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Mexico is facing a health crisis. Diabetes now kills more Mexicans each year than any other disease. For many of the 11 million Mexicans who now have diabetes, managing the condition is a constant challenge. NPR's Jason Beaubien reports.
JASON BEAUBIEN, BYLINE: The Lagunilla Market near the center of Mexico City is famous for its handmade clothes. In the crowded stalls, tailors sew elaborate quinceanera dresses, and they make custom suits for formal parties. Mario Alberto Maciel Tinajero is one of those artisans. Taking a break from tending his shop, he's sitting in a senior center in the interior of the market.
MARIO ALBERTO MACIEL TINAJERO: (Speaking Spanish).
BEAUBIEN: "I've been a diabetic for 20 years," Maciel says. And the disease has come to dominate his life. His mother lost both her feet to diabetes and eventually died from it. His grandson recently had a foot amputated because of the condition. Two decades after being diagnosed with diabetes, the 68-year-old Maciel admits that he only has the condition partially under control.
MACIEL: (Through interpreter) I say 50 percent because I take my medicine. I inject my insulin twice a day in the morning and the night. I try to eat a proper diet as much as I can.
BEAUBIEN: But he says at times he can't afford his medications, and trying to cut down on the amount of sugar, salt and fat in his diet as his doctors tell him he should is easier said than done. His doctors with fancy degrees from Spain or the United States don't understand the life of ordinary Mexicans, he says.
MACIEL: (Through interpreter) For a person who has to work eight or 10 hours, he has to eat what's readily available.
BEAUBIEN: And what's readily available around this market are small stands offering tacos, quesadillas, lard-soaked tamales, soft drinks and juices loaded with sugar. His eyes light up as he talks about the rich roast pork taquitos, the simmering barbacoa and the other foods that he's not supposed to eat.
MACIEL: (Through interpreter) It's difficult to follow a diabetic diet. The truth is it's very difficult.
BEAUBIEN: And this is at the heart of how Type 2 diabetes has become the leading cause of death in Mexico. In the U.S., it's the sixth-leading cause of death with heart disease and cancer claiming 10 times more Americans each year than diabetes. Mexico, however, has seen a rapid increase in obesity over the last four decades with the number of people being characterized as overweight and obese tripling.
As Mexicans' average daily intake of calories has soared, Type 2 diabetes has skyrocketed, too. Currently 14 percent of Mexican adults are believed to have the disease, which is one of the highest rates in the world, higher than even in the United States.
ROSA ESTRELLA CALVILLO GOMEZ: (Speaking Spanish).
BEAUBIEN: Inside the senior center at the Lagunilla Market, Dr. Rosa Estrella Calvillo Gomez runs a one room medical clinic. She sits behind a desk overflowing with drug samples, small packets of medications and bottles of pills.
CALVILLO: (Speaking Spanish).
BEAUBIEN: She says treating diabetes is about far more than just curtailing high blood sugar. It's about controlling multiple health problems at once, and she says most of her diabetic patients don't have the disease under control.
CALVILLO: (Through interpreter) The real problem that I have here, first, is the denial and, second, the cost of the medications.
BEAUBIEN: Patients don't want to accept that they have a disease for which there is no cure. Also it's not an easy condition to manage. The public health system treats severe complications like nerve damage or blindness. Although dialysis to treat kidney failure is not available.
For the daily management of diabetes, however, patients are largely on their own. Dr. Calvillo says a diabetic can easily spend $150 a month out of pocket on insulin injections, blood sugar test strips, medications for hypertension and other issues.
CALVILLO: (Speaking Spanish).
BEAUBIEN: "To get control of diabetes costs a lot of money," she says. "It costs as much as renting an apartment." Mario Alberto Maciel Tinajero, the dressmaker we met earlier, is one of Dr. Calvillo's patients. He says coping with the disease is a real struggle, and many diabetics are desperate.
MACIEL: (Through interpreter) The most dangerous thing for diabetics is to fall into the hands of charlatans and swindlers who offer these miracle products.
BEAUBIEN: As diabetes took its final toll on his mother, he watched as she spent thousands of pesos on useless - he thinks - possibly even toxic herbs and injections. After both her feet had been amputated and doctors were only offering palliative care, salesmen came along, offering magical injections that would give her relief.
MACIEL: (Through interpreter) With the promise of a cure, you can be left in the street with nothing, absolutely nothing.
BEAUBIEN: Diabetes is a terrible disease, he says, and he's grateful to have Dr. Calvillo to help him manage it.
MACIEL: (Speaking Spanish).
BEAUBIEN: "If it wasn't for the free care at this clinic," Maciel says flatly, diabetes would have killed him a long time ago. Jason Beaubien, NPR News, Mexico City.
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