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Concern as diabetes on the rise in Africa

Monday January 02 2017
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With rising incomes due to an expanding middle class, lifestyle diseases are on the rise in most emerging market economies. PHOTO | FILE

Catherine Ndwiga, 34, was diagnosed with diabetes when she was only 5 years old.

Though she has led a normal life, she has also borne the brunt of diabetes related complications such as eye problems, hypertension and recently kidney failure.

She however remains positive about life, eager to create awareness about the prevention and management of the condition.

She is among the more than 14 million people diagnosed with the disease in Africa according to statistics from the International Diabetes Federation (IDF). This figure is expected to reach 34 million by 2040.

Dr Shaukat Sadikot, the IDF president, says that the number of those with the disease is increasing at an alarming rate as most people develop Type 2 diabetes due to unhealthy diets and sedentary lifestyles that promote obesity.

In Type 2 diabetes, the body produces insulin but is unable to utilise it efficiently due to various impeding factors, mainly obesity.

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This differs from Type 1 diabetes, that Ms Ndwiga suffers from, which occurs due to the body’s inability to produce insulin that regulates sugar levels in the body. It has no known cause and cannot therefore be prevented.

“Previously a disease of the old, we are now seeing many young people, even children, getting Type 2 diabetes which can be prevented by adopting healthy lifestyles,” said Dr Sadikot.

He adds that as the burden of diabetes reduces drastically in developed nations, it is on a rapid rise in developing nations that are mostly ill-prepared to manage it.

Based on IDF figures, about 75 per cent of people with diabetes globally reside in low and middle income countries where essential medicines and healthcare services to effectively treat and manage the disease are largely out of reach for most patients.

Consequently, people diagnosed with diabetes are succumbing to ailments associated with the disease such as kidney failure, hypertension, eye problems and leg amputations.

“We are now dealing with a diabetes tsunami. If we don’t address the problem, people will continue dying from it,” says Dr Sadikot.

READ: WHO raises red flag on increased cases of diabetes

He calls for heightened awareness to encourage people to conduct regular diabetes tests.

“With early diagnosis, you begin treatment early and this prevents the development of diabetes related complications.”

Financial burden

Despite knowing their status early enough, Ms Ndwiga notes that many people still die from the disease due to lack of financial resources to adequately treat and manage the condition.

She states that many people are unable to afford daily insulin doses required to stabilise sugar levels in the body. Public hospitals in the region often sell the drug at subsidised rates but frequent stock-outs forces patients to buy it at much higher costs in private pharmacies.

“You therefore find a situation where a patient knows he is supposed to use a specified amount of insulin but they decide to just use half of what is recommended. They know they are putting their life at risk but there’s nothing they can do because they can’t afford the insulin,” says Dr Eric Njenga, a diabetologist at Aga Khan University Hospital (AKUH).

Without adequate insulin in the body, blood sugar rises to extremely high levels that rapidly destroy body organs such as kidneys leading to renal failure.

Statistics show that a majority of patients undergoing kidney dialysis in East African countries are mostly those with diabetes.

They are also at great risk of developing hypertension and eye problems that affect their vision.

To keep these complications at bay, they need frequent check-ups that are also costly.

“It’s sad to see patients succumb to these complications yet you know that they can be largely prevented through proper treatment and periodic screenings to detect any complications early enough,” said Dr Njenga.

Public-private partnerships

East African governments have been tapping on public-private partnerships to address some of these financial hurdles.

For instance, Novo Nordisk - the world’s largest insulin producer - has partnered with health ministries in Kenya, Tanzania and Uganda to roll out an initiative known as the changing diabetes in children programme (CDiC).

The initiative offers thousands of children suffering from diabetes glucometers, insulin and glucose testing slips at no cost until they are 21 years old. The children are also sensitised on the ailment and taught how to effectively manage the disease.

Mr Lars Sorensen, Novo Nordisk Global CEO said the company is also selling insulin at subsidised prices to governments in developing nations to enable them to avail it at lower prices to patients.

Novo Nordisk is also assisting countries in the region to establish centres of excellence for diabetes care as well as training low cadre health workers on how to effectively treat patients.

“In most African countries, doctors will not be found in all health facilities. So we also need to focus on nurses and other health workers so they can learn how to manage people with diabetes,” says Mr Sorensen.

Ultimately, analysts note that the East African governments will need to establish national health insurance schemes that can adequately cover treatment costs of all citizens suffering from diabetes and other non-communicable diseases (NCDs) like hypertension and cancer. This offers a more sustainable approach to healthcare financing that has worked in most developed nations.

“Currently, most people in developing nations are buying medication out-of-pocket, meaning individuals have to pay for the medicine themselves. This is putting a burden on most families,” Mr Sorensen said.

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