Diabetes prevalence in Nigeria

On November 14, 2017, the world commemorated the World Diabetes Day. It is an annual campaign celebrated by the International Diabetes Federation (IDF), in collaboration with the World Health Organisation (WHO), to help in raising public awareness on the dangers and control of diabetes. NAJIB SANI writes on the disease prevalence in Nigeria.
Diabetes overview

Diabetes is a lifelong medical condition that causes a person’s blood sugar level to become too high. It is often caused by the insufficient or lack of the hormone insulin, produced by the pancreas, a gland found behind the stomach.
World Health Organization (WHO) statistics show that about 347 million people worldwide are presently suffering from diabetes. In 2004, an estimated 3.4 million people died from consequences of high blood sugar. The most devastating aspect of diabetes is that, almost half of the people suffering from it do not know that they have the disease. In view of this, WHO stipulates that diabetes would be the seventh leading cause of death by the year 2030.
Many more people worldwide have blood sugar levels above the normal range, but not high enough to be diagnosed as having diabetes. This is referred to as Pre-diabetes. If the blood sugar level is above the normal range, the risk of developing full-blown diabetes is increased. Thus, it’s absolutely very important for diabetes to be diagnosed as early as possible because it would get progressively worse if left untreated.

How 2017 World Diabetes Day was marked in Nigeria
Relevant health organisations and stakeholders organised series of activities to mark the day all over the world. In Nigeria, the World Diabetes day 2017 was organised by the Diabetes Association of Nigeria (DAN), in collaboration with the Olusegun Obasanjo Foundation (OOF), with a one day national workshop for members of the association drawn from the 36 states of the federation, where experts presented lectures on diabetes.
In his lecture, the National president of the Association, and Chief Medical Director (CMD) of the Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH), Bauchi, Dr. Mohammed Alkali, said this year’s theme: “Women and Diabetes, our right to a healthy future,” targeted the womenfolk, considering the fact that they are becoming more vulnerable to the disease.
“There are about 415 million people living with diabetes globally, which is projected to reach 642 million by 2040. More than 14 million people in the sub-saharan Africa had diabetes in 2015 and we are projected to double by 2040. Many people live with the ailment without being aware,” he explained.
Another expert, Professor Bakeri Adamu Girei, of the department of medicine, Ahmadu Bello University (ABU) Zaria, noted that diabetes is categorised into four types; 1, 2, 3 and 4, which affects children, adults, pregnant women and also caused by another diseases.
Girei said the disease is incurable, pointing out that there is no better treatment for it other than frequent taking of medication according to prescription, and eating the right foods.
“Poorly managed diabetes leads to serious complications and early death. However, with good self-management and health professional support, people with diabetes can live a long, healthy life.
“One in two adults with diabetes is undiagnosed. Number of people with diabetes increased from 150 million in 2001 to 382 million in 2013, 415 million in 2015 and is expected to exceed to 642 million by the year 2040. There has been progressive increase in the incidence and prevalence of type 2 diabetes worldwide, which is more pronounced in underdeveloped and developing countries,” He asserted.
In his paper presentation,”Strategies for the prevention of diabetes”, a consultant physician and endocrinologist at the Aminu Kano Teaching Hospital, Kano, Professor Andrew Uloko, revealed that out of the 8.8 percent of world’s population living with diabetes, Africa has the highest number of undiagnosed diabetics.

Diabetes prevalence in Nigeria
All the speakers at the national diabetes workshop, pointed the challenges of managing diabetes in Nigeria as; poverty, ignorance, poor health seeking behaviour, late presentation, traditional medicine among others.
“The state of diabetes care in Nigeria is worrisome, as complications such as renal replacement therapy, laser coagulation among others, are not accessible to the majority of patients,” professor Uloko stated.
They recommended the inclusion of diabetics into the National Health Insurance Scheme [NHIS], provision of free drugs to diabetic patients, as in the case of HIV/AIDS and Tuberculosis, training and retraining of health man power at primary and secondary health centres to detect and manage the disease early, in other to curtail complications, adding that the use of insulin drugs should be made accessible to all to save the lives of the patients.

Managing diabetes
Professor Uloko enumerated some of the ways to manage diabetes to include; “maintaining ‘normoglycaemia’, preventing ‘hypoglycaemia’, avoiding acute or chronic complications of diabetes as well as life style modification with or without some form of pharmacological (drug) intervention.
He warned that poor control of the disease can lead to blindness, foot ulcer and amputation, kidney complications, stroke, heart attacks, poor pregnancy outcomes among other problems.
Also, Professor Girei lamented that while there is organised system of care in most tertiary health institutions in Nigeria, the reverse is the case in most secondary and primary health institutions, as metabolic control is ‘suboptimal’, and optimal care is hampered by lack of accessibility of essential medicines and equipment.

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