Tag: Diabetes

Mr Tunde Fomoye thought himself to be very healthy until five years ago.

“ I took it upon myself to share my story because it takes the grace of God for you to survive diabetes.

“In 2013, I was on night duty in my office when I started shivering; I managed till the morning when I went to a hospital.

“After the initial medication, the fever continued and I was having some pains under my feet; it was checked and something was inside; a tiny piece of glass was removed and pus was coming out.

`’The next day, I went back to the hospital and showed them the glass; the doctor said I should go and check my blood pressure and it was found to be high; it was `crashed’.

“Three weeks later, it got very bad; I was referred to a general hospital where I was admitted; I was found with diabetes and ended up with a limb amputation,’’ the former comoany  worker narrates.

According to Famoye, life has not been the same because of constant medication, medical bills and being out of job.

“However, I am glad and grateful to God for being alive,” he says.

Dr Afoke Isiavwe, an Endocrinologist, notes that diabetes is a worldwide problem and that is why the UN has set aside Nov.14 and now, the whole November annually to raise awareness on Diabetes Mellitus.

“The awareness is necessary because all the complications can be prevented through proper management.

“Diabetes popularly known in Yoruba as `ito suga’ is not strange; it is common and occurs when the body cannot handle blood sugar.

“Diabetes occurs when there are raised levels of glucose in the blood because the body cannot produce any or enough of the hormone, insulin, or use insulin effectively,’’ she explains.

Isiavwe, discloses that a symptom of diabetes is frequent urination.

“Other symptoms include sudden weight loss, wounds that won’t heal especially foot wounds, erectile dysfunction in men, low libido, frequent thirst and recurrent boils.

“For women, they may find out that every time they get pregnant, they have a still birth, the baby dies in the womb or they have very large babies.’’

According to the endocrinologist, who is the Medical Director of Rainbow Specialist Medical Centre, Lekki , there are different sub-types of diabetes including the Type 1, Type 2 and Gestational diabetes.

Isiavwe believes that worldwide, there is a lot of data on diabetes but in Nigeria, there is a dearth of it.

“Currently, we have 16 million people and it is extrapolated that by 2045, we will have 41 million people living with diabetes, which represents an increment of 156 per cent.

“For developed countries, they have a hold of it at 35 per cent and Europe is just 16 per cent.

“The low and middle income countries such as those in Middle East and Africa are the ones that will be battling with diabetes, especially as four out of five people with diabetes live in low and middle income countries, she says.

On solutions to addressing the incidence of diabetes, she believes there is a need to have a national diabetes registry.

“It is going to help us with planning, registration and allocation; in developed countries, they plan for the present and future.

“Screening is another good way because it picks up people who have symptoms; half of the people with diabetes do not know they have diabetes because it is called the silent killer.

“We need to adopt a healthy lifestyle; our eating habit has changed because we are doing fast foods and pastries.

“We need to watch what we are putting in our children’s lunch boxes and on the table for everybody to eat.

“ In addition to eating healthy meals, families should learn to exercise together.’’

The endocrinologist believes  that knowledge is important especially if one has a family history of diabetes, so as to learn about diabetes, the risks, symptoms, complications and how to prevent them.

“There is also need to live in an environment that supports healthy lifestyle; if you stay in a storey building, you can go up and down.

“If you work in an office environment and are always sitting down, you can move around and stretch.

“Eighty per cent of cases of Type 2 diabetes are preventable through the adoption of a healthy life style; 70 per cent of premature deaths among adults are largely due to behaviour initiated during adolescent,” she argues.

The expert emphasises the need to teach children how to eat right, and be active.

“If they have different clubs, sports, encourage them to participate,’’ she urges.

Mr Sam Efaroro, a Media Consultant and Publisher of the Nigeria Health Online,  lives with diabetes.

According to him, he was able to recognise the signs of diabetes having attended a workshop on diabetes few years ago.

He went to a hospital and  was diagnosed with diabetes.

He began treatment with an endocrinologist and today, he lives a normal life with moderation and observes a healthy lifestyle.

“Diabetes management requires daily treatment, regular monitoring, healthy lifestyle, education and family support.

“It is also very essential that diabetes medications and disposables be accessible and affordable.

“The government needs to put policies in place that will make importation of diabetes medication duty-free; that way, it will get to the end user at an affordable price,’’ Efararo says.

Mrs Susan Snell, Head of Roche Diabetes Care, Sub-Sahara Africa calls for structured testing of blood glucose in the management of diabetes.

“It is important to have structured testing of blood glucose as a necessary measure a patient must take to achieve control of the disease.

“ Roche has been involved in diabetes patients care for 30 years by providing the Accu-check blood sugar measurement which they could use at home or anywhere they are.

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“The Accu-chek device is a “tailor-made diabetes self management solutions” designed to help people with diabetes to manage their condition and  enhance quality of life,’’ Snell explains.

On World Diabetes Day, Victoria Ibanga, General Secretary , Nigerian Guild of Editors (NGE), says the media has a major role to play in creating awareness about the disease and shaping public opinion.

Ibanga, who spoke on behalf of the President of NGE, Mrs. Funke Egbemode says: “As the fourth estate of the realm, it is the responsibility of the media to call governments to account and provide good leadership to the benefit of the populace.

“Nigerian governments both at federal and state levels should tell us how much has been achieved in the last one year or long years since the declaration of the day in 1991.

“ It is also our responsibility and business to speak truth to authorities especially in areas like health, which they have failed.

“We have a responsibility to ask questions about the budget for the health sector; how much is allocated, how much is implemented and how does it benefit the low and middle income communities?

“We have a responsibility to spread to the rural communities and provide them information and options, especially on ways to detect symptoms of diseases.”

She says as watch dogs, the media could  bring about change in the society by embarking on extensive campaign to create awareness on the rising cases of diabetes.

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.

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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-sectoral 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 prioritisation 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 urbanisation, 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 individualised.

“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 sensitisation 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.

Ms 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 prioritise 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.