There is a significant gap between demand and supply, and this shortage of resources exacerbates the challenges faced by children with diabetes and their families. The health system must prioritise comprehensive diabetes education and support services, particularly in underserved areas.

Vision 2030 and global health goals

Jamaica’s Vision 2030 plan sets ambitious targets, and we now know we will not meet those targets by 2030. However, these goals will only continue to be highly unattainable if urgent action is not taken to address the escalating cases of NCDs such as childhood diabetes. Vision 2030 includes health and well-being objectives, focusing on reducing the burden of NCDs. The government, healthcare professionals, schools, and communities must coordinate efforts to achieve these targets.

Globally, the Sustainable Development Goals (SDGs) underscore the importance of health and well-being, specifically aiming to reduce premature deaths from NCDs by one-third by 2030. Tackling childhood diabetes, especially T1D, is essential to meeting these goals. By investing in early diagnosis, improved access to care, and education on diabetes management, Jamaica can align itself with the Vision 2030 plan and the SDGs and give ourselves a better shot at attaining them.

Understanding childhood Type 1 diabetes

Type 1 diabetes is a chronic, autoimmune disease in which the body’s immune system attacks insulin-producing beta cells in the pancreas, leading to the inability to regulate blood sugar. Though T1D can manifest at any age, it is most prevalent among children and adolescents. Globally, an estimated 595,000 to 955,000 children are affected by T1D, with annual incidence rates between 1.6 and 3.01 per 100,000. In Jamaica, the estimated incidence of T1D in children is approximately 1.72 per 100,000, based on limited data from 2004.

This lack of up-to-date data is a significant barrier to effectively addressing childhood diabetes in Jamaica. Without a national registry for childhood diabetes and with delays in diagnosis—particularly in rural areas—the situation is likely worse than reported. Many families, especially in lower-income areas, are unaware of the early warning signs of diabetes, often resulting in life-threatening complications before medical intervention is sought. The limited number of healthcare professionals specialising in diabetes and poor health literacy amplifies this issue.

The role of nutrition and physical activity

Nutrition is intricately linked to the management of diabetes, particularly T1D, where insulin production is non-existent or severely compromised. While T1D is primarily an autoimmune disease, proper nutrition is critical in preventing complications associated with the disease. Children with T1D need balanced meals that help regulate blood glucose levels. In Jamaica, where there is a high prevalence of nutrient-poor, calorie-dense foods, children with diabetes often struggle to maintain proper dietary habits. The cost of healthy foods can be prohibitive for many families, and the availability of processed, high-sugar foods in schools and communities further complicates the issue.

The National School Nutrition Policy is critical for addressing these challenges. The policy aims to promote healthier eating habits among children and ensure that schools provide nutritious meals that support physical and cognitive development.

The work of the Diabetes Association of Jamaica

The Diabetes Association of Jamaica (DAJ) has played a critical role in raising awareness about diabetes and providing support to affected families. Through its “Life for a Child” programme, the DAJ offers insulin, glucose monitors, and education to children with diabetes, alleviating some of the financial strain on families. The DAJ’s work is crucial for children’s survival, especially given the inconsistent access to life-saving diabetes care in Jamaica.

To extend these initiatives, the DAJ’s efforts must be reinforced by more substantial government assistance and private-sector collaborations. Programmes like the “Jamaica Diabetes 5” project, which debuted in 2015 and seeks to remove some of these hurdles by delivering insulin for free to children aged 0 to 19 with T1D or T2D, must be promoted, monitored, and sponsored. Public-private partnerships can assist to scale up these efforts, especially in areas where access to healthcare is limited.

A call to action for Jamaica’s future

Childhood diabetes, particularly T1D, is a growing concern in Jamaica, with far-reaching implications for the health of the nation’s children, families, and health systems. Physical activity and proper nutrition are essential components of diabetes management, yet children in Jamaica often face significant barriers to accessing the care and resources they need. The National School Nutrition Policy and initiatives like the Life for a Child Programme offer promising solutions. However, more must be done to ensure these programs are fully implemented and supported.

Addressing childhood diabetes must be a priority. By investing in public awareness, expanding access to care, and fostering a culture of healthy living through physical activity and nutrition, Jamaica can improve the quality of life for children with diabetes and move closer to achieving its national and global health goals. The time to act is now—before the nation misses the opportunity to secure a healthier future for its youngest citizens.

Offniel Lamont is a public health advocate and registered physiotherapist with a master’s in sports medicine, exercise, and health. He specialises in preventing, monitoring and managing sports injuries, particularly among young athletes, and combating non-communicable diseases through comprehensive sports and healthcare management.