By Martins Ifijeh
Amidst studies showing that more than 70 per cent of Nigerians living with diabetes do not achieve control of their blood glucose, experts have advocated for full involvement of patients through self-monitoring to prevent some of the increasing complications and deaths recorded from the disease in the country
In a chat with journalists on the current situation on diabetes management in Nigeria, held in Lagos recently, the Marketing Manager, Roche Diabetes Care, Mr. Adeniyi Adeola regretted that many people living with diabetes were not achieving and maintaining recommended target glucose level due to ignorance both on the part of patients and care givers.
According to him, people living with diabetes in Nigeria are faced with peculiar problems which make the management of the condition and expected blood sugar control (referred to as glycemic control in medical parlance) rather difficult.
He said: “For instance, financial constraint has been recognised as a major factor for poor glycemic control as the nation’s health insurance scheme does not currently cater for a majority of patients and they have to pay out-of-pocket for their drugs and blood glucose tests at a price they can hardly afford.
“Many diabetes patients do not adhere to their therapy while some will not accept that they have to live with the condition for the rest of their lives, until they develop complications.
“ For others, they find daily insulin injections and pricking their finger for self-monitoring too painful and would therefore not comply.”
Adeola also noted that caregivers in Nigeria have developed “therapeutic inertia” in diabetes management.
According to him, because of their heavy schedule, doctors rarely spend enough time with patients and this affects those living with diabetes most as they are denied the opportunity to have enough information that would help them achieve glycemic control.
The communication gap between caregivers and patients, he said, was also responsible for poor personalised diabetes management in the country as only few patients practice self -monitoring, an essential part of the management.
“Caregivers sometimes, do not initiate treatment for diabetes on time while many still do not recommend the use of insulin. For now, decision support is lacking on the part of care givers while the nation itself lacks disease registry.”
He expressed the company’s concern on the current poor glycemic control by Nigerians living with diabetes and pledged that Roche Diabetes Care would continue to support both patients and care givers to change the situation.
He said the company currently supplies the world’s best blood glucose monitoring devise, the Accu-Chek Active and will also launch the latest brand, the Accu-Check Instant System later this month.
“Our goal is to change the way diabetes is being managed and reduce therapeutic inertia,” he said.
In another presentation, the Regional Sales Manager, Roche Diabetes Care, Mubarak Gyedu disclosed that current diabetes management should focus on personalised care and should include Data Assessment, Structured Education, Therapy, among others.
Unfortunately, he noted, many care givers in Nigeria, after Data Assessment progress straight to Therapy, leaving out education and patient involvement through self-monitoring of blood glucose and will not give much information on what the patient needs to know such as whether or not his blood glucose is under control and what to do if it is not.
“If self monitoring of blood glucose is well done, a lot of money can be saved while the patient will be saved the ordeal of being placed on a therapy they may not need,” he said.