By Chioma Obinna

Egbuna Eke, 38, has enjoyed good health since birth to the extent that visiting the hospital was never part of her growing up.

The only time she used drugs then was when she had cold or fever that was treated with over-the-counter drugs, like paracetamol.However, the period of good health ended 10 years ago when she found out that she was drinking more water and had increased frequent urination. She was also losing weight.

Her parents took her to a hospital where she was diagnosed with diabetes mellitus. Her condition became worse. Her fasting blood sugar test read over 300mg/dl.   She was confirmed to have type 1diabetes at the age of 28 and was placed on insulin injections at that time. Although, diabetes is said to be hereditary, she has no family history of the disease.

Unfortunately, the myths associated with diabetes, mostly due to ignorance, did not help her to seek better treatment options.   She was fooled by several words of advice ranging from direction to seek a spiritual cure, to a suggestion to abandon her insulin injections, with no alternative provided.

Challenges face by diabetic patients

Egbuna almost lost her life until she was taken to a public hospital where she met a dietician. Today, the exorbitant costs of managing her diabetes have drained her financially, since she has to procure every item on her own with no assistance.

Many Nigerians suffering from diabetes like Egbuna are faced with challenges ranging from lack of education on diabetes and the need for diagnosis, myths and misconceptions around diabetes, lack of appropriate medical infrastructure, insufficient number of diabetologits and endocrinologists, financial inability to procure the basic diabetic management supplies, ignorance around diabetes management, absence of well-coordinated networks among diabetics in the country and absence of support from government among others.

Experts say tackling these challenges, proper management of the condition as well as adequate healthy diet would go a long way in reducing the burden in the country. For them, adequate support from government would reduce mortality; ensure proper management and better awareness on the disease.

Globally no fewer than 382 million people are living with diabetes and if nothing is done, the number would increase to 592 million by 2035.

Diabetes Mellitus is a life-long disease marked by elevated levels of sugar in the blood either because the body does not produce enough insulin or because cells do not respond to the insulin that is produced. Insulin is the principal hormone that regulates uptake of glucose from the blood into most cells. It is one of the leading causes of death worldwide.

Burden of diabetes in Nigeria

A World Health Organisation report in 2009 revealed that there are 1.71 million people living with diabetes in Nigeria and this figure is projected to reach 4.84 million by 2030. Current prevalence rate estimates of diabetes in Nigeria have been tagged at 2.5 percent compared to its 2.2 percent rate in 2003. The situation is more worrisome as it is estimated that 40 percent of people in Nigeria that had the disease do not know. In the view of the Lagos State Chairman, Diabetes Association of Nigeria, DAN, Hameed Biodun Afinowi, Diabetes incidence and prevalence is on the increase in Nigeria and the healthcare structures in the country are not adequately equipped to handle the various intricate lifelong management of the disease.

Afinowi who blamed the alarming increase on unhealthy lifestyles of Nigerians lamented that Nigerian government has failed to support diabetic patients in the country. He said making free treatment and drugs available for these patients would reduce mortality as well as guarantee proper management of the disease.

He said many of the patients are not only faced with the challenges of cost management but the healthcare delivery system in Nigeria is grossly inadequate with lack of medicines, patient education and functional laboratory for screening for complications.He noted that without proper treatment, many complications may arise from the disease.

“These may be acute or long term. The former include hypoglycaemia, damage to blood vessels around the eyes and legs, blockage of blood supply to vital organs like the heart and the kidneys. These invariably lead to devastating long term complications like ischemic heart diseases and stroke.”

Chairman DAN Lagos reacts

The Chairman, Lagos State DAN, who expressed fear that the number of patients will continue to rise due to Nigerians eating habits said: “Government is not doing enough, to guarantee proper management of diabetes. We have people living with diabetes with either Type 1 or Type 2 and they have to be on insulin for life. Government should support these patients by providing these medications free like they do for HIV/AIDS. Government spends so much money on HIV neglecting diabetes even when they know that all our foods are sugar based and our lifestyle is not helping either.   It is time government support these patients like they do in South Africa.

“The number will be increasing and will continue to increase. People should stay away from fast foods. Our parents ate our natural foods and live well and long. Let us go back to the traditional ways of eating vegetables and fruits. Fast foods are not good for us. Nigerian government has concentrated too long only on HIV/AIDS leaving other killer diseases.

“People with diabetes have the responsibility to manage their condition on a day to day basis, communicate with their healthcare provider periodically throughout the year and seek advice when necessary. To effectively self-manage diabetes, those with the disease must identify symptoms of emerging health crises, adhere to complex medication schedules and modify long-standing lifestyle behaviours such as their diet and physical activity levels.

Recommendations

Health watchers believe that much is still needed to be done in terms of diabetes education, access to insulin, care etc. to address the problem of diabetes globally, particularly in poor countries like Nigeria. Other possible solutions they recommended include encouragement of free or affordable access and management supplies, especially insulin, by government and NGOs and inclusion of diabetes in the country’s health insurance.