ADDRESSING DIABETES IN NIGERIA

Jan 26, 2018 | News

ADDRESSING DIABETES IN NIGERIA

October 20, 201

While Nigeria has the highest burden of diabetes in sub-Saharan Africa with over five million cases diagnosed, Novo Nordisk and other health experts believe its incidence can be reduced if Nigerians adopt healthy lifestyles. Martins Ifijeh writes

Though Fred, a 32-year-old financial consultant has heard about diabetes before, he found out the consequences of the chronic disease the hard way because it most often doesn’t ring a bell when it starts to manifest.

He lost his mother suddenly, who until her death was full of life. They had both discussed her July 2017 trip to the United States, where she was billed to visit her first daughter who she hadn’t seen for years.

But on Friday, May 26th, life served Fred lemons. He lost his 66 years old mother, who hardly get ill and was always full of life. No thanks to the silent, creepy but dangerous diabetes. A disease that doesn’t tell it’s victims to get prepared.

“I got a call from her that morning that she was feeling dizzy and weak. That is something she hasn’t complained about since I can remember. So I told one of our relatives staying with her to take her to the family clinic, but before she could get there, I learned she was fast losing strength.
“Diagnosis was done on her and they realised her blood sugar level was over 400. I had to tell the doctor to do anything he can to stabilise her, and then commence treatment to reduce the fatally high level,” Fred said.

But the damage was done already. There were already severe complications from diabetes. In no time she was gasping for breath, and then she died from what the doctor called heart attack caused by blood clot in the arteries.

The normal blood sugar range is between 70 to 100 but Fred’s mother had over 400 percent higher than the normal level.

“The doctor told me my mum didn’t just develop the disease, that it has been there for years, but was slowly doing damage to her heart and other organs until the day she died. He said if she was doing regular checkups, she would have been able to adjust her lifestyle or possibly be on medication to reduce the level of sugar in her circulating system,” Fred regrettably said.
Fred couldn’t make lemonades from what life served him. He lost his mum to a highly preventable disease when diagnosed on time.

Mummy Fred is just one among several hundreds of thousands of Nigerians who die yearly due to ignorance of their health status, especially on non-communicable diseases like diabetes that do not give warning signs.

In 2015 alone, about 120,000 Nigerians were said to have lost their lives to diabetes; which may, if recent predictions are relied on, become the number one cause of deaths in the country among other non-communicable diseases, thereby topping the chart, as against cardiovascular diseases currently leading the causes of deaths occasioned by NCDs in Nigeria.

What is even more worrisome is that apart from the over five million Nigerians currently suffering from the chronic disease, indications show that not less than an entirely different five million Nigerians are diabetic but unaware since it does not come with symptoms. By indication, this shows that more than 10 million Nigerians are actually suffering from diabetes in the country; a figure experts say will continue to increase unless Nigeria and Nigerians make conscious efforts to tackle it head-on.

This is evident in the steady rise of diabetes, diabetes-related complications or deaths recorded in the country, leaving most sufferers at the mercy of the disease, since they are neither aware of the disease or are unable to receive treatment.

Over the past 30 years, the prevalence rate of the disease was said to be 0.4 percent among the Nigerian population; in 1992, it rose to 1.6 percent; in 2004 it was 3.1 percent, and just recently, it has risen above 4.5 percent, according to a survey conducted by Osuntokun et al.
But experts at the launch of the Base of Pyramid Project by Novo Nordisk say the steady rise of the disease in the country is associated with lifestyle changes; overweight and obesity, physical inactivity, alcohol consumption, dietary changes and cigarette smoking, adding that if nothing was done both on the part of the citizens and the stakeholders, the disease may spiral into a national health emergency that would take more lives out of their prime; a disease they have noted was partly preventable.

Diabetes, the most common disorder of the body’s hormonal system, occurs when blood sugar levels consistently stay above normal, thereby unable to let the body cells receive glucose due to lack of insulin to drive it into the body cells or lack of the cell receptors to recognise insulin, and then utilise its function. Glucose is an essential source of energy for the brain and the body. Insulin is one of the main hormones that regulate blood sugar levels and allows the body to use sugar (called glucose) for energy.

In her presentation at the launch, Consultant Endocrinologist, and Acting Deputy Provost, Academics, College of Medicine, Lagos, Professor Anthonia Obera, said many Nigerians do not access medical checkup, a reason she said has led to delayed or undiagnosed diabetes in the country, leading to complications and possible death.

She said, unfortunately, six out of 10 Nigerians who have diabetes do not know they have it because they are not checking their health status.

“Every adult beyond 40 years old should undergo regular checkups at least twice a year. When tackled on time, there is a very high possibility the person will lead a normal life. Such person will also know first hand what and what to avoid,” she said.

While stating that undiagnosed or delayed diabetes contributes to the development of complications, she said some of the consequences of the disease could result to peripheral neuropathy, retinopathy, cataract, cardiovascular disorders, and even death.

She called for strengthening of the healthcare system, timely screening, provision of treatment guidelines, upgrade of infrastructure and equipment, and the integration of private sector into the national health and information system framework.

The National Vice President, Diabetes Association of Nigeria, Dr. Ejiofor Ugwu, said 75 percent of diabetics globally reside in low and middle-income countries like Nigeria, where the majority could barely afford treatment cost.

He said the burden was heavy in Nigeria than the international federation estimates, adding that due to lack of reliable national data on diabetes, it was difficult putting actual figure to the number of diabetics in the country, but he insisted that the burden is underestimated in the country.

“The last national surgery we had was decades ago. It is a national embarrassment. We are therefore calling for national surgery on non-communicable diseases.

“Another issue is that we have insufficient diabetologists in Nigeria. We have about 140 for the entire 180 million Nigerians. Majority of them resides in urban areas. That means the presence of diabetologists in rural areas is very insignificant,” he added.

He called on Nigerians to eat healthily, avoiding junk foods, smoking, alcohol intake, sedentary lifestyles. “Regular checkup is very important as a step to preventing diabetes,” he added.

On his part, the Minister of Health, Professor Isaac Adewole, who was represented by the Medical Director, Federal Medical Centre, Ebutte Meta, Dr. Adedamola Dada said government, in partnership with stakeholders, have designed framework for intervention against the disease.
He said critical areas the government has considered is the development of national diabetes plan and policy, monitoring trends of the disease, provision of access to care and sustainable financing, provision of nutrition guidelines, among others.

He said Novo Nordisk, through its Base of Pyramid Project, was providing good partnership in the fight against diabetes in the country.

On his part, the General Manager, Middle Africa, Novo Nordisk, Mr. Venkat Kalyan said that Novo Nordisk was committed to addressing the barriers to better care for people with diabetes.
He said the Base of the Pyramid (BoP) project was aimed at providing access to diabetes care for people in low and middle-income countries. “The project runs in Nigeria, Ghana, and Kenya. The purpose of the BoP project is to create shared value by developing scalable, sustainable and profitable solutions that increase access to diabetes care and treatment for the “working poor” as well as provide value to the business of Novo Nordisk.

“Building on the success of a diabetes awareness campaign conducted last year in partnership with Family Health International 360 (FHI 360), the goal of this pilot project is to improve diabetes care through the integration of diabetes screening services and linkage to care and treatment into routine general health services in private health facilities.

“FHI 360 will adopt the ‘House of Care’ approach, a system of delivering care and support centered and coordinated around the needs of individuals living with diabetes at the base of the economic pyramid to enable access to affordable diabetes care.”

He said the approach was predominantly facility-based and will strengthen the capacity of participating hospitals to integrate diabetes care by refocusing services and removing barriers to access. “In addition, this framework will improve outcomes for individuals with diabetes and provide value for the health system.”

According to him, the project objective is to conduct diabetes risk-assessment for 82,500 individuals using a risk-scoring tool; conduct blood glucose tests for 40,000 high-risk individuals, among others.

Addressing Diabetes in Nigeria

DOCTORS EXPLAIN WHY PEOPLE SLUMP AND DIE

Jan 26, 2018 | News

DOCTORS EXPLAIN WHY PEOPLE SLUMP AND DIE

Posted on June 25, 2016, by Encomium

 How to manage Diabetes and Hypertension 

Experts have revealed that for people to slump and die, two vital organs of the body must be involved which are the heart and brain. People are dying from treatable and manageable medical conditions such as malaria, diabetes, heart attack, stroke, hypertension and many more. These avoidable deaths are due to ignorance, deception, and misinformation.

‘Medically some things can cause someone to slump and die’ – Dr. ADERINWALE (Precise Medical Centre)

Medically, there are so many conditions that can cause people slumping and dying. Hypertension can cause it, cardiac failure can cause it, head trauma, homological condition like epilepsy, diabetes, hypoglasphemia, internal or external bleeding can cause it. There are so many other medical conditions that can cause such.

It can be prevented by regular medical checkup. The patient or person must make sure he/she takes the adequate medication as at when due, go for medical checkup generally and manage his or her health condition appropriately.

‘People should create time for medical check-up’ – DR CURTIS OGUAMALAM (Gynecologist)

There are lots of reasons why people slump and die. Let me go straight to the major ones.

Stress – The last time I checked, I realize people no longer give time for themselves. No time to rest, due to the nature of their jobs and other activities. You will see a lot of people waking up as early as 3 am for work, coming back late in the night. This is rampant in the country today. A lot of people don’t know how to manage the crisis. The situation on the road, activities at work, all these contribute to stress.

People know how to endure pains and headache. These are some of the things many people no longer pay attention to. By the time the whole issue piles up, it becomes what we call stress. When one is stressed without proper medical attention, it kills.

Another one is High Blood Pressure and poor diet. Eating foods that will nourish the body should be a habit not just eating anything.

There is what we call secondary and primary causes of death. The primary causes of death are those with possible reason why a person slumped. For instance, diabetes. If someone is diabetic, without proper care, there is possibility that the person would slump, thus, we can call this primary death.

The secondary one is cardiac arrest. A person might slump and if taken care of would survive but once a person slumps and the heart is gripped (cardiac arrest), it’s the end. A layman would say he slumped and died but cardiac arrest is totally different. It has no disease attached. Once it happens, it has no remedy.

I remember I was with one of my patients some time ago when she received a shocking news. Immediately, she started panting heavily. If I wasn’t there to rescue her, I wonder what that could have led to. There are lots of cases like that when we hear the death of someone without knowing the actual cause, a lot of people term it slumps and dies whereas some are cardiac arrest.

People should create time for medical check-up. Go to hospital, examine your body, let medical experts run a test on your body every time.

Stress is something that kills fast. We are all thinking of money and how to settle bills. In the process, the body is stressed. Also what we eat helps in fighting sickness. This is why I always tell people to inspect what they eat. No matter how little the food is, we should eat balanced diet. All these help the body against crisis.

‘Medical check-up is the way out’ – DR FUNSHO SHITTU (Expert)

The main reason why people slump and die is lack of medical check-up. Nigerians no longer create time for their health. Today, you will see people with all sorts of diseases that need medical attention, instead, they end up treating themselves locally with agbo (local herbs) and other concoctions forgetting the fact that medical check-up is the best way one can stay fit.

Hypertension. This is also one of the reasons why people slump. Hypertension is a fast killer. Your reaction towards every situation that comes your way stimulates hypertension. Though the country is in a harsh economic situation, a lot of people are upset, it damages their body system. This is why we hear cases of people slumping and dying. People need medical attention when depressed. Medical check-up is the way out and be crisis free.

-GLORY OSIGWE and OLUWAFEMI SOEWU

DOCTOR EXPLAIN WHY PEOPLE SLUMP AND DIE

WHY PEOPLE SLUMP AND DIE

Jan 26, 2018 | News

WHY PEOPLE SLUMP AND DIE

Experts have revealed that for anybody to slump and die, two vital organs of the body must be involved. These are the heart and the brain. The heart is a major organ that has to function optimally, and during intense physical activities, the heart works more, pumping blood adequately to support the brain. The brain is also what keeps people alive, but if it is deprived of blood supply for more than four minutes, a person can go unconscious and this could lead to death.

The tragedy of these calamities is that most people are not aware that they have hypertension and diabetes – the two conditions that predispose people to suffer stroke or heart attack and kidney diseases. It was, therefore, a shock when Funmilayo Femi, a 20-year old undergraduate fell ill and was diagnosed with hypertension. Funmilayo felt dizzy and had a consistent headache and so had to go to hospital. Her BP was 200/120. 

,’Experts have revealed that for anybody to slump and die, two vital organs of the body must be involved; these are the heart and the brain’, 

None of her parents has it and so it became a puzzle to the doctors. She was lucky and was treated but for her to live on BP drugs from age 20 became incredible to her and her parents. Alhaja Safinatu recently got to her shop at Ladipo, relaxed on her chair to have lunch when she slumped in her chair.

Thinking that something was wrong with the chair, her neighbours in the market rushed instantaneously to give a helping hand and lift her up. Then, apprehension set in when they noticed her still form. And still thinking that she might have suffered a concussion as a result of the fall, they rushed her to the General Hospital but within minutes of her arrival, she was pronounced dead by the doctor. Her BP was 280/150. The recent goal is that BP should be below 120/80. These numbers were extremely high and very dangerous.

These are not isolated cases. Sudden death syndrome is becoming all too common. Apart from slumping and dying, strange diseases are cropping up every day and poverty-stricken Nigerians are falling victims.

Almost every Nigerian knows somebody who has had a stroke or died suddenly. There is an epidemic of both men and women ‘slumping’ and dying. It is bad that someone left home in the morning seemingly healthy and did not make it back home. It is reported that the average life expectancy in Nigeria in 2000 was 51-56 years and by 2011 had declined to 47.56 (World Bank figures). All indications are that this decline occurred even as we have become a more affluent country. The average worldwide life expectancy presently is approximately 65.5 years, while that of countries like the USA is in the 70s. A more realistic comparison would be that of a country like Rwanda, where the life expectancy is estimated to be approximately 55 years in 2011.

What appears most alarming is that people are ‘slumping’ from treatable and manageable medical conditions such as Malaria, Diabetes, Heart Attacks, and Strokes. All have local definitions and ascribable spiritual connections. Such illnesses are preventable and treatable through appropriate health education, change in lifestyle and adequate treatment, despite the misguided ‘spiritual’ diagnosis.

People are increasingly dying of treatable diseases due to ignorance, unholy deception and misinformation. These are preventable health issues. As the body ages, it stops functioning as it should and naturally needs assistance. A body that was able to tolerate a high fever may be unable to do so anymore as it ages. An unintended result of ‘healthy’ eating is obesity which by the way leads to adult-onset diabetes. It is the nature of life. What ordinarily could be treatable with ‘onions’ is now treated with antibiotics. It is bad enough to have incurable diseases but it is good to at the very least deal properly with the ones that are durable and can be managed.

It is advisable to seek medical attention at the first sign of illness and routinely at least once a year. People should understand their family medical history and respond accordingly and proactively.

WHY PEOPLE SLUMP AND DIE