By Doris Obinna
Nigeria on Monday, November 14, 2022, joined the international community to commemorate the World Diabetes Day (WDD) to raise awareness of the growing burden of diabetes and strategies to prevent and manage the threat.
WDD provides opportunity to raise awareness of 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.” It highlighted the importance of prevention and response efforts.
Diabetes according to Dr. Sunday Olaleye, is a group of diseases that result in too much sugar in the blood (high blood glucose): “With diabetes, your body doesn’t make enough insulin or can’t use it as well as it should.
“When there isn’t enough insulin or cells stop responding to insulin, too much blood sugar stays in your bloodstream. Over time, that can cause serious health problems, such as heart disease, vision loss, and kidney disease.
“A recent meta-analysis reported that approximately six million of adult Nigerians are living with diabetes mellitus. This figure has been likened to a tip of an iceberg as it is estimated that two-thirds of diabetes cases in Nigeria are yet undiagnosed.”
World Health Organisation (WHO) Regional Director for Africa, Dr Matshidiso Moeti, said: “Africa’s diabetes statistics illustrate the depth of the challenge, 24 million adults are currently living with diabetes, with that number predicted to swell by 129 per cent to 55 million by 2045.
“Last year, diabetes mellitus took the lives of 416,000 people on the continent and is forecast to become one of the leading causes of death in Africa by 2030. Importantly, diabetes is the only major non-communicable disease (NCD) for which the risk of dying early is increasing, rather than decreasing.
“Known risk factors include family history and increasing age, along with modifiable risk factors such as overweight and obesity, sedentary lifestyles, unhealthy diets, smoking and alcohol abuse. Unfortunately, these modifiable risk factors are on the rise across all countries in the WHO African Region.
“Response efforts are constrained by the fact that more than one in every two people in Africa living with diabetes mellitus has never been diagnosed. Increased access to diagnostic tools and medicines, particularly insulin, is one of the most urgent areas of work.
“Left unchecked, and without management and lifestyle changes, diabetes can lead to several debilitating complications. These include heart attack, stroke, kidney failure, lower limb amputation, visual impairment, blindness, and nerve damage. People with diabetes are also at higher risk for severe COVID-19 symptoms.
“To accelerate progress on diabetes and other NCDs, WHO developed the global diabetes compact. Its vision is to reduce the negative impacts of the disease, and ensure that everyone living with diabetes has access to equitable, comprehensive, affordable, and quality treatment and care.”
Also, the United Nations disclosed that globally, an estimated 422 million adults were lived with diabetes in 2014, compared to 108 million in 1980: “The global prevalence of diabetes has nearly doubled since 1980, rising from 4.7 per cent to 8.5 per cent in the adult population. This reflects an increase in associated risk factors such as being overweight or obese. Over the past decade, diabetes prevalence has risen faster in low and middle-income countries than in high-income countries.
“Diabetes is a major cause of blindness, kidney failure, heart attack, stroke and lower limb amputation. Healthy diet, physical activity and avoiding tobacco use can prevent or delay type 2 diabetes. In addition diabetes can be treated and its consequences avoided or delayed with medication, regular screening and treatment for complications.”
International Diabetes Federation (IDF) Diabetes Atlas Tenth edition 2021, which provides the latest figures, information and projections on diabetes worldwide, stated that approximately 537 million adults (20-79 years) are living with diabetes:
“The total number of people living with diabetes is projected to rise to 643 million by 2030 and 783 million by 2045, three in four adults with diabetes live in low and middle income countries and almost one in two (240 million) adults living with diabetes are undiagnosed while diabetes caused 6.7 million deaths.
“Diabetes caused at least $966 billion in health expenditure – nine per cent of total spending on adults, more than 1.2 million children and adolescents (0-19 years) are living with type 1 diabetes, one in six live births (21 million) are affected by diabetes during pregnancy while 541 million adults are at increased risk of developing type 2 diabetes.”
Olaleye continued: “The exact cause of most types of diabetes is unknown. In all cases, sugar builds up in the bloodstream. This is because the pancreas doesn’t produce enough insulin. Both type 1 and type 2 diabetes may be caused by a combination of genetic or environmental factors.”
He said: “The first signs of being diabetic are; urinating often, feeling very thirsty, feeling very hungry-even though you are eating, extreme fatigue, blurry vision, cuts/bruises that are slow to heal, weight loss-even though you are eating more (type 1) and tingling, pain, or numbness in the hands/feet (type 2).”
Access to diabetes care
According to the United Nations, 100 years after the discovery of insulin, millions of people with diabetes around the world cannot access the care they need: “People with diabetes require on going care and support to manage their condition and avoid complications.
“The centenary of the discovery of insulin presents a unique opportunity to bring about meaningful change for the more than 460 million people living with diabetes and the millions more at risk. United, the global diabetes community has the numbers, the influence and the determination to bring about meaningful change. We need to take on the challenge.”
Foods that cause diabetes
Olaleye stated that heavily processed carbohydrates foods made with white flour, white sugar and white rice are low in bran, fiber, vitamins and minerals. Examples include breads, muffins, cakes, crackers and pasta:
“Drinks sweetened with sugar, sodas, sweet tea, fruit drinks, and lemonade can lead to weight gain and increase your risk of getting type 2 diabetes. Having just two sugar-sweetened drinks per day can increase your risk of type 2 diabetes by as much as 26 per cent.
“Also, saturated fats are found in dairy products such as butter, whole milk, cream, and cheese as well as fatty meats. Trans fats are tied to fried foods (fast food restaurants, “bar” food) and packaged baked goods.
“Processed meats such as hot dogs, bacon, and deli meats have higher levels of sodium and nitrites, which put you at not only higher risk of type 2 diabetes but heart disease.”
He advised on some healthy alternatives, which include, snacking on nuts, not sweets, eating lean meats and/or poultry and removing the skin: “Avoiding salad dressings such as blue cheese, ranch and thousand island and using olive oil and balsamic vinegar instead and cooking and baking with olive or canola oils.”