Nigeria

The recent alarm by the World Health Organisation, WHO, on the African leaders not to be complacent in the fight against diabetes, which it described as a silent killer in Africa, is seen as a wake up call for Nigerians, particularly those in the health sector.

The WHO’s Regional Director for Africa, Dr. Matshidiso Moeti, in a message to commemorate the 2024 World Diabetes Day, said records indicated rising diabetes prevalence in Africa, complicated by multiple drivers, including urbanisation, unhealthy diets and physical inactivity, among others.

She expressed fear that the number of people living with diabetes in Africa could likely rise to 54 million in 2045, the highest projected increase globally, if urgent actions were not taken to mitigate it.

She noted that in Africa, more than 24 million adults are currently living with diabetes, half of whom remained undiagnosed.

“Against a background of the rising diabetes prevalence in Africa, complicated by multiple drivers, including urbanisation, unhealthy diets and physical inactivity, the theme appropriately emphasises the imperative of a collaborative approach to this ‘silent killer.’

“Without urgent interventions, predictions are that the number of people living with diabetes in the African region will rise to 54 million by 2045, the highest projected increase globally,” she said.

She stressed that the challenge is compounded by the fact that Africa has the lowest investment rate in diabetes care worldwide, at only one percent of the region’s health expenditure. She added that health systems were also traditionally designed to deal with acute, infectious diseases, without sufficient attention paid to chronic diseases like diabetes.

“Managing diabetes requires a sustained effort to balance physical health activity, healthy diet, and mental well-being. And WHO in the African Region is committed to holistic solutions, including proper nutrition, access to requisite essential medicines, and mental health support.

“Equally crucial are comprehensive prevention strategies to address risk factors, including obesity, poor diet and physical activity, combined with community engagement to ensure good support systems and reduced stigma,” she added.

She urged individuals, communities, governments, health workers, policymakers and civil society organisations to join hands and act on the recommendations to strengthen the fight against diabetes.

“For individuals, please prioritise healthy lifestyle, and if you’re already living with diabetes, have regular medical check-ups. Communities can also play good roles by creating supportive environments that promote healthy living, reduce stigma, and provide access to affordable diabetes care and education.

“For governments, we commit our full support to your efforts to implement policies that enhance access to essential medicines, strengthen primary health care systems, and foreground investment in diabetes prevention and care.

“Strengthening diabetes control in the African region demands that we address key gaps, including myths and misconceptions about diabetes, fragile primary health care systems and insufficient capacity and training of health care workers.

“Together, let us all commit to breaking down the barriers and addressing the gaps, by raising awareness, spreading knowledge, and creating lasting change for everyone in Africa affected by diabetes,” she said.

However, considering the global indices, the concern is how to prevent its rise in Nigeria, which according to report, has been gradually increasing.

It is estimated that the prevalence rate in Nigeria in 2024 is standing at 3.46 percent of the adult population.

The WHO attributes the increase to lifestyle changes caused by urbanization, industries producing unhealthy diets, including sugar-sweetened drinks, lack of exercise, tobacco use, and harmful use of alcohol, among others.

It was also reported that the prevalence of diabetes in Nigeria varies by region, with the highest rates in the South-South zone and the lowest in the North-Central zone.

According to the figure, South-South has 9.8 percent, South East has 4.6 percent, and South West has 5.5 percent, while the North Central, North East and North West, each has 3.8 percent, 5.9 percent and three percent, respectively.

Contributing to the discourse, Dr Uche Okenyi of the Hova’s Place Hospital, Festac, Lagos, stressed that the first step to address the concern of the WHO is for Nigerians to understand what diabetes is all about and the common causes.

He is also of the opinion that African countries, including Nigeria, must wake and put concerted effort to aggressively tackle the menace, otherwise what the WHO predicted would come to pass.

He described diabetes as an ailment that results from a lack of endogenous insulin, which can result in far reaching metabolic derangement that can attack the kidneys, eyes, nerves, heart and brain because of its effect on blood vessels. He equally noted that it is of two types, Type 1 and Type 2.

Type 1, according to him, mostly affects adolescents but can occur at any age and results from insulin deficiency due to self destruction of the cells producing insulin in the pancreas.

“Type 2 mainly affects adults, mostly over 40 years of age, and is due to reduced insulin secretion/increased insulin resistance that are associated with obesity, calorie and excess alcohol intake and lack of exercise,” he told DAILY POST.

He listed other causes of diabetes to include drugs, like steroids, and retroviral drugs, among others, as well as diseases, like hyperthyroidism and conditions like pregnancy.

In all of this, he emphasized that both the individual, corporate organisations and the government all have roles to play in ensuring that the prevalence of diabetes is drastically reduced and also in ensuring that WHO’s prediction does not come to reality.

On the role of the government, he said: “For Type 1 diabetes mellitus, there is basically little the government can do. But, for Type 2 DM, because of the fact that the causes are mostly exogenous, the government can aggressively pursue awareness campaigns to educate people on the risk factors and what to do to avoid its risks, advice on consumption patterns, exercise and lifestyle changes.

“The government should also properly fund the healthcare sector so that disease conditions that can lead to the development of diabetes could be properly managed.”

He also charged the corporate organisations to take the health of their staff seriously, saying, “Corporate organisations should organise health talks for their staff regarding proper lifestyles and structure their work schedule to allow the staffers have time to exercise. They should also support the government in the funding of the health sector.”

He equally stressed that individuals also need to play their roles. He said: “People should not overindulge alcohol, calories etc, and should exercise regularly. They should also seek early and proper medical care for conditions that can predispose them to diabetes mellitus.”

Also, Dr Innocent Emeka, of Divine Hospital, Ojo area of Lagos State, advocated for increased education, and access to diagnostic tools and medicines, particularly insulin, as the most urgent areas of work to detect diabetes.

He explained that if the disease was left unchecked, and without management and lifestyle changes, diabetes could lead to several debilitating complications.

“Unfortunately, response efforts are constrained by the fact that more than one in every two people in Africa living with diabetes mellitus has never been diagnosed.

“We commit our full support to the requisite training of health workers in the prevention and management of non-communicable diseases at community levels, to improve the availability of these services,” he told our correspondent.