Diabetes: Why should increasing incidence be urgently reduced?

By Vivian Ihechu

When diabetic medical experts met in Lagos on October 25, this year, they needed to critically examine the growing incidence of diabetes in the country and in the African region.

They met at the 2018 Sanofi Diabetes Summit to suggest ways to fight the disease.

According to them, more and more people contract the disease if measures are not put in place to remedy the situation.

In explaining what the disease is, the Diabetes Research Institute at the University of Maimi in the United States says everyone needs carbohydrate foods because they provide our body with its primary source of energy.

When we eat these foods, including bread, cereals, pasta, rice, fruits, dairy products and starchy foods, the body turns them into glucose.

Glucose circulates in the body in the blood; some is taken in our brain to help us think clearly and function.

The remaining glucose is routed to the cells of our body for energy and also to our liver, where it is stored as energy used later by the body.

For the body to use glucose as energy, insulin is needed. insulin is a hormone produced by beta cells of the pancreas.

Insulin works like a door key. it attaches to the "doors" of the cell, opening them to allow glucose to move from the blood flow through the door and into the cell.

If the pancreas is not able to produce enough insulin (insulin deficiency) or if the body can not use the insulin it produces (resistance to Insulin), glucose accumulates in the blood (hyperglycemia) and diabetes mellitus develops.

Diabetes mellitus means high levels of sugar (glucose) in the blood and in the urine. Its complications affect the eyes, kidneys, nerves, heart and blood vessels and can eventually lead to death.

Concerned about the increasing incidence of diabetes in the country and region, they jointly called for increased awareness of the disease, as well as the provision of care as part of the health care plan for the needy , disadvantaged and vulnerable living with diabetes in Nigeria.

JeanClaude Mbaya, professor of medicine and endocrinology at the University of Yaoundé, Yaoundé (Cameroon), said: "In Cameroon, we have a population of about 20 to 21 million people and nearly a million people have diabetes.

"In Nigeria, it's almost the same percentage when you calculate the percentage based on the correct percentage of the population; it's huge.

"However, the problem is that the rate of people likely to develop diabetes is greater by about 10%. which means that in 50% of cases, about 50% of them will develop diabetes, "he said.

Mbaya said that the fight against diabetes is a concern of the entire government with a multi-sectoral approach.

"It's the responsibility of every government to take care of the health of its people, so we have to hold our government accountable.

"The fight against diabetes is not just for the Ministry of Health; the Ministry of Health is there to open clinics, train doctors and ensure that people who already have the disease do not develop complications

"Diabetes prevention also involves the Ministry of Urban and Urban Planning, for example.

"The way we build our roads, our cities and our schools is extremely important because we have to build cities with sidewalks, secondary roads with bike lanes. These are some of the ways we can improve.

"Individually, people have to exercise, I'm not just talking about jogging on the road; I mean, being physically active, we have to walk more, but in a city like Lagos, how can you walk more? "

He called for prioritizing choices by saying, "Preventive measures should be put in place because prevention is easier than dealing with or managing.

"We spend a lot of money on things that can be abandoned, mortgaging the lives of our people; we make the wrong choices by not taking care of the health of our population.

"We need to change this paradigm and if the government does not change it, we decide not to vote them in power," Mbanya said., who is also a The former president of the International Diabetes Federation told NAN.

Professor Sam Dagogo-Jack, professor of endocrinology, said that urbanization, insomnia, stress, depression and carbon monoxide in the atmosphere were some of the risk factors associated with the rise of diabetes cases in Nigeria and around the world.

Dagogo-Jack, who belongs to the Health Sciences Center at the University of Tennesse (USA), said that HIV, tuberculosis, high blood pressure, antibiotic use, obesity, overweight and environmental influences also contributed to increased incidence of diabetes.

Dr. Olufemi Fansamade of Lagos University Hospital Center (LUTH), Idi-Araba (Lagos), agreed that changing our way of life was the reason people are more likely to get diabetes.

"Before, we were very physically active, people were healthy, fit and walked a lot, but currently, very few people walk.

"Bad roads do not help either and people use excuses like rain, bumpy roads and not exercising.

"The children are growing up and the schools are getting smaller and the fields are disappearing," he said.

Fasanmade added: "So many schools do not even have a playground; before, the children played at 13h, 14h. or 15 hours; they are still going for an extra lesson and on returning home they do their homework.

"Nowadays, children spend time playing games on their phones and laptops.

"As a result, we are becoming less and less physically active, resulting in increased weight for children and adults, leading to increased rates of diabetes and hypertension.

"It is urgent to change the story."

The endocrinologist said the treatment options were individualized.

"There are many medications to choose from, there are a lot of lifestyle changes and the lifestyle differs even from one person to the next.

"So, lifestyle changes are individualistic, drugs are too," he said.

Professor Felicia Anumah, also a professor of endocrinology at Abuja University, said that diabetes education is very important for empowering patients.

"We need to educate them about risk factors, physical activity, diet, and foot care.

"The only option for diabetes is prevention and that's why awareness is important," she said.

In addition, Dietitia Chima, a registered dietitian and nutritionist, said diabetic patients and their loved ones should make healthy food choices, understand portion sizes, and know the best times to eat.

"It helps the patient control their weight and get good control of blood glucose, cholesterol, and even blood pressure.

"The management of diabetes by patients involves food, exercise and medication. we need to plan food intake and insulin / medications needed to manage blood sugar. "

"You also need to find a balance between food and insulin / drugs; too much food (or too little insulin / oral medication) can increase blood sugar; too little food (or too much insulin / oral medication) can lower blood sugar, "said Chima.

"Regular physical activity also lowers blood sugar and improves insulin function," Chima said.

Ms. Folake Odediran, Executive Director of RX and President of Sanofi in Nigeria and Ghana, said that although various stakeholders were making significant contributions in their respective areas to improve treatment outcomes, gaps remained.

"These gaps include policy direction, public awareness, advocacy, patient education, diagnosis, infrastructure, and the overall capacity of the health system to effectively manage this disease.

"As a leader in diabetes care, Sanofi will continue to prioritize partnerships and public-private initiatives that support the rapid achievement of universal health coverage for diabetic patients," said Odediran.

The NAN states that Nigeria is one of 32 countries in the African region of the International Diabetes Federation (IDF).

According to IDF, 425 million people worldwide have diabetes and more than 16 million people in the AFR region. By the year 2045, it will be about 41 million. An estimated 1,702,900 cases of diabetes in Nigeria in 2015.