Maritime Health Research and Education-NET/The International Type 2 Diabetes Mellitus and Hypertension Research Group/Seminars on the ILO/IMO Guidelines on medical examinations of seafarers/Seminar 2 Working as seafarer with T2DM

Zoom Seminar No 2,

Objectives: Support the seafarers for a long life working with T2DM & HTN

Ideas for multicenter epidemiological study T2DM/HTN screening

References

TO BE EDITED: Luckily 80% of those first diagnosed have pre-diabetes and do not need pills but diet and regular exercises. We have evidence that by keeping diet and exercise they don’t need Metformin and no insulin. We must establish a Working group with the partners to find out what is possible and make pilot tests of the effect. Luckily, persons with new diagnosed pre-diabetes want to work to get rid of it and with the help from the partners this will be possible,

Regarding the diabetes and the hypertension on board, there is some information included in the STCW training that the seafarers must have before any professional embarkation. From the practical side, the hypertension is easy to control on board with pills and with the electronic measuring device. The diabetes is a bit different because these seamen also need a diet and that is difficult on board due to the limited resources for fresh food and the working hours of the Chief Cook. I think that the key element for both situations is the information:

• We need to know if we have special needs for a specific seaman – it would be nice to have automatic transfer of the data for diabetes and hypertensive patients between the Sanitary Authority and the Maritime Authority (with the agreement of the seaman, for protecting the privacy)
• The private physician of the concerned seaman should be informed when the assignment on board starts and the seaman to always have his telephone number with him available for the ship personnel to be able to contact his doctor at any time (something like soldier tags or a diabetes card)
• First thing after arrival on board the patient must inform the vessel management on his condition and to declare for how many days he is having his own medical supply.
• Special-tailored psychoeducation for seamen with diabetes or high blood pressure once his diagnostic is confirmed.

In addition, I think if it would be possible to concentrate on one ship several patients with diabetes, it will be easier for the vessel management to keep in mind the needs of the crew, we can convince the crewing offices to create special vessels if this is not considered as a discrimination. So far those are my considerations regarding this subject, I had a crew with hypertension on board during the COVID first wave and he was well balanced with his pills, we had to refill his medicine stock because his contract was extended, and we had problems with the prescription. We had to ask the private physician to send a prescription in English (the patient was Polish) and the name of the medicine to be written as the technical name of the active molecule for the doctors in USA to understand what equivalent they could find. Finally, we obtained the refill, and we continued our voyage. For the students, we can explain that both diabetes and the high blood pressure are strongly associated with the stress, and we can only encourage them to follow a healthy life and find healthy coping mechanisms. This is what I am doing for them but that is not necessarily included in the STCW course format.