By Ijeoma UKAZU
Diabetes, a disease known to be one of the leading causes of death worldwide, with an estimated 422 million people globally living with diabetes mostly in low-and middle-income countries according to the World Health Organization, WHO.
WHO says 1.5 million deaths are directly attributed to diabetes each year, as both the number of cases and the prevalence of diabetes have been steadily increasing over the past few decades.
Diabetes according to WHO is a chronic, metabolic disease charged by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and nerves.
In Africa, a 2021 International Diabetes Federation, IDF, report states that 24 million adults aged 20 to 79 years are living with diabetes. This figure is estimated to increase to 33 million by 2030 and 55 million by 2045.
IDF further said about 52 million adults aged 20 to 79 have Impaired Glucose Tolerance, IGT, which places them at high risk of developing type 2 diabetes. This figure is estimated to reach 71 million by 2030 and 117 million by 2045.
The report by IDF reveals that 13 million adults living with diabetes in Africa are undiagnosed – 54 per cent of the total number of adults with diabetes in the region.
In 2021, Diabetes was responsible for 416,000 deaths in Africa. And one in eight live births in the IDF Africa Region is affected by hyperglycemia in pregnancy.
A meta-analysis published on PubMed Central suggests that 11.2 million Nigerians (1 out of every 17 adults) are living with diabetes disease.
The study said there are regional differences in the prevalence of diabetes, with the highest rate observed in the south-south zone and the lowest rate seen in the north-western zone, this mirrored a similar finding for obesity, which is a major risk factor for type 2 diabetes.
Experts reveal that diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation globally.
In the real world of diabetes, Mr Sam Eferaro, a man who has been living with it, tells The Abuja Inquirer that it was devastating news for him when he was first diagnosed 20 years ago. Giving an insight, ” I could no longer eat anyhow as I used to. No more soft drinks and sugary stuff. Conditions like these did not go well with me because I enjoyed taking soft drinks with my meals. I also loved taking ice cream, and yoghurt especially after walking around in the sun. It was difficult at first to cope,” he said.
Mr Eferaro continued, “I begged the doctor to remove the sugary stuff from the “forbidden” list but he simply told me to choose between complications as a result of the sweetened beverages or death after some few years or sound health, then I stopped arguing.”
According to him, “I was given a diet list and things I needed for a daily test to know my blood glucose reading with a stern emphasis on the need for my cooperation with diets as that will play a key role in managing the disease.”
The now sexagenarian advised that someone living with diabetes can live to a ripe old age if controlled, adding that, all it takes is for the individual to adopt a healthy lifestyle, taking prescribed drugs regularly, and eating right, warning that those with family history of diabetes must adopt this healthy lifestyle right from childhood although achieving control is quite a daunting task these days but individuals must make their health a priority.
Reacting to the recent increase in taxation on sugar sweetened drinks, he said “As much as this is a step in the right direction, I am not in any way excited. The question is whether the government is taking these steps because of the rise in diabetes or and other cardiovascular diseases or just to earn more revenue.”
He alarmed that the cost of diabetes and cancer drugs have hit the roof today because of taxation, stressing that treatment for diabetes is becoming too expensive for the common Nigerian as Insulin today is between N5000 and N9000.
Eferaro called on the government to subject the importation of drugs for diabetes and cancer to zero tariff as that would lead to a substantial reduction in cost.
Giving a medical perspective, Dr. Obinwa Uchechukwu Judith, who works with Garki Hospital Abuja, further explained that Diabetes is the inability of the body to take up sugar (glucose) from the blood into the cells where it is used as fuel (energy).
She stated that the disease has two main types: Diabetes Mellitus and Diabetes Insipidus, noting that “Diabetes Mellitus is further sub-divided into three types namely: Diabetes Mellitus type 1: This is autoimmune, that is your immune system destroys the beta cell in your pancreas responsible for producing insulin (needed to transport glucose from the blood into the cells). In this type, there’s a problem with insulin production so patients with this type would require insulin for their management.
“Diabetes Mellitus Type 2: In this type, there’s insulin resistance mainly because of excess fat (which competes with insulin in their binding sites), that is your body produces insulin but can’t make use of it. The pancreas however keeps producing more insulin in response to the high glucose level but gets overwhelmed and gradually reduces its production
“Gestational Diabetes: Usually in patients with pre-existing family history of diabetes. This occurs during pregnancy as a result of the effects of some hormones that block insulin.”
Continuing, Dr Obinwa adds that diabetes is associated with some risk factors such; age, race, obesity, Dyslipidemia, family history, hypertension and sedentary lifestyle amongst others.
While the medical doctor noted that symptoms can be asymptotic, she adds that diabetes can also present with excessive thirst and hunger, frequent urination, blurry vision as well as weakness.
She said that tests should be carried out to ascertain the disease, advising pregnant women with family history of diabetes should carry out a test to check her oral glucose tolerance test.
“Treatment is dependent on; level of blood glucose, lifestyle modifications (regular exercise and avoid sedentary lifestyle) Dietary modifications (low carbohydrate and fibre, high protein.)
Liberal fluid intake and adjustment of food portion,” she said.
To control diabetes in diabetic patients, Dr Uche says, “Firstly is to educate people about the disease, treatments and the part they have to play; regular blood glucose monitoring; compliance with medication and follow up; maintain strict diabetic diet and regular exercise amongst others.
The main characteristics of Diabetes is elevated blood glucose, to control it, patient has to cut down on carbohydrates and consume more of protein
According to her, sugar intake should be cut down especially as one advances in age, they engage more in regular exercise as well as minimize junk food.
She, however, warns that diabetes has no cure, but can be controlled and much better to prevent it.
