Fighting Diabetes to a Standstill

As Nigeria joined the rest of the world last week to mark the World Health Day, with a focus on eradicating diabetes, Martins Ifijeh writes on the need for preventive measures and management of the disease by Nigerians

“There are fat men. There are old men. But you can never see fat old men anywhere. You either lose your fat and grow old or you die a fat man without reaching old age. The two has never been known to cohabit together.” These were the exact words of the Chief Medical Director, Lagos University Teaching Hospital (LUTH), Prof. Chris Bode, during the 2016 World Health Day media roundtable tagged ‘Beat Diabetes’.

He believed one of the risk factors associated with overweight is the tendency to be diabetic, hence fueling the inability of the person to enjoy life up to old age, as the scourge is known to compete with old age if it is not prevented on time or managed properly.

He said one of the ways of beating diabetes was for Nigerians to check their weight, avoid factors that predispose them to increased body size, while engaging in exercises that help bring the body weight back to its physiologic state.

He said with most low and middle income countries like Nigeria fast mimicking the lifestyles and dietary habits of the West (where diabetes was known to be highly prevalent), the incidence rate of the scourge is becoming common, making it no longer an exclusive disease of developed countries or the rich.

“Today, most of us prefer to drink sugary beverages, against taking water. We no longer patronise water the way we used to, rather people prefer to take these sugar-laden substances, forgetting that this represents the bedrock in which diabetes thrives.

“These days, when our children are going to school, we prefer to give them sugary foods, biscuits and all sorts of drinks, and over time the kids will be used to such foods and drinks. The truth is, since these are what they are exposed to, they will continue to eat such things even when they grow up.

This is becoming a growing habit in Nigeria and other developing countries, thereby making us highly prone to diabetes mellitus,” he stressed.

Prof. Bode, who represented the Minister of Health, Prof. Isaac Adewole, at the media roundtable, said the federal government has noticed the high incidence rate of the disease in Nigeria and was putting all measures in place to tackle it head-on, adding that with the recent decision to put the country’s primary healthcare centres to optimal use by the federal government, diabetes care will feature prominently in these centres across the country.

He said Nigerians should be aware that diabetes was essentially a lifestyle disease and can be prevented simply by adopting a healthy lifestyle which involves good diets, regular exercise and health consciousness.

He lamented that diabetes represents a silent killer, which was why many people in the country do not know they have the disease and continue to live without taking necessary precaution to control it. According to him, there was a great need for everyone in the country to join hands and prevent diabetes, while those already diagnosed should adhere strictly to their doctor’s recommendations on control measures.

Diabetes, according to experts, is the most common disorder of the body’s hormonal system, which occurs when blood sugar levels consistently stay above normal, thereby unable to let the body cells receive sugar (called glucose) due to lack of insulin to drive it 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, and insulin is one of the main hormones that regulates blood sugar levels and allow the body to use glucose for energy.

But several years ago, this scourge used to be an exclusive disease of people living in developed countries or that of the few wealthy people in low and middle income countries like Nigeria, but overtime, it has snowballed into a medical emergency in Nigeria, with both the poor and the rich becoming victims of the disease.

Presently, 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), the International Federation of Diabetes and Diabetes Association of Nigeria.

Available report suggests that about 80 per cent of diabetics in the country are either not aware they are diabetic or are unable to treat themselves and be free from the scourge.

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

Over the last 30 years, the prevalence rate of diabetes 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.

No wonder a Consultant Endocrinologist, Dr. Afoke Isiavwe, warned that if nothing was done by the citizens, the government and the stakeholders to reduce the high incidence rate of the scourge, it would immensely reduce the prime of the country’s workforce, while impacting on the country’s economy in a negative way.

She advocated the need for government and other stakeholders to embark on massive public enlightenment to draw attention to the growing problem and rapid increase of diabetes in the country and the world in general.

Dr. Isiavwe, who is also the Medical Director of Rainbow Specialist Medical Centre, emphasised the need for government to improve access to good diabetes care in the country to prevent some complications now being experienced by people with diabetes in the country.

The renowned endocrinologist described diabetes as a chronic metabolic disease characterised by high levels of blood glucose. She listed symptoms associated with it as frequent urination, excessive thirst, increased appetite, weight loss, among others.

Unfortunately, she noted that most people may not notice these symptoms early, which is why the condition is often referred to as a silent killer. “Also many patients do not seek appropriate management for the control of the disease until they begin to develop complications which could sometimes be deadly. Poor management may lead to serious damage to the heart, blood vessels, eyes, kidneys, and nerves,” she disclosed.

According to her, the prevalence of diabetes has been on a steady increase worldwide especially in low-and middle income countries like Nigeria. She however disclosed that the prevalence in Nigeria was still not known, adding that the guess estimates could be in the region of 8 to 10 per cent.

She said, while most people with diabetes in developed countries were people above retirement age, the disease affects people in the productive age between 35 and 64 in Nigeria. She said 80 per cent of deaths from diabetes occur in low-and middle income countries.

She further explained that “knowledge exists to reverse this trend through targeted prevention and appropriate care. When diabetes is uncontrolled, it has dire consequences for health and well-being. It is clear that a diabetes epidemic is also an epidemic of complications.”

She predicted that by 2025, no fewer than 270 million people worldwide would develop diabetes complications such as eye disease, heart, nerves and kidney problems. According to her, diabetes was a leading cause of blindness, amputation and kidney failure, which, she added could result from lack of awareness about diabetes, combined with insufficient access to health services.

On her part, the Medical Director, Roche Nigeria, Dr. Jeanne Coulibaly, commended the Publisher of Nigerian Health Online, Mr. Sam Eferaro for the roundtable initiative to create more awareness about diabetes in Nigeria.

“Good health is important for everyone to be productive and be able to develop the country. We at Roche are conscious of this fact and we strive to assist the communities everywhere we are located, in providing drugs, diagnostic equipment and generally helping in the dissemination of vital health information to the people.”

Also lending his voice, the WHO Coordinator, Lagos, Dr. Omoniyi Abidoye, disclosed that a person dies from diabetes every 60 seconds worldwide. According to him, diabetes will become the 7th leading cause of death in the world by 2030, adding that deaths from the condition would also rise by more than 50 per cent in the next 10 years.