DIABETES MELLITUS IN NIGERIA – A SWEET KILLER ON RAMPAGE!
Introduction
Diabetes Mellitus (commonly called ‘diabetes’) is a chronic disease of metabolism characterised by high level of sugar in the blood. It is not excessive consumption of sugar that causes diabetes. Rather, it is the inability of the body to properly process sugar that is in the blood that gives rise to the symptoms of the disease.
Diabetes is a potentially devastating disease, if not managed properly. It has the capacity to affect all parts of the body from the eyes to the feet.
Prevalence of diabetes mellitus in Nigeria is put at between 4.5% – 5.77%, this translates to a burden of about 12million people in the country that are afflicted with this disease. In 2020, WHO estimated that diabetes mellitus accounted for about 1.52% of all deaths in the country, representing a figure of almost 25,000 deaths from the disease in that year.
Common Factors that Promote the Development of Diabetes Mellitus Among Nigerians
Urban dwelling. Studies have severally demonstrated that sub-Saharan Africa with Nigeria at the epicentre has one of the fastest rates of change in the number of urban dwellers around the world. This change comes with up to three-fold increase in the risk of diabetes.
Physical inactivity & sedentary lifestyle
Dietary in-balance [unhealthy diet]
Family history.
Other specific factors may lead to diabetes mellitus
Obesity
Alcoholism
Regular intake of steroids
Pregnancy
What goes wrong in the body when there is diabetes?
Normally, the human body has a mechanism in place that ensures that glucose (sugar) in the blood stream is absorbed inside the cells of the body. These cells are mainly muscle cells (myocytes) and fat cells (adipocytes). In these cells, glucose is then stored in a special form called glycogen. In diabetes, however, due to an in-balance in the level or action of a chemical called ‘insulin’, glucose (sugar) in the blood is unable to be pushed inside these cells and gets accumulated in the blood stream. When the blood glucose gets high from this challenge, diabetes mellitus sets in.
Insulin is the special chemical produced by the pancreas which helps in pushing glucose into the body cells. Diabetes arises when:
The level of insulin produced by the pancreas is low or the pancreas is unable to produce insulin e.g if the pancreas is injured or diseased
The body cells are not responding to insulin
Types of Diabetes Mellitus
Diabetes mellitus can be classified into different types. E.g insulin dependent (type 1), non-insulin dependent (type 2), gestational diabetes (Diabetes mellitus that develops during pregnancy).
However, irrespective of the classification, treatment of diabetes follows the same principles.
Diabetes mellitus has 4 major symptoms
Polyuria: Excessive, frequent urination
Polydipsia: Thirst and drinking water excessively
Polyphagia: Excessive hunger
Weight loss: despite a good appetite and adequate feeding
Other relatively common symptoms that patients can notice are
Noticing ants invading urine recently passed
Blurred vision [this will return to normal after blood sugar level is controlled]
Skin infections, especially by fungal organisms
Poor wound healing; sores take unusually long time to heal
Poor sexual stamina.
Diabetes is a rampaging silent killer among Nigerians!
Like its twin brother hypertension, sometimes, diabetes does not exhibit any symptom in the patient. In this group, the disease is detected by a discovery of high sugar level in the blood or urine when the patient attends the hospital with another complaint. For this reason, routine regular medical check up and screening for diabetes mellitus is advised.
Signs that may be detected in the hospital on clinical examination
Hypertension
Skin infection especially ‘boils’
Fungal infections
Poor vision or other eye complaints
In some cases, the first sign will be the patient falling into a coma.
**Remember, diabetes mellitus may give no sign or symptom at all!
Investigations and Diagnosis:
Diabetes mellitus is diagnosed in the hospital. This is done by conducting different types of blood sugar and urine tests.
Usually, people have symptoms before going to the hospital where the diagnosis is made after conducting tests. However, it is better for everybody to visit the hospital regularly for check-ups even in the absence of symptoms. Diabetes testing is one of the check-ups that Nigerians should do regularly.
**If you have not already done so, you are advised to visit your doctor to do a routine diabetes screening.
Treatment
The goal of treatment is to bring the level of blood sugar back to normal. Persistent high levels of sugar in the blood (hyperglycaemia) causes many damages to the body and inevitably leads to multi-organ destruction. That is why diabetes mellitus affects virtually all the organs of the body, from the eyes, to the liver to the kidneys.
Treatment is anchored on a threefold strategy:
Diet
Lifestyle
Drugs [drugs are insulin and other drugs that help in reducing blood sugar level – hypoglycaemic agents].
COMPLICATIONS OF DIABETES MELLITUS
The complications of diabetes mellitus are many and very serious when they set in. Some of the complications are:
Cardiovascular diseases [hypertension, myocardial infarction <cardiac arrest>]
Organ damage: Diabetes can lead to damages in the organs of the body; kidney, heart, brain, liver and others.
It destroys the blood vessels in the body.
Eye disease [leading ultimately to blindness], diabetic foot and amputation.
Reduced immunity and Infections: especially of the skin e.g. recurrent boils, abscesses. Fungal infections e.g. candidiasis.
Erectile dysfunction.
Pregnancy complications associated with gestational diabetes e.g. birth difficulty may result from extremely big fetus. It also increases the risk of babies being born with deformities or dying immediately after birth.
The ABC of Managing Diabetes Mellitus
Early detection: go for diabetes screening early. A person may have an intermediate blood sugar level which requires just dietary and lifestyle modification to revert to normal. The earlier you check the better.
Start appropriate treatment early as directed by a qualified doctor. Do not prescribe drugs or remedies for yourself. Do not use another diabetic patient’s prescription or drugs for yourself. There are different types and treatment requirements for this disease.
Regular checking of the blood sugar levels and monitoring of progress in the management of the diabetic condition.
So much depends on lifestyle and nutrition… avoid alcohol, avoid smoking, get your weight to normal and you may have solved the bulk of the problem.
Say no to anxiety. More people than you imagine are living perfectly normal lives with this condition…
