With over 12 million Nigerians said to be diabetic, and several others suffering from complications arising from the disease,Martins Ifijeh writes on the need for stakeholders and government to scale up efforts against the scourge

It is no longer news that Nigeria has the highest number of diabetics in sub-Sahara Africa, with over 12 million persons estimated to be suffering from the non-communicable disease, according to the World Health Organisation (WHO) and the International Federation of Diabetes and Diabetes Association of Nigeria. But what seems to be the news is that over 80 per cent of those diabetic in the country are either not aware they are suffering from the disease or they are unable to treat themselves and be free from the disease.

This is evident in the steady rise of diabetes, diabetes-related complications or deaths recorded in the country, living most sufferers at the mercy of the disease, since they are neither aware of the disease or are unable to receive treatment.

Over the past 30 years, the prevalence rate of the disease was said to be 0.4 per cent among the Nigerian population; in 1992, it rose to 1.6 per cent; in 2004 it was 3.1 per cent, and just recently, it has risen above 4.5 per cent, according to a survey conducted by Osuntokun et al.

In 2015 alone, about 120,000 Nigerians were said to have lost their lives to the disease; which may, if recent predictions are relied on, become the number one cause of deaths in the country among other non-communicable diseases, thereby topping the chart, as against cardiovascular diseases currently leading the causes of deaths occasioned by NCD.

But experts are of the opinion that the steady rise of the disease in the country is associated with lifestyle changes; overweight and obesity, physical inactivity, alcohol consumption, dietary changes and cigarette smoking- factors that are potentially modifiable, adding that if nothing was done both on the part of the citizens and the stakeholders, the disease may spiral into a national health emergency that would take more lives out of their prime; a disease they have noted was partly preventable.

Diabetes, the most common disorder of the body’s hormonal system, occurs when blood sugar levels consistently stay above normal, thereby unable to let the body cells receive glucose due to lack of insulin to drive the glucose into the body cells or lack of the cell receptors to recognise insulin, and then utilise its function. Glucose is an essential source of energy for the brain and the body. Insulin is one of the main hormones that regulates blood sugar levels and allows the body to use sugar (called glucose) for energy.

An Endocrinologist and Medical Director of Royal Rose Medical Centre, Lagos, Dr. Temitope Fatade, said though there were two major types of diabetes; the Type 1 and the Type 2 diabetes, one of them was 100 per cent preventable with healthy lifestyle, including, exercise, good nutrition, weight management plan, among others, while the Type 1 diabetes was caused by the body’s auto-immune system, destroying the insulin-making cells of the body.

He said the Type 2 diabetes usually develops slowly in adulthood, as it is progressive and can sometimes be treated with diet and exercise, but more often may require anti-diabetic medicine and/or insulin injections.

“The Type 2 diabetes is preventable with healthy diets, exercise, weight management, cigarette smoking factors, obesity, alcohol consumption, among others,” Fadade said, noting that, it occurs mostly around or above 40 years of age.
According to him, the Type 1 diabetes occurs majorly at childhood, or adolescence, but could still occur at any stage of life. “People with this type of diabetes will be required to take insulin all through their lives, since their bodies does not produce insulin at all.

He explained that majority of diabetic Nigerians were dying from the scourge because they were either ignorant about the disease, or were unable to receive proper treatment and management plan, which could reverse the disease, in cases of Type 2 diabetes, and then help in managing a Type 1 diabetic person all through lifetime, thereby aiding in saving lives of diabetic persons in the country.

He called on stakeholders and the government to put measures in place to educate Nigerians on the need to be aware of their sugar level status, as this would be a major step in managing the disease, if they eventually have it.
Fatade explained that the best way government can scale up efforts against the scourge was to subsidise the cost of insulin injections, which he noted that poor diabetic Nigerians would be unable to afford, thereby contributing to the high mortality rate of the disease among Nigerians.

“The cost of treating diabetes in the country is very high. “Insulin injection is about N15,000 for a single dose, and a diabetic person needs three doses a week, which is N45,000. One then wonders how the country expects the low and medium income earners in the society to afford insulin injection? The truth is, more than 80 per cent of diabetic Nigerians will not be able to afford the cost of treatment,” he added.

Also lending her voice to the fight against diabetes in Nigeria, the Medical Advisor, Novartis Pharm Services, Dr. Chinwe Adebiyi, explained that on the average, there were about 105,091 deaths per year in Nigeria due to diabetes, adding that a diabetic person spends about $137 monthly on treatment of diabetes. (That is about N43,000).
While stating that the country has about two million people with undiagnosed diabetes mellitus, she called on Nigerians to imbibe the culture of medical check-up at regular basis, as that could help in minimising the prevalence of other diseases apart from diabetes.

Adebiyi, added that there were three main treatment options for the management of the disease. “Healthy lifestyle plan, which is one of the treatments, is a double-edged solution because it is not just for the treatment of diabetes alone, it can also serve the preventive purpose. A person who exercises, eat healthy foods, does not smoke or drink, and have a normal body weight will most likely not be at risk of the disease.

Other treatment options, according to her include oral hyperglycemic drugs (biquanides, sulfunylure23, thiazolidinedione, Di-peptidylpeptidase) and then insulin administration, which is usually given to people whose body does not produce insulin.

According to the initiator of Diabetes Help and Enlightenment Campaign, Mrs. Aisha Bukar Alli, in an earlier interview with the media, said everybody must be concerned about the disease because it seems everyone has someone in their families who is diabetic.

Alli, who was diagnosed of diabetes several years ago, and has been living with it since then, explained that what has been helping her was the fact that she accepted the disease and has been managing it well through lifestyle modifications, healthy living, exercise, among others.

She advised diabetic people to accept and admit, as this would form the first step for them to manage it. “Be the doctor of yourself in the sense that you have to listen to your body. When your sugar is shooting high, you must know the sign. Find out what you have eaten that has made your sugar to go high. Also, I will advise that you have your meter and strips that will help you check your blood sugar level every morning or before you sleep,” she explained.

Like other advocates against the scourge, she called on the government to support people with diabetes, as the disease was difficult and expensive to maintain.

“In this country, the rate at which people are becoming diabetic is alarming. According to World Health Organisation (WHO), every few second, a patient dies of diabetes. If it is that alarming, there is need for government to pay some attention to it. The diabetic patient needs a lot of governmental support the same way HIV patients have gotten attention. The medication of a diabetic patient is very expensive. A diabetic patient needs a very regular medical attention for him or her to live healthy in the society,” Alli stressed.

She also called on the government to dedicate a ward or unit in every public hospital to diabetes management. “This is how it is in Cameroon and South Africa. They have a National Diabetic Centre which is well equipped to take care of diabetic patients. There, they see patients on time and detect the risk early. So, we need the government to provide these kinds of centres in public hospitals or even the National Hospital or anywhere in the country for diabetic patients.

“Apart from that, we wish the government could subsidise drugs for diabetic patients like they do for HIV patients. They HIV patients have drugs which, is almost free but is not the same for diabetic patients and it is equally dangerous and fatal. So, we are expecting the government to prioritise the issue of diabetes management and care, and subsidise the drugs and insulin, and make meters and strips available to people at the grassroot,” she said.