Studies Show Hope For Millions Of Nigerians With Type 2 Diabetes

According to the International Diabetes Federation, 1.7 million Nigerians have type 1 and type 2 diabetes. This figure is about the same as the population of Bayelsa State.

The life of a type 2 diabetic man or woman in Nigeria consists of a regular doctor's visit, testing, and taking expensive drugs, tablets or injections. It's a life laden with financial, physical and emotional stress. But it is becoming increasingly clear that this does not necessarily have to be the case. Research over the past two years has conclusively shown that type 2 diabetes can be reversed.

Roy Taylor wrote in the Diabetes Care Journal of the American Diabetes Association: "Type 2 diabetes has long been considered inevitably progressive, requiring a growing number of oral hypoglycemic agents. [diabetic medication that lowers blood glucose levels] and finally insulin, but it is now certain that the process of the disease can be stopped with the restoration of normal metabolism of carbohydrates and lipids. "

According to the World Health Organization (WHO), the diagnostic criterion for diabetics is a blood glucose level of 6.5% and above. Therefore, it can be said that adults belonging to this group, once they are able to obtain a blood glucose lower than 6% or 42 mmol / mol over a given period and discernible, without taking any drug, diabetes or can be classified as having put diabetes in remission.

So how exactly can an adult with high blood glucose levels reverse this situation?

Experts have recently argued that the solution was based on a new understanding based on the results of extensive research into the causes of type 2 diabetes. The main argument of leading endocrinologists is simply that diabetes is a fat problem. Not just physical fat, because, as we know, thin people with a body mass index (BMI) of less than 18.5% may also have diabetes. This new understanding of FAT focuses on fats in the liver. When there is too much fat in the liver because of an excess of calories or the propensity to store fat around the organs, the liver reacts badly to insulin by producing too much glucose . But the problem does not stop there. As too much of the liver fat passes on the pancreas, the insulin-producing cells fail.

New research results led by renowned endocrinologists have recommended weight loss as a key strategy for reducing fat in the liver. Research shows that "losing less than one gram of pancreatic fat through diet can boost normal insulin production, thus reversing type 2 diabetes." [and] this reversal of diabetes remains possible for at least 10 years after the onset of the disease. According to one study, recommendations for recommended weight loss are 15 kg or 10% of a person's body weight. In doing so, experts argue that the fat from the liver and pancreas is reduced, allowing them to regain their normal function and thus normal insulin production. Some studies even show "a significant drop in liver fat content, which results in a normalization of hepatic insulin sensitivity within seven days of starting a hypocaloric diet in people with diabetes." type 2. "Professor Taylor says that if you lose weight and keep weight in the future, you will get rid of diabetes. Low-calorie diets, daily alternative fasting, high-fat diets or simply, diet and exercise are all recommended for fighting lipids and type 2 diabetes.

Why have not so many tried

So given this great opportunity to roll back diabetes, why are not more people doing the recommended lifestyle changes? Why are people still spending millions of nairas to buy medicine and / or experiment with traditional medicine options?

The answer is simple: it is difficult to reach and maintain the reversal.

Another reason is the perception of diabetes as a chronic degenerative disease leading to death. For example, a recent study exploring the psychological aspects of diabetes in Nigerian adults has revealed their negative perception and lack of commitment to achieve self-management of diabetes. The perception identified was "fear of dying from hypoglycemia, frustration and lack of control over the course of the disease". Indeed, this is correlated with global studies that observe that most people with diabetes perceive their disease as "progressive and incurable". So while diabetics consider that their condition is treatable, they perceive it as untreatable, which gives them a sense of helplessness.

Today, there are approximately 488 different licensed drugs in the world that have the sole purpose of lowering blood glucose levels in type 2 diabetics. However, experts note that most antidiabetic drugs aim to treat the symptoms and complications of the disease and not its cause. "The goal of most diabetes medications is to prevent the problems caused by diabetes, such as excessive thirst, hunger, urination, irritability, weakness and fatigue …. they relieve these symptoms, but they do so without making the body more receptive to insulin, which is causing 95% of type 2 diabetes cases. "

However, diet and exercise can do for those who want to go beyond the treatment of symptoms of type 2 diabetes. For those who manage to reverse it, it has physical, psychological and emotional benefits. not only for diabetic adults, but also for his entire family and the Nigerian community.

From an expert

Jokotade Adeleye, a lecturer at the endocrinology unit of the College of Medicine of Ibadan University, said that the organization of diabetes care in Nigeria was largely unsatisfactory at the present time. A multicentre study of 531 diabetics found that the majority of patients (nearly 70%) did not meet the recommended goals for glycemic control and control of coexisting cardiovascular risk factors. Knowledge of diabetes treatment among health care providers in Nigeria is generally poor at the primary and secondary levels. As a result, Ms. Adeleye added, the referral rate for university hospitals is very high and the atmosphere of many tertiary hospital clinics for people with diabetes in Nigeria is an overcrowded and understaffed clinic.

While emphasizing the centrality of management, Ms. Adeleye said that "self-management of diabetes is an integral part of success. Patient education is essential, we work closely with a group of nurses who do much of our diabetes education. Each patient newly presented to the outpatient clinic is referred to this unit, as well as patients from the hospital departments. Follow-up patients can also access health nurse educators afterwards. Unfortunately, the number of nurses is small compared to the number of patients. This forced them to organize group sessions in parallel with individual sessions. "

She added that "the state of diabetes in Nigeria is now considered a disease of public health importance in Nigeria. In a national survey of noncommunicable diseases in Nigeria published in 1992, the age-standardized prevalence of diabetes mellitus was 2.2%. The International Diabetes Federation (IDF) estimates that the gross prevalence of diabetes mellitus in Nigerian adults is 2.0%. These data are based on the extrapolation of data from other neighboring African countries, but it is thought that the burden would be heavier than that. A recently published systematic review and a meta-analysis of studies of the prevalence of diabetes mellitus among Nigerians reported a combined overall prevalence of 5.77%. "

Adeleye added that "the majority of Nigerians pay for their own health care. Diabetes mellitus has become an increasingly important cause of morbidity and mortality in Nigeria. The most common causes of morbidity and mortality in the hospital departments of the hospital where I work are diabetic foot ulceration and its consequences, hyperglycemic emergencies, diabetes-associated infections, and cerebrovascular disease. Morbidity and mortality are often exacerbated by late presentation and inability to pay for the cost of care. Chronic kidney disease and vision loss resulting from diabetes are also becoming more common. I think other centers have observations similar to ours. "

She concluded by recalling the importance of personal care. "Our unit is a strong advocate for patient education and has a tremendous benefit for our patients. In addition to the internal training of this group of nurses, we are looking for and looking for other opportunities in other centers with considerable experience in this area, to enable them to receive additional training and to be updating their knowledge. "