Dr. Tosca Highlights Growing Threat of Non-Communicable Diseases in Trinidad and Tobago

The “Lunchtime Doctor” segment on the TBC Radio Network featured Dr. Tosca, a family physician, who warned listeners that non-communicable diseases (NCDs) – often termed lifestyle or “silent” diseases – now account for a majority of mortality in Trinidad and Tobago.

Dr. Tosca explained that the four main NCDs – heart disease, hypertension, diabetes and cancer – are responsible for over 62% of all deaths in the country. While the statistics are alarming, the doctor emphasized a shift from focusing solely on mortality figures to improving quality of life through a holistic, evidence-based approach.

According to Dr. Tosca, modern medicine has dramatically increased life expectancy, but the health system must address every component of a person’s wellbeing. “Think of health as a bicycle wheel,” the doctor illustrated, “with the hub representing the individual and the spokes representing nutrition, physical activity, mental health, social support, and medical care.” Neglecting any spoke, she warned, can undermine overall health.

The physician described the role of the family doctor as distinct from specialists. While specialists concentrate on a specific organ or system, family physicians treat the whole person, integrating physical, emotional, mental and spiritual care. Preventive medicine, she said, involves not only prescribing drugs such as metformin, ACE inhibitors or SGLT2 inhibitors, but also recommending diet, exercise, stress-management techniques and community support.

Dr. Tosca highlighted the importance of regular monitoring. She noted that a target HbA1c below 7.0% is recommended for type-2 diabetes patients, with levels under 5.7% indicating possible reversal of the disease. Achieving these targets, she stressed, requires combined pharmacologic therapy and lifestyle modifications.

The doctor also addressed common misconceptions about medication. “There’s a cultural fear of drugs,” she observed, noting that misinformation and reliance on non-experts can lead patients to self-treat with unverified remedies. She urged patients to engage with qualified health professionals, ask about the evidence behind prescriptions, and maintain consistent follow-ups.

In a practical example, Dr. Tosca described a typical consultation: a patient with an HbA1c of 7.5% and blood pressure readings of 150/90 would receive an ACE inhibitor, metformin, and an SGLT2 inhibitor, alongside a tailored plan for diet, exercise, and stress reduction. Over months, the patient might see blood pressure improve to 115/70 and HbA1c drop below 6.5%, allowing the physician to safely adjust medication doses.

Concluding, Dr. Tosca called for a collaborative effort between doctors and patients: “Trust is a two-way street. We must stand by the evidence, and patients should feel empowered to question and understand their treatment.”

The segment underscored the urgent need for comprehensive public health strategies that combine medical treatment with lifestyle education to curb the rising tide of non-communicable diseases in the Caribbean region.