Diabetes: Why rising incidence should urgently be curbed
When medical experts on Diabetes
met in Lagos on Oct. 25, this year, it was to critically examine the rising
incidence of diabetes in the country and the African region. They met at the
2018 Sanofi Diabetes Summit to proffer ways to tackle the disease. According to
them, more persons are still coming down with the disease if measures are not
put in place to address the situation.
From Left: Professor of Medicine
and Endocrinology, Faculty of Medicine and Biomedical Sciences, University of
Yaounde, Cameroun, Jean Claude Mbanya; Professor of Diabetes Metabolism,
Faculty of Medicine Alexandria University Egypt, Abdelrahim Aly, General
Manager, Rx and Country Chair, Sanofi Nigeria-Ghana, Folake Odediran and Head,
Department of Medicine, College of Health Sciences, Obafemi Awolowo University,
Ile-Ife, Professor Babatope Kolawole at the Summit.
Explaining what the disease is
all about, the Diabetes Research Institute, University of Maimi, U.S., says
everybody needs carbohydrate foods because they provide our body with its main
source of energy. When we eat these foods, which include bread, cereal, pasta,
rice, fruit, dairy products and starchy vegetables, the body breaks them down
into glucose. The glucose moves around the body in the bloodstream; some of it
is taken to our brain to help us think clearly and function.
The remaining glucose is taken to
the cells of our body for energy and also to our liver, where it is stored as
energy that is used later by the body. In order for the body to use glucose for
energy, insulin is required; insulin is a hormone that is produced by the beta
cells in the pancreas.
Insulin works like a key to a
door; it attaches itself to “doors’’ on the cell, opening them to allow glucose
to move from the blood stream, through the door and into the cell. If the
pancreas is not able to produce enough insulin (insulin deficiency) or if the
body cannot use the insulin it produces (insulin resistance), glucose builds up
in the bloodstream (hyperglycemia) and Diabetes Mellitus develops.
Diabetes Mellitus means high
levels of sugar (glucose) in the blood stream and in the urine and its complications
affect the eyes, kidneys, nerves, heart and blood vessels and may eventually
lead to death.
Concerned by the rising incidence
of diabetes in the country and region, they jointly called for improved
awareness of the condition, as well as the provision of care on the healthcare
plan for the indigent, disadvantaged and vulnerable people living with diabetes
in Nigeria.
Prof. JeanClaude Mbaya, Professor
of Medicine and Endocrinology, University of Yaounde, Yaoundé, Cameroon said:
“In Cameroon, we’re accounting for a population of about 20 to 21 million
people with almost one million people suffering from the diabetes.
“In Nigeria, it is almost the
same percentage when you calculate the percentage based on the right percentage
of the population; it is huge. “However, the problem is that the rate of people
who are susceptible to developing diabetes is higher at about 10 per cent;
which means that in five to 10 years, if the risk factors in the population are
not curbed, about 50 per cent of them will develop diabetes,’’ he said. Mbaya
said that fighting diabetes is a whole of government concern with multi-sectorial
approach. “It is every government’s responsibility to take care of the health
of its population and so, we should hold our government responsible.
“Fighting diabetes is not only
for the Ministry of Health; the ministry of health is there to open clinics,
train doctors and make sure that those who already have the disease do not
develop complications “Preventing diabetes also involves the Ministry of Town
and Urban Planning, for instance. “How we build our roads, cities and schools
is extremely important because you have to build cities with sidewalks, side
roads with bicycle lanes; these are some of the ways we can improve.
“Individually, people need to
exercise, I don’t mean just jogging on the road; I mean being physically
active, we have to walk more but in a city like Lagos, How can you walk more?’’
He called for prioritization of choices saying: “Measures should be put in
place for prevention because it is easier to prevent than to treat or manage. “We
spend a lot of money on things that can be forgone thereby mortgaging the lives
of our people; we are making the wrong choices by not taking care of the health
of our population. “We should change that paradigm and if the government does
not change the paradigm, we resolve not to vote them to power,’’ Mbanya, who is
also a past president of the International Diabetes Federation told NAN.
Another Professor of
Endocrinology, Prof. Sam Dagogo-Jack, said urbanization, sleeplessness, stress,
depression and carbon monoxide in the atmosphere are part of risk factors
associated with the rising cases of diabetes in Nigeria and the world at large.
Dagogo-Jack, who is of the University of Tennesse, Health Science Centre, U.S.,
said that HIV, tuberculosis, high blood pressure, antibiotics use, obesity,
overweight and environmental influences also contribute to rising incidence of
diabetes.
Dr. Olufemi Fansamade of the
Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, agreed that the
reason why people are more susceptible to diabetes now was our changing
lifestyle. “Before, we used to be very physically active, people were healthy,
trim and do a lot of walking but presently, very few people walk. “The roads
that are bad are also not helping and people use excuses like rain, rough roads
and driving not to exercise. “Children are getting bigger than before and
schools are getting smaller in size just as fields are disappearing,’’ he said.
Fasanmade added: “So many schools don’t even have a playing field; before,
children used to play at 1 p.m., 2 p.m. or 3 p.m.; they still go for extra
lesson and on getting home again they do homework. “Nowadays, children spend
time playing games on their phones and laptops. “So, we are becoming less
physically active and that is reflecting in the increase in weight of children
and adults, leading to increased rate of diabetes and hypertension. “There is
an urgent need to change the narrative.’’
On treatment options, the
endocrinologist said it was individualized.
“There are many drugs to choose
from, there is a lot of lifestyle changes and lifestyle even differs from a
person to a person. “So the lifestyle changes are individualistic, the
medications are also individualistic,’’ he said.
Prof. Felicia Anumah, also a
professor of endocrinology at the University of Abuja, said that diabetes
education was very important to empower patients. “We need to educate them
about risk factors, physical activities, about diet, about foot care. “The only
option as far as diabetes is concerned is prevention and that is why sensitization
is important,’’ she said.
Also, Patience Chima, a
Registered Dietitian and Nutritionist, said diabetic patients, as well as their
relations need to make healthy food choices, understand portion sizes and learn
the best times to eat. “This helps patient to control weight and achieve good
blood sugar control, cholesterol and even blood pressure. “Managing diabetes
successfully by patients involves food, exercise and medication; we need to
plan food intake and insulin/drugs to manage blood sugar.’’ “There’s also the
need for balance between food and insulin/drugs; too much food (or too little
insulin/oral drugs) can increase blood sugar; too little food (or too much
insulin/oral drugs) can lower blood sugar,’’ Chima said. “Regular physical
activity also lowers blood sugar and improves the way insulin works,’’ Chima
said.
Mrs. Folake Odediran, the General
Manager, RX and Country Chair, Sanofi Nigeria and Ghana, said that though
various stakeholders were making tremendous contributions in their respective
spheres to improve treatment outcomes, there still exists gaps.
“These gaps are in terms of
policy direction, public awareness, advocacy, patient education, diagnosis,
infrastructure and overall capacity of the healthcare system to effectively
manage this disease. “As leaders in diabetes care, Sanofi will continue to
prioritize public-private partnerships and initiatives that support speedy
attainment of universal health coverage for diabetes patients,’’ Odediran said.
NAN reports that Nigeria is one
of the 32 countries of the International Diabetes Federation (IDF) African
region. According to IDF, 425 million people have diabetes in the world and
more than 16 million people in the AFR Region; by 2045 it will be around 41
million. There are an estimated 1,702,900 cases of diabetes in Nigeria in 2015.
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