Opinion Review
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Feb 15, 2021; 12(2): 98-107
Published online Feb 15, 2021. doi: 10.4239/wjd.v12.i2.98
Diabetes in French Guiana, adapting national standards of therapeutic education and care to the amazonian challenge
Nadia Sabbah, Gabriel Carles, Magalie Demar, Mathieu Nacher
Nadia Sabbah, Endocrinology Diabetology Nutrition, Centre Hospitalier Andree Rosemon, Cayenne 97300, French Guiana
Gabriel Carles, Department of Obstetrics and Gynaecology, Centre Hospitalier Franck Joly, St Laurent Du Maroni 97320, French Guiana
Magalie Demar, Department of Laboratory, University of French Guiana, Cayenne 97300, French Guiana
Mathieu Nacher, Department of Medicine, COREVIH Centre Hospitalier Andree Rosemon, Cayenne 97300, French Guiana
Author contributions: Sabbah N, Carles G, Demar M and Nacher M drafted the article; Carles G provided the data on gestational diabetes; Nacher M reviewed the article.
Conflict-of-interest statement: The authors declare that they have no personal interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nadia Sabbah, MD, PhD, Chief Doctor, Senior Researcher, Endocrinology Diabetology Nutrition, Centre Hospitalier Andree Rosemon, Avenue des Flamboyants, Cayenne 97300, French Guiana. nadia.sabbah@ch-cayenne.fr
Received: August 26, 2020
Peer-review started: August 26, 2020
First decision: November 16, 2020
Revised: November 25, 2020
Accepted: December 2, 2020
Article in press: December 2, 2020
Published online: February 15, 2021
Processing time: 149 Days and 9.9 Hours
Abstract

French Guiana is a territory located more than 7000 km from France. It is also the largest French territory, with almost 84000 km2 and 90% of it is covered by forest. Some municipalities are isolated due to the scarcity of transportation and the poor road infrastructure. The population is extremely diverse ethnically and culturally, and includes more than thirty ethnic groups. Immigration is high because it is one of the richest countries in the area bordering northern Brazil, Suriname, Guyana, and as a result of socio-economic crises in some other countries such as Haiti, and it has permeable natural borders. Diabetes and obesity, are emerging issues, with double the prevalence of Mainland France, whereas infectious diseases, such as HIV, take second place. Therapeutic and educational management are challenging because they require the adaptation of tools and treatments to the mul-ticulturalism and precariousness often encountered in these populations. The French and European recommendations are unsuited to the needs of the territory and must take into account the epidemiological, sociological and cultural parameters of these populations in order to provide appropriate and graded management of diabetes in the French Amazon.

Keywords: French Guiana; Diabetes mellitus; Ethnicity; Consensus workshops; Poverty; Immigration

Core Tip: The prevalence of diabetes and obesity in French Guiana is approximately twice that of the departments of hexagonal France. French Guiana is a French territory, but very far from it geographically because it is located on the South American continent. The ethnicities in French Guiana are numerous and explain the linguistic, cultural difference and probably also the genetics of diabetes. Very few studies have described diabetes in French Guiana despite its importance in the department. The management of metabolic pathologies must be adapted to the specificities of the department, and it is essential to describe the situation in detail in order to be able to set up an appropriate sector.