Barbados is in the grip of a diabetic foot amputation crisis

For the past two decades Barbados has held the dubious nickname of “amputation capital of the world,” says Brian Payne, deputy nutrition officer at the Barbados Ministry of Health and Wellness. The reason? A tide of diabetes.

A staggering 89% of diabetes related hospital admissions in Barbados involve foot complications.1 Amputations are largely attributed to poorly managed type 2 diabetes, with approximately 80% of cases stemming from diabetic foot ulcers.2 These often develop from diabetes related complications such as diabetic neuropathy and peripheral arterial disease, which contribute to the formation of leg ulcers and delayed wound healing. The gravity of this health crisis is underscored by the stark five year survival rates after amputation in the country: 28% for below knee amputations and 10% for above knee amputations.3

“Diabetes touches everyone here in Barbados in one way or another,” Payne says. The most comprehensive study of diabetes prevalence in Barbados, conducted by the health ministry in 2015,4 concluded that 19% of the adult population had diabetes, nearly three times the rate of the UK, which stands at 7%.5 The same study established that two thirds of adult Barbadians were either overweight or obese, raising concerns that the situation might have worsened in the near decade since.

Payne puts much of the blame on the influence of industry: “The fast food industry and the beverage industry have a huge impact on Barbadian society as a whole . . . when you look at some of the things that they do, they actually use the same playbook that the tobacco industry uses to perpetuate its …