By Chioma Obinna & Arinola Kolade
Diabetes is a silent disease that does not often present with symptoms until serious complications set in. Diabetes occurs when the body can no longer control the amount of sugar in the blood because of problems linked to the hormone insulin. High levels of blood sugar can cause damage to the heart and blood vessels, nerves, kidneys, eyes and feet, among other things and medical experts advise that the best way to diagnose and confirm diabetes accordingly is through a blood screening test.
In 2017, according to the International Diabetes Federation, IDF, an estimated 15.5 million adults aged 20-79 years were living with diabetes in Africa. The continent reportedly has the highest proportion of people with undiagnosed diabetes, with over two-thirds (69.2 percent) adults currently living with diabetes but are unaware of their condition.
Specifically, in Nigeria, an estimated 3.9 million people are living with diabetes while about 846,000 people have diabetes but are not aware they have it. Findings by endocrinologists showed that most of them will likely get to know only when complications set in. Such was the story of Mr. Tunde Famoye who has been living with diabetes in the last five years.
“It took the grace of God for me to survive diabetes,” he told Good Health Weekly recently, recalling that it all began as a simple cold six years ago.
Tunde was not bothered initially by the cold because he regarded himself a healthy young man and the thought of battling such serious condition never crossed his mind. But it was a rude shock when in 2013 he was diagnosed with diabetes.
“I had a serious cold while on night duty. I was shivering so much I was excused for a day,” he said. The next day at the hospital, Tunde was treated for malaria and he went back to work. But on the third day, he felt a tingling sensation on the sole of his right foot.
“On examination, a tiny piece of glass was found and removed. It was a bad sore already oozing pus. I returned to the hospital and the doctor ordered a blood glucose check. Lo and behold the reading was 490.” Tunde had hyperglycemia – a dangerous condition that is typified by an abnormally high level of sugar in the blood.
Experts say normal blood sugar levels are less than 100 mg/dL after not eating (fasting) for at least eight hours. And less than 140 mg/dL two hours after eating. For most people without diabetes, blood sugar levels before meals hover around 70 to 80.
Doctors later explained that the nerves in the lower limbs had been extensively damaged and even when he sustained an injury and developed sores, he couldn’t feel any pain. The wound got badly infected and before long, a condition known as gangrene set in.
He learned a hard lesson. What had started off as a harmless cold turned out to be disabling diabetes. “I started treatment but three weeks later, it got very bad and I was referred to a general hospital where I was admitted and at the end of the day I had above the knee amputation.
Since then life has not been easy. I thought it was a spiritual attack but when I saw pictures online I believed it was real,” he stated.
Tunde who identified the cost of treatment as a big challenge for people living with diabetes said the death of a patient he met while in the hospital who couldn’t afford to buy drugs forced him to discipline himself by taking his own drugs regularly.
According to the President of the Endocrine and Metabolism Society of Nigeria, Prof. Olufemi Fasanmade Nigeria on the average loses about N92 billion yearly to the scourge of diabetes.
“I was on insulin for two years, when I went back to the hospital they discovered I was having low blood sugar and the doctor asked me to stop the insulin and I have been on other drugs until now,” he said Tunde has since lost his job. Like many other Nigerians living with diabetes who pay for treatment out of pocket, the financial burden forced him and his wife is also jobless to pull their children out of school.
“It isn’t a palatable situation at all. I went through a lot, but I’m thankful that I have my family members around even though it took a lot to make them understand the situation, to know it was not my fault.”
Tunde was being blamed for his own predicament until two and half years later when his mother- in- law went into a diabetic coma and died.
“Only then did everyone realise what happened and everybody has been cautious. That was what saved me because my family initially believed it was my lifestyle that caused the problem. but I let them understand that it is hereditary.”
Tunde recalled how he was unable to purchase his drugs for four months because he had no money. Findings show that a patient who has complication may be indebted to the tune of N500, 000 to N1millon.
He said the government should help people living with diabetes by providing social welfare packages.
Diabetes is a disease commonly ignored by many patients. Endocrinologists say most of the people living with diabetes will only get to know when complications such as blindness, stroke, foot ulcer that could result in amputation, among several other conditions, set in. Findings by Good Health Weekly show that about 90 percent of people with diabetes have type 2 diabetes, which is linked to lifestyle factors such as obesity and inactivity. Type 1 diabetes, once called juvenile diabetes, commonly develops among children.
An endocrinologist, Dr Afoke Isiavwe explained that everybody is at risk of diabetes hence the need for access to life-saving medication.
Isiavwe who is the Medical Director, Rainbow Specialist Hospital, Lekki, Lagos, while speaking during a media roundtable to mark this year’s World Diabetes Day with the theme: “Diabetes and The Family”, urged the government to waive import duties for diabetes medication, glucometers and all the consumables and equipment required in managing the condition.
Isiavwe harped on the need to teach children to eat well, have balanced meals and drink water regularly but worried that half the number of persons living with diabetes do not usually present with symptoms.
“There are what we call the modifiable and non-modifiable risk factors. The non-modifiable risk factors are the things we really cannot do anything about, for instance, ethnicity.
Isiavwe said diabetes impacts the quality of life once a family member is down with diabetes, hence, the need for all hands to be on deck to recognize, prevent and manage the condition.
The Head of Roche Diabetes Care, Sub -Sahara Africa, Susie Snell, urged the Federal government to get involved by focusing on making the medication easy and affordable for the society to access.
In her presentation titled: “Structured Testing of Blood Glucose in the Management of Diabetes”, she said Roche has been involved in diabetes patient care for 30 years by providing the Accu-Chek blood sugar measurement which they could use at home or anywhere.
She highlighted the importance of structured testing of blood glucose as a necessary measure a patient must take to achieve control of the disease.
Snell described the Accu-Chek device as a “tailor-made diabetes self-management solutions” designed to help people with diabetes to manage their condition and also enhance their quality of life.
Roche will be introducing new devices in 2019 to further assist Nigerians living with diabetes and also help in early detection of new cases in the country.