EMSON: Over 10m Nigerians Have Diabetes
As Nigeria participates in World Diabetes Day (WDD) with the rest of the world today, the Endocrinology and Metabolism Society of Nigeria (EMSON) has cautioned that there are over 10 million Nigerians living with the disease and the numbers are expected to double by 2030, if nothing is done urgently.
The Society also decried a situation where there are only 150 endocrinologists in a population of more than 220 million to manage the condition, adding that diabetes is a major cause of blindness, kidney failure, heart attacks, stroke, and lower limb amputation.
The alarming dearth of endocrinologists is worrisome, as these specialists and diabetologists investigate, diagnose and treat disorders of the endocrine system. Endocrinologists treat diabetes, a disease of the pancreas, and diseases that affect other endocrine systems such as the thyroid, pituitary gland, and adrenal glands.
WDD provides an opportunity to raise awareness about diabetes as a global public health issue and what needs to be done, collectively and individually, for better prevention, diagnosis, and management of the condition.
This year’s theme, ‘Access to Diabetes Education’, underpins the larger multi-year theme of ‘Access to Care’. Nine out of 10 diabetics have the Type 2 variant, a lifestyle disease linked to obesity and unhealthy living. The Type 1 variant is an unpreventable autoimmune disease that develops in childhood.
President of EMSON and a Consultant Endocrinologist/Physician at Lagos University Teaching Hospital (LUTH), Idi-Araba, Prof. Olufemi Fasanmade, told The Guardian that the burden of diabetes mellitus in Nigeria is increasing.
“In the 1960s to 1970s, diabetes was found in only 0.5-1 percent of adults in Nigeria. In the 1980s to1990s, the figures rose to 1.4-2.2 percent of adults. Currently, there is about 5.7 percent of adults affected with diabetes, and 10 to 15 percent with pre-diabetes.
“In urban towns and cities in Nigeria, one in 10 adults have diabetes and we have just 90 to 100 million adults in Nigeria. Almost 10 million people in Nigeria have diabetes, while 30 percent of people with hypertension also have diabetes.
“The total number of people in the country with diabetes is the highest in sub-Saharan Africa. Higher than the number of tuberculosis, Human Immuno-deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS), and COVID-19 put together. Diabetes kills more people in Nigeria than COVID-19, tuberculosis, HIV/AIDS, and cancer put together,” he said.
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Fasanmade added that diabetes remains the commonest cause of lower limb amputation and chronic kidney disease. “There are only 150 practicing endocrinologists in Nigeria, which is about 1:1,000,000,” he said.
Commenting on the cost of living with diabetes, Fasanmade said: “Diabetes is a very costly condition. In Nigeria, a typical patient with it will spend N20,000 to N30,000 to properly control it. This is the minimum and covers medications, blood tests, and clinic attendance. When complications like kidney disease come into the picture, some patients have a monthly expenditure of N100,000 to N150,000.
“In the United States, up to $300 billion is spent on diabetes per annum. The figures for total diabetes expenditures in Nigeria are uncertain. One vial of insulin is N6,000 to N10,000 and patients use one or two per month.
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“A box of strips for testing blood sugar is about N6,000 and patients need one or two per month. Some tablets are as cheap as N2,000 per month and others as high as N30,000 monthly. Usually, patients are on two to three of the drugs.”
On factors fueling an increase in the number of diabetic cases, Fasanmade said western lifestyle, smoking, and drinking are risk factors.
“Western lifestyle is very harmful in that it encourages sedentary life, consumption of calorie-dense food (fast food and soft drinks) and stress. Unfortunately, people exercise less nowadays and they resort to cars, cabs, and bikes for even the shortest of distances leading to increasing obesity, which is another risk factor for developing diabetes,” Fasanmade said.
The endocrinologist, while admitting that there is no clinically available cure for diabetes, added that there are just a few reports of largely impracticable experimental cures such as transplants of the whole pancreas, or islet cells of the pancreas to people, “But getting a pancreas is not easy and the operation comes with its own challenges.”
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He stressed that diabetes, like hypertension and many other non-communicable diseases, are degenerative or chronic diseases, which have to be managed since they are lifelong conditions, “In future, however, there may be a cure, but presently there is none.”
While regretting the absence of a current population-based national prevalence figure for diabetes in the last 20 years to aid national health planning, policies, and financing, Fasanmade said the last true national prevalence of diabetes was given in 1992 as 2.24 percent. And the prevalence estimates given by the International Diabetes Federation for Nigeria over the years have relied mainly on data extrapolated from other countries with similar socio-demographic characteristics as Nigeria.
“Right now, there is a serious dearth of skilled diabetes personnel across the country,” he said, adding that diabetes research is currently inadequately funded in Nigeria and there is inadequate public enlightenment and support for diabetes prevention and care at all levels.
According to the World Health Organisation (WHO) Fact Sheet on Diabetes, “in 2014, 8.5 percent of adults aged 18 years and older had diabetes. In 2019, diabetes was the direct cause of 1.5 million deaths and 48 percent of all deaths due to diabetes occurred before the age of 70 years. Another 460,000 kidney disease deaths were caused by diabetes, and raised blood glucose causes around 20 percent of cardiovascular deaths.
“Between 2000 and 2019, there was a three percent increase in age-standardised mortality rates from diabetes. In lower-middle-income countries, the mortality rate due to diabetes increased 13 percent.
“By contrast, the probability of dying from any one of the four main non-communicable diseases (cardiovascular diseases, cancer, chronic respiratory diseases, or diabetes) between the ages of 30 and 70 decreased by 22 percent globally between 2000 and 2019.
“A healthy diet, regular physical activity, maintaining normal body weight, and avoiding tobacco use are ways to prevent or delay the onset of type 2 diabetes.
“Diabetes can be treated and its consequences avoided or delayed with diet, physical activity, medication and regular screening and treatment for complications.”
SOURCE: The Guardian
