Felix Ofungwu: Regular Testing is Most Important Method of Controlling Diabetes

As the World Diabetes Day is marked round the globe on November 14 with the global theme, “Access to Diabetes Care”, ISN Products Limited, one of the predominant suppliers of medical diagnostic solutions across Nigeria and major supplier of Accu-Chek, the most widely used product for testing blood sugar levels in Nigeria, is leveraging the 2021 WDD to increase awareness on the disease and the access to care with an outreach event scheduled for November 13 at Gbagada General Hospital. The Managing Director, ISN Medical, Felix Ofungwu, in this interview with MARY NNAH insists that diabetes is one of the silent killers in Nigeria at the moment, thus there is need for regular testing. This is just as he appealed to government and all stakeholders to see the health condition as an emergency

Tell us briefly about your journey to ISN Medical Limited.

My background is in business. I worked as a business consultant for a number of years and then got into healthcare through ISN six years ago.

ISN Products Limited, also known as ISN Medical, is one of the predominant suppliers of medical diagnostic solutions across Nigeria. We have about 200 employees across 10 offices in Nigeria and we service over 1,000 hospitals, laboratories and diagnostic centres. So, I have been with ISN for six years now.

As a major stakeholder in diagnostic healthcare, how would you describe the diagnostic healthcare industry in Nigeria?

I will say that the overall healthcare landscape in Nigeria is rapidly changing, and I think a lot of that has to do with the Covid-19 pandemic that we are still going through. I think it has really focused attention on many aspects of the healthcare sector including diagnostics, the need for proper and accurate testing.

We’ve seen that patients have become more aware of the need for timely and accurate testing and they are demanding those types of services. You see a proliferation of testing centres across Lagos that are open 24/7, and patients are even able to do drive through testing; they are able to get results generally within a day. These are things that we didn’t see before and now they are becoming more and more common in Lagos and perhaps soon across other parts of the country. I think the private sector especially, has risen up to that challenge that has been thrown down as a result of Covid-19.

ISN Medical was incorporated in Nigeria in 1976 with initial focus on industrial products and nutrition, what led the company into medical services and diagnostics?

Yes, we were incorporated in 1976 but I wouldn’t say that our major focus was on industrial products and nutrition. The company was founded by a former Medical Lab scientist and while there were at a point, arms of the business that dealt with industrial products and nutritional products, the core and focus of the company has always been around scientific products used in medical settings, especially in laboratory settings and that is what we have done for over 40 years now. We equip labs, hospitals, and diagnostic centres with the products that they would need to accurately diagnose their patients and therefore, provide the right sets of therapy for those patients.

This focus as a provider of medical solutions is what led us to our first distribution agreement with a company called Boehringer Mannheim in 1981, which is now Roche Diagnostics GmbH. That’s how essentially, we got started in the medical diagnostics space and we’ve been operating in that space since then.

Besides being heavily involved in diabetic advocacy, what other areas of the medical business is ISN majoring in?

As I mentioned earlier, our heritage really is in the provision of diagnostic products to hospitals, Labs and diagnostic centres and that is still a big part of our business today.

How would you leverage on the November 14th WDD?

Let me provide a little more context and rationale behind the World Diabetes Day activities we have planned. So, we are a supplier of a product called Accu-Chek, the most widely used product for testing blood sugar levels in Nigeria and it is also the most accurate. It is commonly referred to as a Glucometer because it is used to test blood glucose levels. We have supplied Accu-Chek for over 10 years now, and as a result, we have become quite embedded within the whole diabetes management system in Nigeria. We took it upon ourselves to not just play the role of a supplier but also to act as evangelists for better management of diabetes among patients.

So, over the years, we have had events, especially commemorating World Diabetes Day, which is always on November 14th. Therefore, we have these events which include outreaches and related events aimed at spreading awareness around diabetes and diabetes management. This year is no different; we have a number of activities planned and the hallmark for this year’s is an outreach event, which we are doing in conjunction with Gbagada General Hospital on November 13th. We have another series of events with Access Bank throughout the week of the WDD.

ISN’s theme for this year’ WDD is, “Improved Access to Diabetes Care” and that is really what we are trying to establish – how do you increase the level of access to diabetes care specifically, starting with testing? Once one is diagnosed to be diabetic, what next? How do you increase the level of access to diabetes care for the diabetic patients? Another thing I really want people to know is that accuracy is really important in managing any disease condition but particularly, diabetes. So, it is important that patients are using the right products that give accurate results, because the consequence of treating based on inaccurate results can be fatal. It is really important that people understand that this is not an area where guess work suffices. This is an area where precision is key.

Apart from these events that are focused on WDD, what other activities do you do to create awareness on the disease?

We do a lot of activities. Our business is divided into what we call the diagnostic arm and the diabetes arm. For diabetes, we do outreaches and screening events all through the year. We have various promotions aimed at improving awareness around diabetes; improving people’s knowledge of how to manage diabetes conditions and what products they should use. We usually do them in collaboration with our partners.

On the diagnostic side of our business, we have a whole other set of activities we do like continuous adult medical education, seminars, clinical meetings, various exhibitions and conferences.

When and how would someone know that he or she is diabetic?

There are some warning signs, though we wouldn’t want people to start experiencing those warning signs before they start doing something. Typically, what you see is that people are diagnosed as being pre-diabetic before they are actually diagnosed as being diabetic generally.

There two main forms of diabetes, the adult-onset or type 2 diabetes and juvenile or type 1 diabetes. Type 1 diabetes is usually diagnosed as a child and there is very little that can be done to prevent that. Adult onset or type 2 diabetes comes with risk factors like family history, types of food that we eat and other lifestyle factors.

Some red flags include frequent urinations, night sweat, and constant thirst. Like I said, you wouldn’t want to wait till you experience the warning signs, since we know enough about some of the risk factors; we try to advocate that people try to manage the risk factors before those warning signs start to occur. But once those signs start to occur and you go to a doctor, typically, they are able to diagnose whether you pre-diabetic or diabetic. Also, patients can be diagnosed as pre-diabetic or diabetic during medical check-ups or wellness screening sessions.

There is this needle phobia, what is the painless method of carrying out this test?

There are products we offer currently that are relatively painless. Technology has enabled us to come up with relatively painless ways of drawing a patient’s blood and testing them. However, there are now needle–free testing devices available, they are not the most affordable but they are available. Things that, for example, use patches and other devices to read something that is equivalent to what you would get from a blood test but they are not affordable as needle–based products.

Can diabetes be cured?

As far as we are aware, there is no cure necessarily for diabetes. What we focus on and what the literature supports is proper management of diabetes and when diabetes is properly managed, people live very long and relatively healthy lives. We are not aware of any cure or any therapy that reverses diabetes. Insulin does not cure diabetes; it manages and regulates our blood sugar levels. If you are supposed to be taking Insulin to control your diabetes and you stopped taking Insulin, you are going to have a problem. So, that is not a cure but a management tool.

Is this medical condition diabetes a death sentence?

Diabetes is not close to being a death sentence if it is well managed and of course, things are done in moderation – nutrition, diet, drinking and all of that needs to be done in moderation and with the understanding of the impact it has on your body and blood sugar level.

For me, I think that knowledge is very important because if you know how certain things affect your sugar level, you are more empowered to make the necessary adjustments.

First of all, testing your blood sugar levels regularly is very important because that is when you would know whether it is in or out of control. You need to know that regularly. Now if you have been diagnosed with diabetes by a doctor, then they would set a therapeutic course for you. It might involve Insulin and oral medication; it always involves testing regularly just to make sure that your blood sugar levels are in control. It will also generally involve lifestyle modifications – the things you eat, exercise, movement and limiting sedentary activity. Usually a doctor will set a course of action and one`s ability to live a relatively long and healthy life even with diabetes is based on how well they adhere to the recommendations of their doctors.

How do you see diabetes cases in Nigeria compared to other West Africa countries?

Part of the challenge in answering that question is the relative lack of data around diabetes and diabetes management in Nigeria. One of the challenges we see is that there are a lot of people living with diabetes without knowing. So, the proportion of undiagnosed diabetes is something that gives a lot of experts concern. There are a lot of people living with this disease that do not know because they haven’t been screened or tested.

In some places, once you enter a clinic or hospital, for any condition, testing of diabetes is automatically part of the protocol but here, we don’t necessarily have that. But what we have seen, depending on which studies you look at, is that around 3 to5 per cent of the adult population have type 2 diabetes in Nigeria.

In terms of access to care, we have seen an improvement, especially as people are becoming more aware of diabetes. For a long time in our country, the focus has been on infectious and parasitic diseases and not so much on non-communicable diseases like diabetes. But we have seen a shift of attention to non-communicable diseases like hypertension, diabetes and even cancer and with that come added awareness, increased testing, increased screening and better care for diabetes. We are encouraged by this growing awareness.

According to the brief stats you’ve mentioned, for a population of 200 million and with 3 to 5% assuming to be living with diabetes, is it about time, government declared this medical condition as an emergency?

I think so for a number of reasons. Now, with Nigeria’s population, which is over 200 million, 5 percent of 200 million is ten million, so a disease condition that affects millions of people definitely requires attention from the government on one hand.

On the other hand, the consequences of not managing diabetes well are quite drastic – it is a leading cause of blindness, as well as amputation. So, there are all these severe consequences as a result of not managing this disease condition that make it even more critical that it is well managed and taken seriously by all stakeholders, government included.

Government should get involved by really understanding it as a public health epidemic, I would say, just like the reaction we got on the Covid-19 pandemic. I think over the years diabetes has been a bigger killer than Covid-19 in our country. I think it starts with that general declaration from a public health standpoint of the status of diabetes. Then, we need to think about how to establish the right protocol for testing and managing diabetes and how to ensure that protocol is cascaded across the various tiers of healthcare system- Primary health care, general hospitals or secondary care, tertiary institutes or teaching hospitals – there should be a protocol for both testing for diabetes when patients come in and managing diabetes conditions once they are diagnosed.

As a young man who sits atop this establishment, what are the challenges you have faced and what should be your advice to young people who aspire for such responsibility?

I think the challenges of doing business in Nigeria have been well covered. We are not immune to many of those challenges. I think having the right orientation is very important. At ISN, we are oriented around quality, excellence in everything we do and you will see it in the types of people we hire, the types of products we supply, and in how we do business. Our view for business and the return from business is a long term view. I think many people run into trouble when they take a short-term view of business and the opportunities. We try to take a long-term view and praise God; that is one of the reasons we have been around for 40 years now. We are not looking for shortcuts or short term gains. We are looking for sustainable gains over a long period of time.

I also think that perseverance is also very important. Challenges come anywhere you are doing business in the world but one’s ability to persevere through those challenges and rise above those challenges, has a high correlation with their degree of success in business.

The third thing I would say is that in any way, one creates their own good fortune in terms of things you do and how you do business. If you do business in the right way, generally good fortune comes back to you. This is what I have found. I`m personally very spiritual and I attribute a lot of the success that we have had to the grace of God. I know what is required to really tap into the grace of God – it is important that there is some consistency along those lines and that you are not doing the things that detract from the grace of God and still expect that the grace of God will help you through. No, there has to be some constituency in what you do and how you live your life.