The increasing incidence of diabetes

A recent report has confirmed the increase in new cases of diabetes in Nigeria while the number of   people that are down with the disease is equally huge. In other words, both in terms of incidence and prevalence, the numbers are unsettling. The prevalence of diabetes in sub-Saharan Africa is estimated at one per cent in the rural areas while it ranges from five per cent to seven per cent in the urban areas. And for a population that is reputed to be approaching the 200 million mark with approximately 50 per cent dwelling in the urban centres, the foregoing statistics are worrisome.  Indeed, Nigeria is said to constitute over a quarter of the 15 million cases of diabetes in Africa.

The challenge  is  however  more  rampant  in  the  South  than  in  the North and more common in urbanised areas because of lifestyle choices.  Since lifestyle choices contribute immensely to the risk factors of diabetes and since the disease is non-communicable, its frightening incidence and prevalence can only be a product of inadequate sensitisation and/or indiscipline. Ironically, a disease whose incidence could be effectively prevented at a cost so minuscule that it amounts to nothing has been described as one of the costliest conditions to treat. The average diabetes patient who is on the country’s minimum wage reportedly requires at least 29 per cent of his or her income to procure insulin alone.

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In a clime where proactive measures take precedence over reactive ones, all that would be needed to prevent the incidence of diabetes are aggressive sensitisation and public enlightenment campaigns on the menace of the disease, with emphasis on the causative factors which are patently avoidable.  The sedentary lifestyle, unbridled consumption of refined sugar and fast foods that easily convert to sugar in the body system which are major causes of diabetes  are choices that can be avoided through disciplined and focused dietary variation arising from information and knowledge.  Yet, diabetes is reputed to be one of the commonest causes of blindness and a major cause of end-stage renal failure, in addition to predisposing its victims to tuberculosis three times more than the otherwise healthy persons. Out of every 11 adults that had diabetes, half were reportedly not diagnosed, let alone being given the needed medical treatment.

The mortality rate of the disease is equally intolerable as 80 per cent of the victims reportedly die of cardiovascular complications such as stroke, kidney failure and foot gangrene. The devastating impact on the family units and the economy of the untimely death of the victims, usually in their prime, is better imagined.  All of these adverse consequences are, to a great extent, down to inadequate knowledge and information about the disease and, perhaps, indiscipline.

It is nonetheless gladdening to note that last month, the Federal Government, through the Federal Ministry of Health (FMoH), inaugurated the National Steering Committee for Diabetes Awareness and Care (DAC) in Nigeria. The Minister of Health, Professor Isaac Adewole, stated that the overriding objectives of DAC were safeguarding the health of Nigerians and improving diabetes care in the country. The DAC, which the minister described as a product of active collaboration between the FMoH and Health Strategy Delivery Foundation (HSDF) with the support of the Word Diabetes Foundation (WDF), is proposed to take off in the Federal Capital Territory (FCT) and Imo State.

While we do not quarrel with the wisdom of the FMoH in wanting to test its implementation strategies in the chosen jurisdictions before full-blown execution, we however enjoin it to begin the implementation of the awareness component of its strategy in earnest across all states of the federation. The standardised protocol for medical care and patient self-management education which DAC intends to foster can wait if it must. But the country does not have the luxury of time to delay public enlightenment campaign in 35 states, especially when adequate information/knowledge of the causes and prevention promises to be the most efficacious strategy to rein in the incidence of diabetes in the land.

The concerted efforts by healthcare professionals and stakeholders in the health industry are cheery, but it is urged that emphasis be placed on citizen education on prevention of the disease.  In addition, the joint commitment will need to be combined with a better functioning health insurance scheme so that access to diabetes treatment is not hampered by affordability.  It is hoped that DAC will succeed in strengthening and positioning the healthcare system to deliver the needed services that will lead to drastic reduction in the incidence and prevalence of diabetes in the country.