How lifestyle, late detection fuel diabetes crisis in Nigeria

As Nigeria joins the rest of the world to commemorate World Diabetes Day(WDD), marked annually on Nov. 14, health experts have warned that changing lifestyles and late detection are fuelling a diabetes crisis in the country. WDD is commemorated to raise awareness on prevention, early detection and care. Diabetes Mellitus, a chronic metabolic condition characterised by elevated blood sugar due to inability of the pancreas to produce enough insulin or impaired insulin action, has become a major public health concern, with complications including blindness, kidney failure, heart failure, stroke and limb amputation.

According to the International Diabetes Federation (IDF) Diabetes Atlas, globally no fewer than 589 million adults live with diabetes, with 24.6 million in Africa. About 11 million adults live with the condition in Nigeria, with many unaware of their status. Experts said the disease, which could remain undetected for years without symptoms, was now killing more Nigerians than malaria, HIV and tuberculosis combined.

An Endocrinologist, Prof. Michael Olamoyegun, said diabetes killed more Nigerians than malaria, HIV and tuberculosis combined. Olamoyegun is Professor of Medicine and Endocrinology at Ladoke Akintola University of Technology and also Consultant Physician and Endocrinologist at LAUTECH Teaching Hospital, Ogbomoso, Oyo State. He said diabetes is a metabolic disorder of carbohydrates, fats and protein.

He added that it is characterised by elevated blood sugar due to inability of pancreas to produce enough insulin. According to him, diabetes also occurs if insulin action is impaired. He said there are many variants but three main types existed – Type 1, Type 2 and Gestational Diabetes. ” Type 1 diabetes, which occurs due to absolute deficiency of insulin, is seen mainly in younger age group, usually less than 30 years, although occasionally in adulthood.

“It is found in about five to ten per cent of all individuals with diabetes. “This group is managed with insulin injections since the body no longer produces insulin.” The endocrinologist said Type 2 diabetes represented 90 to 95 per cent of individuals with diabetes, stressing it occurred when insulin was not able to function well in the body. He also noted that it usually occurred in older individuals who had family history in first-degree relatives.

Olamoyegun, also the Secretary General of the Association of Clinical Endocrinologists of Nigeria (ACEN), added that hypertension, overweight or obesity and sedentary lifestyles were contributory risk factors. He said it is usually managed with oral medications, dietary control and occasionally with insulin. On gestational diabetes mellitus, he said it was first detected in pregnancy, saying it complicated about 7.5 to 12 per cent of all pregnancies.

He explained that diabetes in pregnancy made it high risk as it could worsen outcomes for mother and foetus. On prevalence, he said the number of people living with diabetes had increased worldwide and in Nigeria. “Globally, more than 600 million people are living with diabetes, 25 million in Africa, while seven per cent, that is 11 million adults older than 18 years, in Nigeria have diabetes.

“Most people with diabetes are unaware of their status. “The number of Nigerians living with diabetes increased by more than 21 per cent in last five to six years. “In Nigeria, most individuals with diabetes are aged 45 to 59 years (mostly productive years). “At least 15 to 20 per cent of people admitted into medical wards in most tertiary hospitals in Nigeria have diabetes and they usually have one complication or another,” he said.

“Globally, diabetes kills one person every five to six seconds, every 30 seconds, someone’s leg is amputated due to diabetes. “Nigeria has one of highest rates of amputation due to diabetes in the world and most amputations are major amputations, below or above the knee,” he said.