Do you describe yourself as having 'a touch of sugar?' According to diabetes experts, there's no such thing.

Femi Bada heads a Government task force that is producing specific guidelines on diabetes care in Bermuda. He said by the end of this year, no healthcare worker or medical practitioner in Bermuda should be using this terminology.

According to Dr. Bada, telling someone they have 'a touch of sugar' gives them the impression that they are not diabetic and therefore don't need to follow medical advice given to persons with diabetes.

They continue living their life as normal and their diabetes becomes progressively worse regular doses of several medications must then be prescribed.

The development of diabetes guidelines specific to Bermuda will help ensure consistent care and will limit misunderstanding scenarios like the one described above, Dr. Bada stated.

"It will make no difference whether you are coming to me or going to someone else in Bermuda," the family practitioner said. "We all will be on a level playing field, adhering to the same standard.

"At the moment things are being done willy-nilly."

Diabetes is one of the prevalent diseases in Bermuda. About 13 percent of the population has been diagnosed with the illness and educators in the field believe that for every two diagnosed cases, there's an undiagnosed one.

In the black community almost everyone has a personal connection to the illness. If it's not in the immediate family then it's in the extended family an in-law or cousin once removed has it.

Much research has been conducted on the disease and the developments are closely followed by diabetes educators here.

In recent years, diabetes has become almost a symptom of modern living, developing in those who eat too much and don't exercise enough. This new group of diabetics, those with Type Two Diabetes, is growing rapidly and placing a huge burden on healthcare costs.

For this reason decreasing the incidence of diabetes, and properly managing the disease from the outset, will not only improve people's health but also help reduce the skyrocketing costs.

The Bermuda Diabetes Association, the lead agency on the disease locally, lobbied Government for guidelines to be produced. The association held that guidelines would enable diabetes to be managed, controlled and, in some cases, even prevented in Bermuda.

The Bermuda Diabetes Association's call followed the recommendation from the International Diabetic Federation that each jurisdiction develop its own guidelines.

Government was in complete agreement with that call Dr. Bada was sent to the Caribbean Research Health Council's conference in Trinidad where guidelines for managing the disease in the Caribbean were presented.

That was last July. Dr. Bada became chairman of a 17-member task force addressing the matter here, in October.

"We are using the guidelines of the Caribbean, the US, Britain, Europe and Canada to create guidelines for Bermuda," he said.

The physician said the task force includes about ten medical doctors as well as diabetes nurses, administrators, pharmacists, dieticians and lab technicians. Members are paired to research different aspects of diabetes care, and report back to the main group.

"For example my group is looking at glycemic control," said Dr. Bada. Other pairs are examining things such as disease screening and requirements for effective delivery of care. Each group considers the recommendations made in their area from the guidelines established abroad, to help determine what would be best practice in Bermuda.

It's a big commitment. Dr. Bada said several medical professionals turned down his request to join the task force because they didn't have the time.

"We really have a lot of information to consider there are binders and binders and we are all already busy people," he said.

"We've also found that we've become much more knowledgeable about diabetes and this is a very good thing. We are now collating the information for the Bermuda booklet."

According to Dr. Bada, two sets of guidelines will be published.

"One will be very simple for the patients so that they will know how to manage their own diabetes. For example, they will be able to ask their doctor the specific blood sugar readings they must stay within to avoid being put on the next level of medication," he said. "It will also tell them how to self monitor their diabetes as well as how to look after their feet etc."

The second booklet, which will include guidelines for primary care of diabetes in Bermuda, will be used by physicians and health care providers. It will provide step-by-step detail on how patients are to be handled from the screening stage through to secondary care.

"It will tell doctors exactly what to do," said Dr. Bada.

However the guidelines won't be legislated, he added. As such, doctors will not be legally bound to adhere to them.

And if they decide not to?

Such behaviour would be irresponsible, the physician stated.

"There's no point saying 'I'm going to do it my own way'," he said. "For example, at the moment a doctor will say, 'I see my diabetic patient once a year'. We may recommend that they see the patient every three months. If they still decide to see that patient once a year then the patient may vote with their feet, because they'll know from the booklet that their doctor should be seeing them every three months.

"And if the patient doesn't pay attention to [the guide] then they are also negligent in their own healthcare."

Dr. Bada anticipates the guidelines will be in effect this autumn.