WORLD HEALTH DAY 7 APRIL 2016: BEAT DIABETES
Today is marked as the International World Health Day. This World Health Day, 7 April, the World Health Organization has selected as its theme ‘Beat Diabetes’. As part of its Health and Wellbeing Programme, SpringAid International Development (SAID) is joining the International Community in marking this year’s World Health Day through screening exercises reaching over three hundred person in Ihitte Uboma in Imo state. According to the WHO the number of people living with diabetes has almost quadrupled since 1980 to 422 million adults, with most living in developing countries. Factors driving this dramatic rise include overweight and obesity. WHO is marking its annual World Health Day (7 April), which celebrates the Organization’s founding in 1948, by issuing a call for action on diabetes.
In its first “Global report on diabetes”, WHO highlights the need to step up prevention and treatment of the disease. Diabetes is a chronic, progressive noncommunicable disease (NCD) characterized by elevated levels of blood glucose (blood sugar). It occurs when the pancreas does not produce enough of the insulin hormone, which regulates blood sugar, or when the body cannot effectively use the insulin it produces. The complications of diabetes can lead to heart attack, stroke, blindness, kidney failure and lower limb amputation.
There are three main forms of diabetes: type 1, type 2 and gestational diabetes. The cause of type 1 diabetes is unknown and people living with it require daily insulin administration for survival. Type 2 accounts for the vast majority of people living with diabetes globally, and is largely the result of excess body weight and physical inactivity. Once seen only in adults, type 2 diabetes is now increasingly occurring in children and young people. Gestational diabetes is a temporary condition that occurs in pregnancy and carries long-term risk of type 2 diabetes. Gestational diabetes is present when blood glucose values are above normal but still below those diagnostic of diabetes.
Diabetes mellitus type 2, a metabolic disorder also known as “non–insulin–dependent diabetes”, is the most common and the most alarming type of diabetes worldwide (IDF Atlas 2013:22). Diabetes mellitus type 2 is a chronic and non-communicable disease (NCDs) that usually has a gradual onset; in most cases, clinical symptoms and diagnosis occur several years before the beginning of the disease (The International Expert Committee on Diabetes 2009: 1327). The cause is that the body either resists the effects of insulin or the pancreas does not produce enough insulin to circulate the blood glycogen (sugar) into the body cells. This may lead to high blood glucose level (hyperglycemia) that causes serious damage to the cells and tissues, which when accompanied by multiple complications such as Blindness, Kidney failure, Foot ulcer, Limp amputation, Charcot joints, sex and autonomic dysfunction and infectious disease can led to death or a double burden if it remains untreated (IDF Atlas 2013:22). Persons with diabetes mellitus type 2 may experience signs like an excessive excretion of urine, thirstiness, constant hunger, weight loss, vision change and fatigue.
The main cause of diabetes mellitus type 2 is not yet known. However, factors like obesity, poor diet, physical inactivity, advancing in age, family history diabetes, ethnicity, and high blood glucose during pregnancy are known risk factors for developing diabetes Mellitus type 2(IDF Atlas 2013, 23). The diabetes type 2 is a complex disease due to its multiple causes and management. However, it could be treated with oral medication and insulin. Most people with type 2 diabetes do not need daily doses of insulin injection or oral medication to survive, but rather can improve their situation through healthy diet and physical exercise.
The most dangerous diseases in Nigeria as well as in many other African countries are communicable diseases like Malaria, Tuberculosis (TB), and HIV/AIDS, etc. However, in recent years, non-communicable diseases like diabetes Mellitus, cancer, and cardiac disease, and chronic respiratory disease, musculoskeletal and mental disorder have emerged as major public health hazards in Nigeria (Maiyaki/ Garbati 2014:1ff). Recent studies in some rural areas of Nigeria have also indicated increased cases of non-communicable diseases among the rural population. Diabetes alone is projected to cause about 52% of all mortalities in Nigeria in the near future if no serious action is taken to combat the spread (Ekpenyoung, et al. 2012: 251).
In Africa, the spread of the disease is rapidly rising. Approximately 20 million people are currently suffering from the disease and it is estimated to increase to 41.4 million by 2035 (IDF Atlas 2013:55), with an estimated increase rate of 109% by the next 20 years. The fact that many African countries lack the means to effectively combat the disease, it is not surprising that Africa has a high estimate of 63% of undiagnosed diabetes and roughly 522,600 diabetes related deaths every year (IDF Atlas 2013: 11). It has to be stated however that there are few Data on the prevalence of diabetes mellitus type 2 in Africa. The most of the diabetes burden in seems to be type 2 diabetes Mellitus and only about 10% diabetes incidences in Africa are type 1 diabetes, with a gradient variation between the Urban to rural dwellers (Olokoba 2012: 268). Most of the affected persons are between the ages of 40 – 59years (IDF Atlas 2013:34).
In Nigeria, data on the level of prevalence of diabetes mellitus type 2 are few and often imprecise (Chinenye 2012:559). Many authors strongly believe that this disease poses serious health challenge to Nigeria (Ekpenyoung et al. 2011:17f, Ogbera et al. 2006:30ff). The International Diabetes Federation (IDF) estimated that approximately 3.9 million people are suffering from diabetes mellitus in Nigeria, a national average prevalence of 4.9%. The figure is expected to increase, considering the fact that there are many undiagnosed cases (IDF Atlas 2013:56). Nigeria, in relation to other sub-Sahara African countries, has the highest number of diabetic patients (Mbanya 2006: 273). Chinenye and Ofoegbue estimated that about 96% of adult diabetes patients in Nigeria have diabetes mellitus type 2 (Chinenye/ Ofoegbue 2011: 25).
In Nigeria today, communicable diseases such as HIV/AIDS, TB, Diarrhoea, Meningitis, Hepatitis, Malaria, Dengue, Typhoid fever, and Yellow fever are still the major sources factor of suffering, mortally and morbidity (CIA World Factbook 2015). Nonetheless, Nigeria is experiencing a transition from communicable to non-communicable diseases. The new epidemic of non-communicable diseases such as cardiovascular disease, cancer, respiratory disease and diabetes mellitus which have preventable causes, do not replace the burden of Communicable diseases in Nigeria, but rather poses a double burden of disease (Yach et al 2004:2617, Marquez/Farrington 2013:1f). According to Howitt, NCD has been projected to become the leading cause of death in Nigeria by the year 2030.
Approximately 50% of Nigerians with diabetes type 2 have no symptom and their diabetes remains undiagnosed for many years. As a result, most newly diagnosed diabetes patients have already complications before diagnosis (Chinenye 2015:20).
In spite of the progress in NCD awareness, there are still enormous lingering challenges to tackling diabetes in Nigeria. Encouragingly, Nigeria has partially implemented the national diabetes and NCDs plans, but there are no diabetes prevention primary healthcare plan nationwide (IDF 2014:24). With the prevalence of diabetes and its associated morbidity and mortality, preventive measures and effective treatments are being now recognized in Nigeria. In the 90s diabetes disease was not well known in Nigeria. It was attributed to “curses” and “hexes”, and was diagnosed only through blood or urinary test for glucose. Presently, oral hypoglycemic medications are more easily accessible and acceptable to the patient suffering from diabetes mellitus type 2 than insulin (Okeoghene/Ekpebegh 2014: 908). In practice, however, this knowledge is not well utilized due to ineffective hospital financing system, lack of affordable universal health insurance and poor health system. Diabetic patients seeking hospital treatment have to travel long distances and must pay out-of-pocket. Consequently, many patients who cannot pay the exorbitant hospital bills or lack the means of transportation are bracketed out of hospital care (Chinenye et al. 2012:562). The diabetes mellitus type 2 patients especially in rural areas who have no access to hospitals, seek for treatment from traditional medicine practitioners, buy their medication from chemists and medication stores; sometimes they even avoid treatment, thus, worsening their health conditions (Aikins 2005:739ff). Most Nigerian diabetes patients have cases of suboptimal glycemic control, hypertension and chronic complication (Chinenye/Young 2011:101).
Measures needed include expanding health-promoting environments to reduce diabetes risk factors, like physical inactivity and unhealthy diets, and strengthening national capacities to help people with diabetes receive the treatment and care they need to manage their conditions.
“If we are to make any headway in halting the rise in diabetes, we need to rethink our daily lives: to eat healthily, be physically active, and avoid excessive weight gain,” says Dr Margaret Chan, WHO Director-General. “Even in the poorest settings, governments must ensure that people are able to make these healthy choices and that health systems are able to diagnose and treat people with diabetes.”
Please support our awareness and screening activities in communities in Nigeria. You could do this by contacting us and choosing the community where you want us to conduct the activity. To beat Diabetes, we all need to engage and promote healthy life style and living.
For More Information
Contact: Sr Innocent Omumu
SpringAid International Development (SAID)