They are a common sight in our hospital clinics and wards, a recurring decimal across the landscape. Sometimes they hobble as a result of lower limb amputations, and other times, their eyesight is the victim. Regardless of the part of the body under plague, the culprit is the same. Diabetes.
In 2014, diabetes and its complications were responsible for nearly 106,000 deaths across Nigeria. Alarmingly, 77.6% of these deaths occurred in adults under the age of 60 thus, it is not ‘a disease of old people’ as is commonly thought. All these fatalities constituted a large part of the 481,000 deaths that were estimated to occur across Africa.
At the risk of oversimplification, diabetes occurs when the body cannot effectively control its sugar levels. Virtually every cell and organ in the body depends on one simple sugar, glucose, for most of its energy needs. When the body’s glucose control mechanisms fail, the high concentrations of glucose wreak havoc all through the body. Cardinal symptoms to watch out for in diabetes are increased frequency of urination and increased thirst. The list of problems associated with, or caused by, diabetes is endless – male and female infertility, kidney failure, nerve damage, stroke, blindness etc. Newer studies are establishing correlations with Alzheimer’s disease, dementia, frozen shoulder and sleep apnea.
Figures from the International Diabetes Foundation (IDF) have indicated that 3.75 million people (ages 20 – 79) have diabetes in Nigeria. Of this number, 1.7 million people do not know they have the disease. These figures are underestimates as epidemiological data from Nigeria is only starting to improve. Nigeria, and much of Africa, now faces an increase in the incidence of non-communicable diseases like diabetes and hypertension. This upsurge in the face of known problems like malaria, HIV/AIDS et al is due to increased urbanisation and changes in lifestyle such as physical inactivity among urban dwellers and, surprisingly, in rural areas.
There are many forms of diabetes. Most people will have a form known as Type 2 Diabetes. It used to be called adult onset diabetes since it was not seen in children, however, rising rates of obesity in children have proved that diabetes is no respecter of youth. In addition to the millions of people who have established diabetes, a larger number have “pre-diabetes”. A person with pre-diabetes has not distinct symptoms, they only have a blood glucose level which is higher than normal – but not in the range of diabetes. Without adequate intervention, up to 70% of people with pre-diabetes will progress to Type 2 Diabetes within 10 years or less. Studies conducted among various Nigerian populations have reported pre-diabetes in populations as young as university undergraduates.
The good news is that not everybody with pre-diabetes has to develop full blown diabetes. Healthy changes in diet, body weight and exercise habits will prevent progression to diabetes and may even send pre-diabetic blood sugar levels back to their normal range.
A host of genetic and environmental factors are responsible for diabetes. However, not everybody with genetic predisposition to diabetes will develop the disease as environmental factors are more important. Thus, it is safe to say that diabetes is not curable but preventable. Several clinical trials and prevention programs have demonstrated that simple lifestyle modifications have the capacity to prevent diabetes. These benefits extend beyond the realm of diabetes and lower the risk of heart disease and some cancers.
So, If you have diabetes, what do you do?