A non-communicable disease, or NCD, is a disease caused by something other than a pathogen,

which is not contagious. Risk factors such as a person's lifestyle, genetics, or environment are
known to increase the likelihood of certain non-communicable diseases. Of these three risk
factors, 50% of all non-communicable diseases are a result of poor lifestyle choices such as drug
use, alcohol and tobacco use, diet, lack of exercise or stress management. Examples of noncommunicable diseases include heart disease, hypertension, cancer, asthma, diabetes, allergies,
stroke, and more.
Sixty percent of the deaths in The Bahamas are related to chromic non-communicable diseases
(CNDCs) such as hypertension, and cancer. Just mention the word cancer, and so many dreadful
feelings are conjured up by our Bahamian society. No other disease has had such a profound
affect (next to the HIV virus) on the human psych like cancer to the point where scientists around
the world are literally working day and night to find a cure.
Here in The Bahamas, Breast Cancer has become the most common form of cancer found in
women. In men, it is Prostate Cancer. This mysterious disease has been the centre of many
worthy causes by a number of committed civic organizations (e.g. The Cancer Association),
whose goal is to educate the public and to provide encouragement on the best available care and
treatment for those who are diagnosed with it. For Cancer, a recent study discovered that a

significant percentage of Bahamian females possess an abnormal gene that exposes them to
cancer, and according to what was found, their condition has been ranked the highest in the
world. This of course, has led medical experts in the country to step up their efforts and is
reportedly getting ready to conduct a final round of cancer testing around the Family Islands.
The statistics have shown that many of the illnesses that we refer to today are related to chronic
non-communicable diseases and or their consequences. These statistics show that approximately
120 new cases of breast cancer are diagnosed annually, as well as 80 to 100 new cases of prostate
cancer in men. The latest statistics show approximately 1,153 men in The Bahamas have prostate
cancer and 1,530 women have breast cancer.

What is blood pressure?

Blood pressure is the pressure exerted on the artery tube when blood flows through the arteries.
The pressure exerted when the heart contracts and sends out the blood is called systolic (highest)
blood pressure. The pressure when the heart dilates and blood flows into the heart is called
diastolic (lowest) blood pressure. Blood pressure is normally measured at the brachial artery.
What Causes Hypertension?
The cause of primary hypertension in the majority of people is not known. This condition can be
the result of a variety of causes. However, there are risk factors that contribute to this disease.
Risk factors include:

Age and Sex-The risk of developing high blood pressure increases as you age. Most
cases of high blood pressure are diagnosed in men, until the age of 45. From age 45 to 54,
men and women are equally at risk for high blood pressure. After the age of 54, women
are actually more likely to have high blood pressure than men. This may suggest that
estrogen has a protective role in blood pressure. It is thought that estrogen helps keep
blood vessels flexible. Estrogen may also work with other hormones to reduce the risk of
high blood pressure in younger women.

Family History-People with relatives who have high blood pressure are more likely to
develop high blood pressure.

Ethnicity-People of African American and Native American ethnicity have very high
rates of high blood pressure, and the situation appears to be a growing problem.
Compared with Caucasians, African Americans develop hypertension earlier in life, and
their average blood pressures are much higher.

Diet-People who regularly eat foods that are high in salt are more susceptible to high
blood pressure.

Obesity-People who are overweight are at risk for many illnesses, including high blood
pressure.

Stress-Studies have shown that people with heightened anxiety, intense anger, and
suppressed expression of anger are more at risk of developing high blood pressure.

Symptoms of High Blood Pressure

One of the most dangerous aspects of hypertension is that you may not know that you have it.
There are generally no symptoms of high blood pressure, so you usually don't feel it. In fact,
nearly one-third of people who have hypertension don't know it. The only way to find out if you
have high blood pressure is to get your blood pressure checked on a regular basis. This is
especially important if you have a close relative who has high blood pressure.
If your blood pressure is extremely high, there may be certain symptoms to look out for,
including:

Severe headache

Fatigue or confusion

Vision problems

Chest pain

Difficulty breathing

Irregular heartbeat

Blood in the urine

Pounding in your chest, neck, or ears

If you have any of these symptoms, see a doctor immediately. You could be having a
hypertensive crisis that could lead to a heart attack or stroke.
Untreated hypertension can lead to serious diseases, including stroke, heart disease, kidney
failure and eye problems.
How can you prevent Hypertension?
Lifestyle changes can help you prevent high blood pressure. These changes are especially
important for people who have risk factors for high blood pressure that cannot be changed,
including family history, race, or age.
Lifestyle changes include:

Staying at a healthy weight, with a body mass index (BMI) of 18.5 to 24.9.

Reducing sodium in your diet to less than 2,300 mg a day, which is about 1 teaspoon of
salt.

Exercising, such as brisk walking, that raises your heart rate. Aim for at least 2 hours of
moderate exercise a week.

Limiting alcohol drinks to 2 drinks a day for men and 1 drink a day for women.

Following a diet that is rich in fruits, vegetables, and low-fat dairy products, with reduced
amounts of saturated and total fats.

Diagnosis and Treatments

Treatment for high blood pressure depends on the severity of the disease and whether you have
other health problems, such as heart failure or diabetes. Your doctor may want you to try lifestyle
changes first, including losing weight, increasing activity, and eating a balanced diet. If your
blood pressure is above a certain level, your doctor may prescribe medicine along with the
lifestyle changes.
Some people may only need lifestyle changes to control their high blood pressure, while others
need medicine as well. Either way, treating high blood pressure usually is a lifelong process.
Treatment of primary high blood pressure, especially moderate or severe high blood pressure,
decreases the risk of heart failure, coronary artery disease, heart attack, abnormal heartbeats,
stroke, and kidney disease, and it reduces the risk of death from these conditions.
Overall, goals of treatment are to:

Prevent death and disease associated with high blood pressure (heart disease, stroke, and
kidney disease).

Reduce systolic blood pressure below 140 millimeters of mercury (mm Hg) and diastolic
blood pressure below 90 mm Hg. The blood pressure goal may be lower, less than 130/80
mm Hg, for people with certain health conditions like diabetes, kidney disease, heart
failure, or coronary artery disease.

Control other risk factors, such as smoking, lack of exercise, and high cholesterol that can
lead to complications such as a heart attack and stroke.

Minimize side effects of medicines.

Live a full and active life.

Initial treatment
If you fall into the pre-hypertension range (120139/8089), your doctor will likely recommend
lifestyle changes, including:

Losing excess weight.

Exercising.

Limiting alcohol to 2 drinks a day for men and 1 drink a day for
women.

Cutting back on salt.

Quitting smoking.

Following the Dietary Approaches to Stop Hypertension diet.

Consider an eating plan that is a low-fat and low-saturated-fat diet that emphasizes eating more
fruits, vegetables, whole grains, and low-fat dairy foods. If you have high blood pressure (140
159/9099 mm Hg) and you do not have any organ damage or other risk factors for heart disease
(this is called uncomplicated high blood pressure), your doctor will likely recommend lifestyle
changes and possibly medicines. Most people with high blood pressure will need two or more
medicines, including a thiazide-type diuretic, to lower their blood pressure to below 140/90 mm
Hg, which is the goal for people with uncomplicated hypertension. If you have other conditions,
such as diabetes, heart failure, coronary artery disease, or chronic kidney disease, your doctor
may recommend that your blood pressure should be less than 130/80. If your blood pressure is
160179/100109 mm Hg or higher, you may need to try various combinations of medicines to
find what works best for you. You will also need to make aggressive lifestyle changes.
Treatment of secondary high blood pressure varies depending on the cause. For example,
treatment of high blood pressure caused by kidney disease will also include treating the kidney
problem. If you have secondary high blood pressure, you may have to take blood pressure
medicine long term, even if the condition that is causing your high blood pressure is treated.
People with high blood pressure who require special treatment considerations include:

Older adults

African Americans

Children

Pregnant women

Ongoing treatment

Most cases of high blood pressure cannot be cured but can be controlled with lifestyle changes
and medicine. Treatment is a lifelong process.
You may need to try several different medicines or combinations of medicines, such as ACE
inhibitors and diuretics, before finding the right combination that lowers your blood pressure to a
safe level. If you have secondary high blood pressure, you may need treatment for the condition
that is causing your high blood pressure.
It is important to follow the lifestyle changes your doctor recommends for the rest of your life to
reduce your risk of heart disease and stroke.
People with heart disease and high blood pressure have a high risk for future heart problems and
need aggressive treatment.
Treatment if the condition gets worse
Untreated high blood pressure can lead to fatal heart attacks or strokes. The higher your blood
pressure the greater your risk for these complications. Lowering blood pressure reduces the risk
of damaging blood vessels and developing atherosclerosis.
As your high blood pressure rises, you may need to take higher doses of medicine or a
combination of medicines. Many people take a combination of several medicines.
What to Think About
In older adults, even small decreases in systolic blood pressure may be enough to prevent
complications, if their diastolic blood pressure is normal.
People who have high blood pressure are encouraged to make lifestyle changes and stay with
these changes for the rest of their lives to reduce their blood pressure. Lifestyle changes such as

eating a low-fat diet, quitting smoking, and exercising will help reduce the overall risk of heart
disease and stroke and may reduce blood pressure significantly.

Cancer is the second most common cause of death, after heart disease. Cancer is the
abnormal, uncontrolled growth of cells which, if left untreated, can ultimately cause death.
Cancer refers to any one of a large number of diseases characterized by the development of
abnormal cells that divide uncontrollably and have the ability to infiltrate and destroy normal
body tissue. Cancer also has the ability to spread throughout your body. But survival rates are
improving for many types of cancer thanks to improvements in cancer screening and cancer
treatment.

Cancer develops when cells in a part of the body begin to grow out of control. Although there
are many kinds of cancer, they all start because of the out-of-control growth of abnormal cells.

Because cancer cells continue to grow and divide, they are different from normal cells. Instead
of dying, they outlive normal cells and continue to form new abnormal cells. Cancer cells
develop because of damage to DNA. This substance is in every cell and directs all the cells
activities. Most of the time when DNA becomes damaged, the body is able to repair. In cancer
cells the damaged DNA is not repaired. People can inherit damaged DNA, which accounts for
inherited cancers. Many times though, a persons DNA becomes damaged by exposure to
something in the environment, like smoking.

Causes
Cancer is caused by damage (mutations) to the DNA within cells. Your DNA contains a set of
instructions for your cells, telling them how to grow and divide. Normal cells often develop
mutations in their DNA, but they have the ability to repair most of these mutations. Or, if they
can't make the repairs, the cells often die. However, certain mutations aren't repaired, causing the
cells to grow and become cancerous. Mutations also cause cancer cells to live beyond their
normal cell life span. This causes the cancerous cells to accumulate.
In some cancers, accumulating cells form a tumor. But not all cancers form tumors. For example,
leukemia is a cancer that involves blood, bone marrow, the lymphatic system and the spleen, but
doesn't form a single mass or tumor.
The initial genetic mutation is just the beginning of the process by which cancer develops.
Scientists believe you need a number of changes within a cell in order to develop cancer,
including:

An initiator to cause a genetic mutation: Sometimes you're born with this genetic
mutation. Other times a genetic mutation is caused by forces within your body, such as
hormones, viruses and chronic inflammation. Genetic mutations can also be caused by
forces outside of your body, such as ultraviolet (UV) light from the sun or cancer-causing
chemicals (carcinogens) in your environment.

A promoter to cause rapid cell growth: Promoters take advantage of genetic mutations
created by initiators. Promoters cause cells to divide more rapidly. This could lead to an
accumulation of cells, such as a tumor. Promoters could be inherited, could come from
inside your body or could come from outside your body.

A progressor to cause cancer to become aggressive and spread: Without a progressor

a tumor may remain benign and localized. Progressors make cancers more aggressive,
more likely to invade and destroy nearby tissue, and more likely to spread to other parts
of your body. Like initiators and promoters, progressors could be inherited or they could
come from environmental sources.

Your genetic makeup, forces within your body, your lifestyle choices and your environment can
all set the stage for cancer or help complete the process once it's started. For instance, if you've
inherited a genetic mutation that predisposes you to cancer, you may be more likely than other
people to develop cancer when exposed to a certain cancer-causing substance. The genetic
mutation begins the cancer process, and the cancer-causing substance could play a role in further
cancer development. Likewise, smokers who work with asbestos are more likely to develop lung
cancer than are smokers who don't work with asbestos. That's because tobacco smoke and
asbestos both play roles in cancer development.

Risk Factors
While doctors have an idea of what can put you at risk of cancer, the majority of cancers occur in
people who don't have any known risk factors. Factors known to increase your risk of cancer
include:
Your age: Cancer can take decades to develop. That's why most people diagnosed with cancer
are 55 or older. By the time a cancerous mass is detected, it's likely that 100 million to 1 billion
cancer cells are present, and the original cancer may have been growing for five years or more.
While it's more common in older adults, cancer isn't exclusively an adult disease cancer can
be diagnosed at any age.
Your habits: Certain lifestyle choices are known to increase your risk of cancer. Smoking,
drinking more than one drink a day (for women) or two drinks a day (for men), excessive
exposure to the sun or frequent blistering sunburns, and having unsafe sex can contribute to
cancer. You can break these habits to lower your risk of cancer though some habits are easier
to break than others.
Your family history: Only about 10 percent of cancers are due to an inherited condition. If
cancer is common in your family, it's possible that mutations are being passed from one
generation to the next. You might be a candidate for genetic screening to see whether you have
inherited mutations that might increase your risk of cancer. Keep in mind that having an inherited
genetic mutation doesn't necessarily mean you'll get cancer.
Your health conditions: Some chronic health conditions, such as ulcerative colitis, can
markedly increase your risk of developing certain cancers. Talk to your doctor about your risk.

Your environment: The environment around you may contain harmful chemicals that can
increase your risk of cancer. Even if you don't smoke, you might inhale secondhand smoke if you
go places where people are smoking or you live with someone who smokes. Chemicals in your
home or work place, such as asbestos and benzene, also are associated with an increased risk of
cancer.
Symptoms
Signs and symptoms caused by cancer will vary depending on what part of the body is affected.
Some general signs and symptoms associated with, but not specific to, cancer include:

Fatigue

Fever

Lump or thickening that can be felt under the skin

Pain

Weight changes, including unintended loss or gain

Skin changes, such as yellowing, darkening or redness of the skin, sores that won't heal,
or changes to existing moles

Changes in bowel or bladder habits

Persistent cough

Difficulty swallowing

Hoarseness

Persistent indigestion or discomfort after eating

Common Cancer
The cells in malignant tumors can invade and damage nearby tissue and organs. Cancer cells can
also break away from a malignant tumor and travel through the bloodstream or lymphatic system
to form new tumors in other parts of the body. Most cancers are named for the organ or type of
cell in which they begin. For example, cancer that begins in the lung is lung cancer, and cancer
that begins in cells in the skin known as melanocytes is called melanoma. When cancer cells
spread (metastasize) from their original location to another part of the body, the new tumor has
the same kind of abnormal cells and the same name as the primary tumor.
Primary bone cancers (those that originate in the bone) represent less than 0.2 percent of all
cancers. The most common types occur most frequently in children and adolescents and are
especially rare in middle-aged adults. The most common form of bone sarcoma in adults is
chondrosarcoma. It usually occurs in adults between the sixth and eighth decades of life. This
form of cancer is treated by surgery alone, as radiation therapy and chemotherapy are not
effective for this entity.
Brain cancer, or a primary brain tumor, is a cancer that begins in the tissues of the brain. It
rarely spreads to other parts of the body, although if not treated, it will grow and the symptoms
will worsen over time. Brain cancer is a leading cause of cancer-related deaths, but research has
produced new, more effective treatment methods. Surgery, radiation and chemotherapy are the
most commonly used treatments.

Breast cancer, a disease in which malignant cells form in the tissues of the breast, is the most
common type of cancer (other than skin cancer) among women. Less than 1 percent of breast
cancers occur in men. The risk of getting breast cancer increases with age, and inherited gene
mutations or a family history of breast cancer may increase the risk.
Lung cancer is cancer that begins in the lungs. It is the leading cause of cancer deaths in both
men and women, although the survival rate has improved slightly in recent years. Cigarette
smoking is the most common risk factor for lung cancer, with almost 90 percent of all lung
cancers attributable to smoking or secondhand exposure to cigarette smoke.
The prostate, part of the male reproductive system, is a gland located under the bladder and in
front of the rectum. Prostate cancer usually begins in the gland cells and grows slowly, so
many men have prostate cancer but are unaware of it. Sometimes, however, prostate cancer will
grow and spread quickly. Prostate cancer is highly curable when detected and treated early.
Skin cancer is a disease in which cancer cells grow in the tissues of the skin. There are two
major groups: nonmelanoma and melanoma. Nonmelanoma skin cancers are by far the most
common types of cancer, with more than 1 million new cases diagnosed annually, and most are
highly curable. Melanoma is much less common, but more serious. Melanoma is highly curable
in its early stages, but may spread to other parts of the body.

Preventions
There's no certain way to prevent cancer. But doctors have identified several ways of
reducing your cancer risk, such as, stop smoking, avoid excessive sun exposure, eat a healthy

diet, exercise most days of the week, maintain a healthy weight, schedule screening exams, and
by asking your doctor about immunizations. If you smoke, quit. If you don't smoke, don't start.
Smoking is linked to several types of cancer, not just lung cancer. Quitting now will reduce your
risk of cancer in the future. Harmful ultraviolet (UV) rays from the sun can increase your risk of
skin cancer. Limit your sun exposure by staying in the shade, wearing protective clothing or
applying sunscreen. You should choose a diet rich in fruits and vegetables and select whole
grains and lean proteins. Regular exercise is linked to a lower risk of cancer, as well. You should
aim for 30 minutes of exercise most days of the week. If you haven't been exercising regularly,
start out slowly and work your way up to 30 minutes or longer. Being overweight or obese may
increase your risk of cancer. Work to achieve and maintain a healthy weight through a
combination of a healthy diet and regular exercise. Talk to your doctor about what types of
cancer screening exams are best for you, based on your risk factors. Certain viruses increase your
risk of cancer. Immunizations may help prevent those viruses, including hepatitis B, which
increases the risk of liver cancer, and human papillomavirus (HPV), which increases the risk of
cervical cancer and other cancers. Ask your doctor whether immunization against these viruses is
appropriate for you.
Diagnosis
Diagnosing cancer at its earliest stages often provides the best chance for a cure. With this in
mind, talk with your doctor about what types of cancer screening may be appropriate for you.
For a few cancers, studies show screening tests can save lives by diagnosing cancer early. For
other cancers, screening tests are reserved for people with the highest risk. Doctors recommend
screening for the following cancers in adults considered to have an average risk of cancer:

Type of cancer

Who should consider screening?

Breast cancer

Women 40 and older

Cervical cancer

Women 21 or older, or beginning three years after first sexual

intercourse

Colon cancer

Men and women 50 and older

Prostate cancer

Men 50 and older

Screening tests and procedures have risks and benefits. Discuss these with your doctor to
determine whether screening is right for you.
Most cases of cancer are detected and diagnosed after a tumor can be felt or when other
symptoms develop. In a few cases cancer is diagnosed incidentally as a result of evaluating or
treating other medical conditions. Diagnosis begins with a thorough physical examination and a
complete medical history. Your doctor may feel areas of your body for lumps that may indicate a
tumor. During a physical exam he or she may look for any abnormalities, such as changes in skin
color or enlargement of an organ that may indicate cancer.
Laboratory studies of blood, urine and stool can detect abnormalities that may indicate cancer.
When a tumour is suspected, imaging tests such as X-rays, computerized tomography (CT),
magnetic resonance imaging (MRI), ultrasound and fibrotic scope examinations help doctors
determine its location and size. Imaging tests allow your doctor to examine your bones and
internal organs in a noninvasive way.
To confirm the cancer diagnosis, a biopsy is performed: a tissue sample is surgically removed
from the suspected malignancy and studied under a microscope to check for cancer cells. During
a biopsy, your doctor collects a sample of cells for testing in the laboratory. There are several
different ways of collecting a biopsy sample. Which biopsy procedure is right for you, depends

on your type of cancer and its location. In most cases, a biopsy is the only way to definitively
diagnose cancer. In the laboratory, doctors look at biopsy samples under the microscope. Normal
cells look uniform, with similar sizes and orderly organization. Cancer cells look less orderly,
with varying sizes and without apparent organization.
Cancer Stages
Once cancer is diagnosed, your doctor will work to determine the extent, or stage, of your cancer.
Your doctor uses your cancer's stage to determine your treatment options and your chances for a
cure. Staging tests and procedures may include imaging tests, such as a bone scans or X-rays to
see if cancer has spread to other parts of the body. Cancer stages are generally indicated by
Roman numerals (I through IV), with higher numerals indicating more advanced cancer. In some
cases, cancer stage is indicated using letters or words.

Treatment
Many cancer treatments are available. Your treatment options will depend on several factors,
such as the type and stage of your cancer, your general health and your preferences. Together you
and your doctor can weigh the benefits and risks of each cancer treatment to determine which is
best for you. Goals of the treatment of Cancer are to use treatment to kill or remove cancer cells
(primary treatment), treatment to kill any remaining cancer cells (adjuvant therapy), and
treatment to manage side effects of cancer and its treatment (palliative care). The goal of a
primary treatment is to remove the cancer from your body or kill the cancer cells. Any cancer
treatment can be used as a primary treatment, but the most common primary cancer treatment for

the most common cancers is surgery. If your cancer is particularly sensitive to radiation therapy
or chemotherapy, you may receive one of those therapies as your primary treatment. The goal of
adjuvant therapy is to kill any cancer cells that may remain after primary treatment. Any cancer
treatment can be used as an adjuvant therapy. Common adjuvant therapies include chemotherapy,
radiation therapy and hormone therapy. The goal of palliative care is to decrease pain or other
symptoms and help you maintain quality of life during and after cancer treatment. Palliative
treatments may help relieve side effects of treatment or signs and symptoms caused by cancer
itself.

Methods or Treatments

Doctors have many tools when it comes to treating cancer. There are four standard methods of
treatment for cancer: surgery, chemotherapy, radiation therapy, immunotherapy and biologic
therapy. Clinical trials may be an option for some as cancer treatment who meet certain study
criteria. Surgery can be used to prevent, treat, stage (determine how advanced the cancer is), and
diagnose cancer. In relation to cancer treatment, surgery is done to remove tumors or as much of
the cancerous tissue as possible. It is often performed in conjunction with chemotherapy or
radiation therapy. For those whose cancer is not treatable, palliative surgery may be an option to
relieve pain that may be caused by the cancer. Palliative surgery is not intended to treat or cure
the cancer, or even to prolong life, but more to lessen discomfort.
Chemotherapy is a type of cancer treatment that uses of drugs to eliminate cancer cells. Unlike
surgery, chemotherapy affects the entire body, not just a specific part. It works by targeting
rapidly multiplying cancer cells. Unfortunately, other types of cells in our bodies also multiply at
high rates, like hair follicle cells and the cells that line our stomachs. This is why chemo can

cause side effects like hair loss and an upset stomach. Chemotherapy is most commonly given by
pill or intravenously (IV), but can be given in other ways. A single type of chemotherapy, or a
combination of drugs, may be prescribed for a specific length of time. Like surgery,
chemotherapy can be prescribed alone, in conjunction with radiation therapy or biologic therapy.

Radiation therapy uses certain types of energy to shrink tumors or eliminate cancer cells. It
works by damaging a cancer cell's DNA, making it unable to multiply. Cancer cells are highly
sensitive to radiation and typically die when treated. Nearby healthy cells can be damaged as
well, but are resilient and are able to fully recover. Radiation therapy may be given alone, along
with chemotherapy, and/or with surgery. The decision to combine radiation therapy with other
types of treatment depends on the stage of cancer and other factors.

Biologic therapy is a term for drugs that target characteristics of cancerous tumors. Some types
of targeted therapies work by blocking the biological processes of tumors that allow tumors to
thrive and grow. Other types of therapies cut off the blood supply to the tumor, causing it to
basically starve and die because of a lack of blood. Targeted therapy is used in select types of
cancer and is not available for everyone. It is given in conjunction with other cancer treatments.

For clinical trials, research studies of the latest drugs and therapies against many types of cancer
are continuously being conducted. This type of research requires human volunteers to test the
safety and effectiveness of new therapies. Volunteers must meet the criteria of each study to
participate. When initially diagnosed with cancer, a cancer specialist, an oncologist, will provide
you with the cancer treatment options. He or she will recommend the best treatment plan based
on your type of cancer, how far it has spread, and other important factors like your age and
general health.

Cancer and Depression

Chances are you will know someone affected or suffering from this disease and yes, you can
help. When someone learns that they have cancer, they can go through a period of grief and
sadness. They are grieving the loss of being a healthy person and the loss of certainty in their
lives. This period of sadness may seem like clinical depression, but it is not the same. Grieving
(experiencing sadness, fear, anger, or crying spells) is normal, and a healthy reaction to learning
of a serious health concern. It usually does not last a long time and it is a normal reaction to a
profound change in a persons life. About one in four people (25%) develop clinical depression.
Sometimes depression can make it hard for a person to follow his or her medical treatment
because symptoms can include very low energy and motivation, difficulty making decisions
about treatment, and feelings uselessness or helplessness.
Here is where we can help someone may be embarrassed to ask for help. Cancer affects the
entire family and friend and not just the person who has been diagnosed. We must assure the
person that clinical depression is not a sign of weakness, nor is it anyones fault. It may also be
helpful to know that it can be treated with medicines, counseling, or a combination of both.
Treatment for depression can help the person feel better fairly quickly and help them regain a
sense of control and hope for the future.

The term "diabetes mellitus" refers to a group of diseases that affect how your body uses blood
glucose, commonly called blood sugar. Glucose is vital to your health because it's the main
source of energy for the cells that make up your muscles and tissues. It's your body's main source
of fuel.
If you have diabetes, no matter what type, it means you have too much glucose in your blood,
although the reasons may differ. Too much glucose can lead to serious health problems.

Chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Potentially reversible
diabetes conditions include prediabetes when your blood sugar levels are higher than normal,
but not high enough to be classified as diabetes and gestational diabetes, which occurs during
pregnancy.
Symptoms
Diabetes symptoms vary somewhat, depending on what type of diabetes you have. If you have
prediabetes or gestational diabetes, you may not experience symptoms. Or you might experience
some or all of the symptoms of type 1 and type 2 diabetes:

Increased thirst

Frequent urination

Extreme hunger

Unexplained weight loss

Fatigue

Blurred vision

Slow-healing sores

Frequent infections, such as gum or skin infections and vaginal or bladder infections

Although type 1 diabetes can develop at any age, it typically appears during childhood or
adolescence. Type 2 diabetes, the most common type, can develop at any age and is often
preventable.

Causes
To understand diabetes, first you must understand how glucose is normally processed in the
body.
How glucose normally works
Glucose is a main source of energy for the cells that make up your muscles and other tissues.
Glucose comes from two major sources: the food you eat and your liver. During digestion, sugar
is absorbed into the bloodstream. Normally, sugar then enters cells with the help of insulin.
The hormone insulin comes from the pancreas, a gland located just behind the stomach. When
you eat, your pancreas secretes insulin into your bloodstream. As insulin circulates, it acts like a
key by unlocking microscopic doors that allow sugar to enter your cells. Insulin lowers the
amount of sugar in your bloodstream. As your blood sugar level drops, so does the secretion of
insulin from your pancreas.
Your liver acts as a glucose storage and manufacturing center. When you haven't eaten in a while,
for example, your liver releases stored glucose to keep your glucose level within a normal range.
Causes of type 1 diabetes
In type 1 diabetes, your immune system which normally fights harmful bacteria or viruses
attacks and destroys the insulin-producing cells in the pancreas. This leaves you with little or no
insulin. Instead of being transported into your cells, sugar builds up in your bloodstream.
Causes of prediabetes and type 2 diabetes
In prediabetes which can lead to type 2 diabetes and in type 2 diabetes, your cells become

resistant to the action of insulin, and your pancreas is unable to make enough insulin to
overcome this resistance. Instead of moving into your cells, sugar builds up in your bloodstream.
Exactly why this happens is uncertain, although excess fat especially abdominal fat and
inactivity seem to be important factors.
Causes of gestational diabetes
During pregnancy, the placenta produces hormones to sustain your pregnancy. These hormones
make your cells more resistant to insulin. As your placenta grows larger in the second and third
trimesters, it secretes more of these hormones making it even harder for insulin to do its job.
Normally, your pancreas responds by producing enough extra insulin to overcome this resistance.
But sometimes your pancreas can't keep up. When this happens, too little glucose gets into your
cells and too much stays in your blood. This is gestational diabetes.

Risk factors
Risk factors for diabetes depend on the type of diabetes.
Risk factors for type 1 diabetes
Although the exact cause of type 1 diabetes is unknown, family history may play a role. Your
risk of developing type 1 diabetes increases if you have a parent or sibling who has type 1
diabetes. Other factors have been proposed, as well, such as exposure to a viral illness.

Risk factors for prediabetes and type 2 diabetes

Researchers don't fully understand why some people develop prediabetes and type 2 diabetes and
others don't. It's clear that certain factors increase the risk, however, including:

Weight. The more fatty tissue you have, the more resistant your cells become to insulin.

Inactivity. The less active you are, the greater your risk. Physical activity helps you
control your weight, uses up glucose as energy and makes your cells more sensitive to
insulin.

Family history. Your risk increases if a parent or sibling has type 2 diabetes.

Race. Although it's unclear why, people of certain races including blacks, Hispanics,
American Indians and Asian-Americans are at higher risk.

Age. Your risk increases as you get older, especially after age 45. Often, that's because
you tend to exercise less, lose muscle mass and gain weight as you age. But type 2 diabetes
is increasing dramatically among children, adolescents and younger adults.

Gestational diabetes. If you developed gestational diabetes when you were pregnant,
your risk of developing prediabetes and type 2 diabetes later increases. If you gave birth to
a baby weighing more than 9 pounds (4 kilograms), you're also at risk of type 2 diabetes.

Polycystic ovary syndrome. For women, having polycystic ovary syndrome a

common condition characterized by irregular menstrual periods, excess hair growth and
obesity increases the risk of diabetes.

Other conditions associated with diabetes include:

High blood pressure

High levels of low-density lipoprotein (LDL), or "bad," cholesterol

Low levels of high-density lipoprotein (HDL), or "good," cholesterol

High levels of triglycerides, another fat in the blood

When these conditions high blood pressure, high blood sugar and abnormal blood fats
occur together with obesity, they are associated with resistance to insulin.
Risk factors for gestational diabetes
Any pregnant woman can develop gestational diabetes, but some women are at greater risk than
are others. Risk factors for gestational diabetes include:

Age. Women older than age 25 are at increased risk.

Family or personal history. Your risk increases if you have prediabetes a precursor to
type 2 diabetes or if a close family member, such as a parent or sibling, has type 2
diabetes. You're also at greater risk if you had gestational diabetes during a previous
pregnancy, if you delivered a very large baby or if you had an unexplained stillbirth.

Weight. Being overweight before pregnancy increases your risk.

Race. For reasons that aren't clear, women who are black, Hispanic, American Indian or
Asian are more likely to develop gestational diabetes.

Complications
Diabetes complications vary depending on the type of diabetes you have.

Complications of type 1 and type 2 diabetes

Short-term complications of type 1 and type 2 diabetes require immediate care. Left untreated,
these conditions can cause seizures and a state of unconsciousness (coma).

High blood sugar (hyperglycemia). Your blood sugar level can rise for many reasons,
including eating too much, being sick or not taking enough glucose-lowering medication.

Increased ketones in your urine (diabetic ketoacidosis). If your cells are starved for
energy, your body may begin to break down fat. This produces potentially toxic acids
known as ketones.

Low blood sugar (hypoglycemia). If your blood sugar level drops below your target
range, it's known as low blood sugar. Your blood sugar level can drop for many reasons,
including skipping a meal and getting more physical activity than normal. However, low
blood sugar is most likely if you take glucose-lowering medications that promote the
secretion of insulin or if you're receiving insulin therapy.

Long-term complications of diabetes develop gradually. The earlier you develop diabetes and
the less controlled your blood sugar the higher the risk of complications. Eventually, diabetes
complications may be disabling or even life-threatening.

The government will consider legislating a ban on smoking in public places, improve
physical education facilities at public schools and provide tax incentives for the creation of onthe-job exercise facilities, all as part of its ongoing commitment to stemming the incidences of

chronic non-communicable diseases (CNCDs) in The Bahamas, Prime Minister Hubert Ingraham
said Saturday. Prime Minister Ingrahams remarks came during an interview with Trinidad and
Tobagos C-News Station at CARICOMs Summit on Chronic Non-Communicable Diseases
diseases the Caribbean Community has dubbed one of the greatest threats to development in the
region.
Back in 2001, CARICOM Heads adopted the Nassau Declaration that The Health of the
Region is the Wealth of the Region, which was designed to accelerate the response to various
health conditions facing the region. The 2007 summit in Trinidad was the result of progress from
the Declaration adopted in The Bahamas. Specifically, we have a problem with respect to
hypertension, Mr. Ingraham indicated. We have high levels of diabetes. Apart from the fact
that were are going to put in place a national programme for the provision of medicines for all
persons irrespective of ability to pay for their prescriptions, we are going have a major effort in
terms of prevention.
Diseases such as hypertension, heart disease, diabetes and cancer, coupled with obesity
and a lack of physical activity, are the leading cause of death and disability in The Bahamas, with
the summit revealing that Bahamians are ten-times more likely to die of hypertension than their
Canadian counterparts. Highlighting the governments recent announcement of a new dietary
programme for all public schools, the prime minister also foreshadowed improvements to public
school exercise facilities, adding that the government is going to seek to have health promotion
as a major part of initiatives within the public health sector.
The Prime Minister said, We are going to seek to duplicate what we have in a few
government offices, that is rooms with exercise equipment in many more government facilities

and we are going to seek to encourage employers to do so by providing incentives and tax
exemptions for them to acquire equipment to be able to facilitate people engaging in exercise.
Emphasizing that most CNCDs can be prevented through lifestyle changes in diet and
exercise, the Trinidad summit also placed emphasis on the role of tobacco consumption in the
incidences of cancer and heart disease in the region, and the need to enact tobacco control
measures such as increased import taxation and the prohibition of smoking in public places.
A 2005 Ministry of Health study on CNCDs revealed that just over seven percent of the
Bahamian population smokes cigarettes. The Prime Minister pointed out that The Bahamas
currently has a 200 percent tax on cigarettes and that during its previous terms in office, his
government made the now Lynden Pindling International Airport a smoke-free environment. He
indicated that decisions will now have to be made regarding the way forward for tobacco control
measures in The Bahamas. So, therefore, after all that has been said, the Bahamas government is
now going to consider banning [smoking] in public places period. We have casinos and we have
conflicting views as to whether or not a casino should be exempted from a policy. The
government said that it is going to make some decisions about that but it can be assumes that at
the end of day we will either have a total ban on smoking in all public places, or the number of
public places will be very minimal and even if that happens that will have to be for a minimal
period of time.
Also, the Declaration also called for the mandating of the re-introduction of physical
education in schools where necessary; provide incentives and resources to effect this policy and
ensure that our education sectors promote programmes aimed at providing healthy school meals
and promoting healthy eating.