Imagine having to make the choice between taking your medication and paying the rent.

Unfortunately, many diabetics in the community, particularly senior citizens, face this dilemma on a regular basis.

This is why the Bermuda Diabetes Association is embarking on a fundraising drive to open and run their own pharmacy.

Marlee Robinson, a volunteer with the Bermuda Diabetes Association said that in the past financially strapped diabetics were able to get their medications at a reduced cost from a pharmacy run by TB Cancer & Health.

?They were able to get their medications for a nominal amount for about $5,? said Ms Robinson.

?The payment for their medication was made by the Diabetes Association. We were spending about $1,000 a month for each patient.?

Unfortunately, TB Cancer & Health has since closed that pharmacy, leaving many diabetics in a difficult position.

They now buy their medications through regular commercial pharmacies, and the Bermuda Diabetes Association?s costs have jumped from $1,000 per patient to about $6,000. There is also a doctors fee of $25 per prescription for the association to pay, which can really add up.

?Although we are getting a reduction for the insulin and strips, we are still paying a lot more,? said Ms Robinson.

?The pharmacy would make it financially viable for people who do not have enough insurance. It will be for the elderly or people who are having job challenges so that they have access to the full range of medications and other things they need - medications, strips, the special socks and the things that go with having diabetes.?

Unfortunately, diabetes is a disease that comes with a lot of complications including high blood pressure and circulatory problems, which also need to be treated with medication.

?A typical patient that we would help might be someone who has worked as a waitress in a hotel for many years, for example. She has a small pension, but not a large one. Her medications even with our support are about $500 a month.

?She doesn?t have that. So what she is doing is she will look at the medications every month and say, ?I can afford this one this month and I can?t afford that one?. So she is not getting her full range of medications. So she is going to get more sick.?

Ms Robinson said the ideal would be a one-stop shop pharmacy. The pharmacy is especially important as, according to a visiting diabetes expert, the global rate of diabetes is growing so quickly that it will soon outstrip medical resources.

Dr. Martin Silink, president elect of the International Diabetes Federation (IDF) and a professor of Paediatric Endocrinology at the University of Sydney in Australia told the Royal Gazette in a recent interview, ?Diabetes is increasing at such a rate that soon we won?t be able to graduate enough doctors and nurses fast enough to cope with it.?

Dr. Silink is on the editorial board of several diabetes related publications such as ?Pediatric Diabetes?, ?Clinical Pediatric Endocrinology? and the ?IDF Diabetes Atlas?. His main research interests are diabetes complications in the young and the changing patterns of diabetes in childhood and adolescence.

Dr. Silink was on the island to give the keynote address at the annual general meeting of the Bermuda Diabetes Association at the end of April. He also spoke with various other community groups such as the Rotary Club.

In Bermuda about 20 percent of the population has diabetes. Diabetes effects more than 200 million people in the world, and is increasing at a rate of 6 million per year. Diabetes causes a death every ten seconds and an amputation every 30 seconds.

?All forms of diabetes are increasing,? said Dr. Silink.

?The major increase is in the adult form of type two diabetes, but type one diabetes is also increasing.?

Nobody is really sure why diabetes is increasing, but one theory is that our immune systems are weakening because we are underexposed to germs and minor illnesses in today?s modern world.

?As President elect of the International Diabetes Federation I am very happy to come and talk to the Bermuda Diabetes Association,? said Dr. Silink. ?The importance of diabetes is something that society has to recognise. I urge Bermudians effected by diabetes to join the Bermuda Diabetes Association and help make it stronger.?

Dr. Silink said he wanted people to understand that diabetes is a manageable disease.

?It never takes a holiday, but with simple effective changes in the way diabetics live and the way diabetics take care of themselves they can improve their health quite a bit.?

He said diabetics need to get their blood pressure and cholesterol under control, and they need to exercise regularly.

?You have to look at how diabetes is being taken care,? he said. ?If you have diabetes, find out how to check your glucose.?

He said the community has to take a stand against diabetes and say, ?enough is enough?.

?When 20 percent of the community has diabetes... when there are children now at risk ... a whole new generation of society needs to ask what needs to be done to bring this epidemic down. What is going to happen to their children and grandchildren??

He said a change in lifestyle and physical activity can half the risk of developing diabetes.

Dr. Silink and the IDF are campaigning to have the United Nations officially acknowledge the global diabetes epidemic.

?I think people vaguely understand that diabetes is a major problem, but this will actually highlight that this a problem equal to other epidemics such as HIV and AIDS,? he said. ?It is rising at such a rate that governments must do something about it.

?The UN resolution is to seek the support of at least 96 nations, because there are 191 voting nations and to bring about a whole government approach to diabetes.?

The IDF hopes that the resolution will increase awareness of diabetes, worldwide; show what a humanitarian, social and economic burden diabetes is, and encourage countries to come up with creative solutions for diabetes prevention.