Aug 22, 2021 | News
DIABETES NEXT EPIDEMIC IN NIGERIA
By Sola Ogundipe
The growing number of people living with diabetes mellitus in Nigeria is worrisome and an explosion in the number of diabetic patients may be imminent if urgent measures are not taken to address the trend.
The World Health Organisation, WHO, estimates for Nigeria, show that 4 million Nigerians are diabetic, and nearly 4 – 11 per cent of the population lives with diabetes.
Experts say it is getting commoner worldwide with the number of affected people rising yearly with projections showing that Africa and Nigeria in particular, is likely to experience the highest increase in the near future. The International Diabetes Federation estimates that by 2040, the global prevalence of diabetes is likely to affect 10 per cent of humanity.
Currently, diabetes care is poorly coordinated, especially at the primary and secondary public health care centres.
Many Nigerians are living with undetected diabetes and even for those that have been diagnosed, just a fraction is receiving proper care and treatment.
A recent study showed that pooled prevalence of diabetes mellitus in the six geopolitical zones were 3.0 percent in the northwest, 5.9 per cent in the northeast, 3.8 percent in the north-central zone, 5.5 percent in the southwest, 4.6 percent, in the south-east, and 9.8 percent in south-south zone.
Findings by Good Health Weekly reveal diabetes screening programmes are few across the States and have limited impact.
The steady increase of diabetic foot, a major complication of diabetes mellitus is equally worrisome.
Many people living with diabetes lack basic knowledge and information about diabetes foot care even as reliable support for diabetic foot care programmes are largely unavailable, leading to poor outcomes for the patient.
Nigeria is currently the most affected country in Africa. It is estimated that over four million Nigerians are living with either the type 1 or type 2 diabetes and findings show that more than 50 per cent the persons with diabetes in the country are unaware that they have the disease.
More than 1 in 3 people with diabetes will develop” a complication of the eyes known as diabetic retinopathy. There is also high prevalence of complications such as diabetic foot among diabetics who risk suffering nerve damage and end up losing their limbs from amputation.
Findings by Good Health Weekly show that patients with diabetes are 25 times more likely to have amputations than people without diabetes.
The amputations unfortunately often do not only result in the loss of the limb but in the loss of life of the patient. Worse still, treatment for diabetic foot complications is the most expensive part of diabetes care even though there is no guarantee that the leg or the life of the patient will be saved.
“Diabetic foot is one of the commonest reasons for prolonged hospitalization in tertiary hospitals. The patient suffers nerve damage to the affected limb even as the tissues develop ulcers, infection sets in and it begins to decay (gangrene),
With the majority of patients financing their medical bills out of pocket, several diabetic patients fail to adhere to their medications and tests. Only 1 in 5 of the patients perform self–blood glucose monitoring among other tests. Several patients even resort to traditional treatment and complementary alternative medicine options.
Today, many Nigerians have become victims of foot amputation, stroke, blindness, kidney failure, heart attack, among other serious conditions, all linked to diabetes.
Already, the rate of amputation among Nigerians living with diabetes is as high as 53.2 per cent of the number of people with foot ulcers in some centres across the country, making diabetic foot the most common cause of non-traumatic amputation in the lower extremities in the country.
“Diabetes places an extra burden on the individuals and families affected, especially for the majority of patients unable to access quality health care,” said Prof Femi Fasanmade. an endocrinologist at the Lagos University Teaching Hospital, LUTH.
Many patients report late to the health care centre when they have developed advanced disease making treatment and care difficult.
A Consultant Endocrinologist and diabetes expert, Dr Afoke Isiavwe, who is the Medical Director of Rainbow Specialist Medical Centre, Lagos, said diabetes is not getting the attention it deserves even as she decried the current situation whereby a lot of Nigerians are living with undetected diabetes.
“Diabetes is not getting the attention it deserves. There is a bigger problem coming in the near future and if we don’t get the right attention now, people will continue to die.
“We need to address the situation urgently. It is affecting the poor, the rich, the young and the old. What we need to do is set up centres that offer free screening and care for diabetes,” she argued.
An examination of the diabetes burden within sub-Sahara Africa showed that the region has the highest potential by an estimated 156 per cent increase by 2045.
“By 2040, 642 million will be diabetic. Diabetes kills more than HIV, TB and malaria combined and this is made worse by the fact that there are no dedicated diabetes centre in Nigeria. Worse still, mortality rate following diabetic foot amputation is higher than for breast cancer.
Among the main reasons for the expected rise are ageing population, increasing urbanization, (sedentary lifestyle) reducing physical activity and increasing obesity.
Noting that it is long overdue for all the States of the Federation to have dedicated diabetes Centres, Isiavwe said there are currently 16 million persons affected by diabetes, but the figure will rise in coming years.
“There is a very urgent need for all hands and voices involved in the diabetes circle – persons living with diabetes, advocacy groups and associations, diabetes care providers, Diabetes Health Care Trainers, policymakers, etc., to be united to birth the right atmosphere for both primary and secondary prevention of diabetes mellitus in Nigeria.
In her research on diabetes foot in Nigeria, Prof Anthonia Ogbera, an Endocrinologist and Consultant at the Lagos State University Teaching Hospital documented the financial burden of diabetic foot problem in the country.
The research published in 2005 showed that the direct costs of treating the diabetic foot ulcer were about 1000 Euros (N400,000), whereas the average monthly wage was about 46 Euros (N18,000).
Findings reveal that today, even the proposed average monthly wage of N30,000 would be inadequate.
“The accompanying social, emotional, and psychological implications of diabetes foot ulcers and amputations are severe, with high mortality rates. A foot care programme including education about foot care should be directed at patients and also at health-care providers.
“All health professionals should have the knowledge and skills to help individuals and families manage diabetes. It is important that every clinic is set up to provide appropriate care and to know when to refer patients to the Endocrinologist/diabetes specialist.”
Isaiavwe said training in Podiatry, a branch of medicine dedicated to the study, diagnosis, medical and surgical treatment of disorders of the foot, ankle, and lower extremities, should be part of the package.
Coping tips
Diagnosis
Early diagnosis can be accomplished through relatively inexpensive testing of blood sugar Treatment
Treatment involves diet and physical activity along with lowering blood glucose and the levels of other known risk factors that damage blood vessels.
Maintenance of blood glucose control, particularly for people with type 1 diabetes who require insulin. People with type 2 diabetes can be treated with oral medication but may also require insulin.
Maintain blood pressure control and foot care.
Prevention
Adopt simple lifestyle measures such as maintaining healthy body weight, being physically active eating a healthy diet, avoiding sugar and saturated fats intake, and avoiding tobacco use. Go for regular screening for early signs of diabetes-related kidney disease and treatment.
Jun 7, 2021 | Events
ROHSI CALL TO ACTION
I am writing to say thank you and to show my appreciations for all that you have made us to achieved in terms of being able to provide access to healthcare treatment to our targeted community members. A huge thank you!
I am also using this as a call to action to my other friends to be part of what we are doing at Rays of Hope Support Initiative – #ROHSI3
Within my work as a social development worker, whenever I hear of people battling with health-related issues especially hypertension and diabetes that have led to strokes, heart attack, sudden death, or stories such as he/she wasn’t sick, we were still together yesterday give me and my team great pains because death such as this could be prevented with access to information, measures and monitoring of our health numbers, medication, and change in lifestyle.
I do wish we saved many of these lives by influencing their diets and lifestyles in a way that would keep them healthy and strong to be able to be alive for their loved ones! We know how unbearable it is; to lose a loving and dependable member of a household. I do not want this to happening again because many of these deaths could be prevented with our efforts at Rays of Hope Support Initiative.
I am asking you to join my team with your resources, time (as our ambassadors/Volunteers), network, collaborations, recommendation, money, donations. Let us save lives by inculcating healthy lifestyles through awareness and access to equity healthcare treatment among people when we were able to take the good news to their doorsteps.
You can start from here:
For the donations, use any of our secure links:
STANBICIBTC BANK PLC: Rays of Hope Support Initiative
Naira: 0022069426
Dollar: 0027047650
Or through
www.rohsi.org/donate
If you could support this by donating and then sharing it with your network. I would greatly appreciate it. I know that money can be tight, so please know that every donation makes us closer to our goal.
Kindly reach out to me in case you have any questions, and I will be happy to answer them. I thank all for rejoicing with me and joining me in this mission of impacting and saving the majority of our people from avoidable/sudden death.
Let’s do this together! Love, Health and Joy,
Benjamin Olorunfemi
Executive Director
Oct 11, 2020 | Healthy Foods
UNHEALTHIEST HABITS FOR YOUR HEART
Emilia Paluszek
“One Love! One Heart! Let’s get together and feel all right,” sang Bob Marley. But without a heart, one can forget about love or frankly — anything else. The good news is that if you manage to avoid certain mistakes and adopt a couple of simple rules you can keep your heart in mint condition for years. Love your heart and you will feel all right. Read on, and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had Coronavirus.
1 You’re Not Making Muscle Health a Priority
“Not making muscle health a priority is a major issue for your health. Make sure that you treat your heart with the respect it deserves,” says Dr. Neerav Dilip Padliya, Ph.D., PMP, Vice President, Research for MYOS RENS Technology. If you don’t know which heart risk factors you have, ask your healthcare provider to conduct or request screening tests during regular visits.
Here are the key screening tests for monitoring cardiovascular health recommended by the American Heart Association:
- Blood pressure. The American Heart Association recommends checking your blood pressure during each regular healthcare visit or at least once per year if blood pressure is less than 120/80 mm Hg.
- Cholesterol. The recommendation is to check it every 4-6 years for normal-risk adults; more often if any you have elevated risk for heart disease and stroke.
- Weight/Body Mass Index (BMI). The American Heart Association recommends checking both during your regular healthcare visit.
- Waist circumference. The recommendation is to check it as needed to help evaluate cardiovascular risk if your BMI is greater than or equal to 25 kg/m2.
- Blood glucose test. The American Heart Association recommends testing it at least every 3 years.
Discuss smoking, physical activity, diet. Each regular healthcare visit
- 2. You’re Not Exercising Regularly
“The most unhealthy heart habit is a sedentary lifestyle. With the COVID pandemic and everyone stuck at home, it has been hard to keep an active lifestyle for most people,” says Dr. Paris Sabo. “The best thing you can do for your heart is to keep it pumping by being active regularly. The best activity is walking to get your heart rate up. Try to walk outside if you can, a minimum of three days a week for 30 minutes each.”
- 3. You’re Smoking
“Do not smoke — it’s by far and away the biggest risk factor for coronary artery disease. It does not matter how good your cholesterol is or how far you can run if you smoke one pack per day,” says Christopher Drumm, MD. “Put the Newports down. A pack a day over 5 years costs around 12,000 dollars and many years of your life.”
- 4. You’re Drinking Too Much
According to Hopkins Medicine, “Heavy drinking is linked to a number of poor health outcomes, including heart conditions. Excessive alcohol intake can lead to high blood pressure, heart failure or stroke. Excessive drinking can also contribute to cardiomyopathy, a disorder that affects the heart muscle.”
- 5. You’re Stressed
“Stress increases cortisol levels, a hormone that is pumped out in excess during times of stress,” says Leann Poston, MD. “Stress can also lead to avoiding exercise and enjoyable activities, unhealthy eating habits, insomnia, and abuse of drugs or alcohol. All of which further stress the heart.”
- 6. You’re Snoring
“Heavy snoring can sound funny to your sleep partner, but the condition is no joke,” says Michigan Health. “Snoring is often the sign of a condition called obstructive sleep apnea, which raises the risk for diabetes, obesity, hypertension, stroke, heart attack and other cardiovascular problems.”
- 7. You Have Diabetes
“Over time, high blood glucose from diabetes can damage your blood vessels and the nerves that control your heart and blood vessels,” says the NIH. “The longer you have diabetes, the higher the chances that you will develop heart disease. People with diabetes tend to develop heart disease at a younger age than people without diabetes.”
- 8. You’re Obese
“Obesity changes in the structure and function of the heart. It increases your risk of heart disease,” says Summit Medical Group. “The more you weigh, the more blood you have flowing through your body. The heart has to work harder to pump the extra blood.”
- 9. You’re Not Eating High-Quality Protein
“One of the most common mistakes that people make is not consuming enough high-quality protein. Sufficient high-quality protein, or protein with leucine, in your diet, is integral to maintaining good cardiovascular health,” says Dr. Padliya. Some of the best examples of natural protein are eggs, almonds, chicken breast, cottage cheese, and Greek yogurt. Some protein to avoid is sugary yogurt, fried meats, and protein bars.
- 10. You’re Not Thinking About the Future
“Muscle loss can also begin as early as 35-40 years old, so people should be cognizant of their muscle health, exercise, and good diet intake much earlier in life,” says Dr. Padliya.
According to Medical News Today, “People can prevent and minimize this loss by staying active. If they do not, it may contribute to poor health and well-being. Some past studies have suggested that people with cardiovascular disease who experience higher loss of muscle mass also have a higher risk of premature death.”
- 11. You’re Over 70 And Don’t Take Protein Supplements
“People in their senior years should also be exceeding the daily recommended allowance since they are at greater risk of muscle atrophy or muscle loss which can result in an increased risk of injuries, leading to lessened vitality. According to a recent study, requirements change for people as they grow older so sticking to the general recommended allowance is not sufficient for those over the age of 70,” says Dr. Padliya. “That said, the majority of people 70+ don’t eat enough protein to even meet the general recommended daily allowance. It is recommended that a 40-50-year-old person should ingest .8 grams per kilogram of protein per day for optimal muscle health, but someone who is 70+ should really be over 1.2 grams per kilogram per day. The quality of protein makes a difference as well. You want to make sure the protein you consume has enough leucine as it is very important for building muscle, particularly in older people,” states Dr. Padliya.
- 12. You’re Avoiding Egg Yolks
“Many people avoid the egg yolks opting for the egg whites only as the seemingly “healthier’ option, but the majority of the essential nutrients for muscle health are found in the yolks. Egg yolks are a great source of protein. A major study released in The American Journal of Clinical Nutrition, concluded that consuming one egg including the yolk per day is safe for cardiovascular health, too,” says Dr. Padliya.
- 13. You’re Eating Too Much Salt
“Salt is a common flavour enhancer that is in almost every food. Salt can cause problems such as increased blood pressure,” says Dr. Sabo. “When eating out, ask to leave the salt out of dishes, or when cooking at home use salt alternatives such as herbs and spices that are salt-free to flavour up your food. Always look at the sodium count on packaged foods to make sure that you’re not getting too much of the unhealthy flavour additives.”
- 14. You’re Ignoring the Doctor’s Orders
“When it comes to heart disease, not following your doctor’s advice is the biggest mistake,” says Dr. Rashmi Byakodi. “Heart treatment goals fail due to poor adherence to the medication regimen. Be aware of the medications you are taking and its side effects’’
- 4. Use PPE Accessories
I assess if PPE—personal protective equipment—such as masks, gloves, eyewear fits properly and comfortably and wear it consistently.
- 5. Study Data
I study available data and studies in small segments to not become overwhelmed. I know that data is continually evolving and may not be complete. I disaggregate the data by human factors such as age, race/ethnicity, sex/gender, SES to assess how it applies to the individual. I am aware that COVID-19 is a multi-system disease just like adaptation to space. As for yourself: To get through this pandemic at your healthiest, don’t miss these 35 Places You’re Most Likely to Catch COVID.
Sep 20, 2020 | News
ROHSI CREATES AWARENESS ON SALIENT ILLNESSES
By Canice Opara
The Rays of Hope Support Initiative (ROHSI) has been creating awareness on salient sicknesses in the country, such as hypertension and diabetes through education on their health implications.
According to Mr. Benjamin Olorunfemi, founder of the organization, these ailments have been causing a lot of problems in the country, and unfortunately people are not always taking them seriously, hence his organization has embarked on an awareness campaign to education citizens.
Olorunfemi, who narrated how he almost died through these sickness, said he later researched on them only to discover that high blood pressure and diabetes are among other non-communicable diseases millions of Nigerians are battling with without knowing what they are, that this has led to his desire to raise awareness, provide health education, get people screened for hypertension and diabetes with the vision to reducing the untimely death resulting from complications caused by these ailments. Hence, Rays of Hope Support Initiative (ROHSI) was born in March 2017.
“We found out that if people had access to information and medical services early, deaths and other health complications arising from these ailments could be prevented. Then we decided to fight against these diseases with one-on-one talk Initiative, which was later extended to our communities because of the increasing number of people who need information and treatment”, he said.
Olorunfemi, quoting the World Health Organisation (WHO), said hypertension and diabetes are responsible for an estimated 45 percent of adults’ death due to heart diseases, and 51 percent of deaths due to stroke globally, with studies blaming the increasing prevalence of the condition on lifestyle and dietary factors such as physical inactivity, alcohol and tobacco use, and a diet high in sodium usually from processed and fatty foods. That unfortunately, the control of hypertension and diabetes has become a priority in many countries of the world, but remains a crisis in Nigeria in terms of awareness and management as the condition continues unabated.
He stated that studies continue to show from experts that more Nigerians are daily battling with these ailments without laid down measures, and asked why?
The ROHSI founder believes that economic downturn and the astronomical increase in managing these ailments are forcing many people to go on compulsory “drug holiday’’, as they found it hard to get funds in getting medical screening and medication on real-time. And that it could be why today people are seeking an alternative to orthodox drugs and treatment, as the economic situation has not allowed the majority of them to be able to cope with continuing medication.
He wondered why government, whose responsibility it is to create awareness and help pharmaceutical companies in curbing these sicknesses, is not doing much in that regard.
“Our government that was supposed to help in terms of awareness, providing relief and subsidies to pharmaceutical companies and the people with hypertension and diabetes to ameliorates their health conditions are not doing much even; our primary healthcare centres that supposed to be the first point of call for screening, detecting and helping in alleviating these ailments are not functioning to their name. Today, many of these patients are going back to alternative medicine or ‘’drug holiday’’ as I have said earlier, which often worsens the condition resulting in more health complications”, Olorunfemi lamented.
He said based on this, they are coming in to bridge that gap by coming in today as an organization to provide means by which more of people with these ailments could be reached through programmes like community outreaches, where they have provided free screening and medication to over 3,000 Nigerians.
“We all know there are significant health and economic gains attached to early detection, adequate treatment and good control of hypertension and diabetes than treating the complications of these ailments”, he reminded.
While saying that his organisation has the vision of supporting the health and well-being of people through health education and enlightenment, Olorunfemi said “but it’s not what we can do alone as an organisation; we need like minded people like you to help us with your time, network, resources among others in achieving the following:
“To create awareness on the effects and management of hypertension and diabetes among our people with special interest among the low income and the less privileged members of our society.
“To help increase the understanding among the communities, especially the less privileged members of the communities battling with these ailments about its impact on their health.
“To reduce the percentage of people with these diseases significantly through our awareness, health education and community outreaches respectively with follow-up on a great percentage of the people.
“To provide people living with hypertension or diabetes with comprehensive information on the causes and management.
“To provide our targeted audience with ongoing follow-up information on hypertension and diabetes.
“To reach a larger number of the communities with pamphlets, handbill, lecture in local dialects for clear and better understanding of what hypertension and diabetes are all about, and how deadly they could become if not discovered and managed on time”.
Olorunfemi advised that Nigerians should discourage people from resorting to self – medication, but instead seek for proper medical attention.
He added that all of the above cannot be achieved without Nigerians’ efforts and contributions, and that is why his organisation is asking people to join them with all that they have in achieving these.
First Published By Dispatch News Online http://dispatchnews.com.ng/2020/09/19/rohsi-creates-awareness-on-salient-illnesses/
Sep 17, 2020 | Healthy Tips
MANAGING HIGH BLOOD SUGAR IS KEY TO REDUCING COVID-19 COMPLICATIONS: STUDY
By: Kara-Marie Hall, RN, BSN, CCRN
Key Takeaways:
- Researchers at Michigan Medicine are using a targeted algorithm to help manage blood sugar levels in COVID-19 patients.
- High blood sugar (hyperglycemia) is linked to severe illness in those with COVID-19.
- Having a severe case of COVID-19 can also cause high blood sugar in people who do not have diabetes.
- Aggressive management of high blood sugar in patients with COVID-19 appears to reduce their risk of long-term health consequences associated with the virus.
Researchers at Michigan Medicine have created a management tool that could improve outcomes for patients with high blood sugar (hyperglycemia) and COVID-19. The research, which was published ahead of print on August 11 in the journal Diabetes, shows a two-way relationship between blood sugar levels and COVID-19.
According to the researchers, having high blood sugar can put patients at risk for more severe illness if they contract COVID-19. The reverse also appears to be true: patients with COVID-19 also are at risk for high blood sugar levels, even if they do not have diabetes.1
“Based on current evidence, it’s fair to say that the COVID-19 virus, particularly in its most severe forms, leads to much higher blood glucose levels,” study senior author Rodica Pop-Busui, MD, PhD, tells Verywell. Pop-Busui adds that having high blood glucose levels can also lead to worse outcomes for patients with COVID-19.
If left uncontrolled, the inflammation from COVID-19—often called a “cytokine storm”—can cause complications when coupled with inflammation caused by hyperglycemia.1 It also increases the likelihood of needing mechanical ventilation.
What Is Hyperglycemia?
Sugar (glucose) is necessary for proper organ function. Glucose enters your organs’ cells through a hormone called insulin. If the amount of glucose in your body exceeds the amount of insulin available, the glucose builds up in your blood and causes high blood sugar levels, known as hyperglycemia.
Hyperglycemia is typically defined as a blood sugar level of at least 180 mg/dl or greater when measured one to two hours after eating.2 However, the defined range varies among health organizations. Diabetes mellitus (type 1, type 2, and gestational) is the most common cause.
Michigan Medicine Introduces Hyperglycemia Management Teams
The researchers at Michigan Medicine designed a personalized, targeted clinical algorithm—a set of guidelines that helps healthcare providers make decisions—to help frontline healthcare workers without adding to their already heavy workload.
To put the guidelines into practice, the researchers launched several hyperglycemia management teams that were tasked with:
- Checking patients’ glucose values through venous and arterial blood specimens rather than bedside glucose checks (because it’s more convenient)
- Creating timely insulin dose adjustments multiple times a day
- Reducing the number of glucose checks for most patients to every six hours
Not only did the algorithm lower patients’ glucose levels to an acceptable target range (generally 150-180 mg/dL), it also lessened the burden on frontline health care workers.
“We developed this early in the course of the pandemic, and we have continued to adapt and improve it based on lessons learned daily on the frontlines,” Pop-Busui says. “Others have started to use variations of this algorithm as well.”
What This Means For You:
If you have diabetes or even prediabetes, keeping your blood sugar levels well-controlled can help you reduce the risk of complications if you contract COVID-19.
COVID-19 Can Trigger Hyperglycemia
The Michigan Medicine researchers also found that some of the COVID-19 patients who had been referred to them for treatment developed high blood sugar levels even though they did not have diabetes.
“The severe inflammatory reaction triggers insulin resistance and high blood sugar even in people who may not have had known diabetes, but could have been in a prediabetic state,” Pop-Busui says.
A recent study published in the Journal of Medical Virology corroborates this idea, showing that out of 184 patients hospitalized with COVID-19, about 24% of patients were prediabetic.3
What is Prediabetes?
Prediabetes is a precursor to type 2 diabetes. According to the Centers for Disease Control and Prevention, more than 1 in 3 Americans have prediabetes. Over 84% of people with prediabetes are unaware that they have it.4
However, factors beyond diabetes and prediabetes can contribute to high blood sugar.
“[Patients with hyperglycemia] may also simply have stress hyperglycemia, which can occur from the stress of illness,” Roma Gianchandani, MD, another author of the Michigan Medicine study, tells Verywell,
Regardless of whether patients have prediabetes, diabetes, or stress hyperglycemia, Pop-Busui says their high blood sugar levels need immediate and sustained treatment.
Risks of Untreated Hyperglycemia
Romy Block, MD, an endocrinologist and co-founder of Vous Vitamin, tells Verywell that long-term, high blood sugars can directly injure blood vessels. Several health problems can result from this damage, including:
“In many medical conditions, tightly controlled sugars can decrease the duration of illness and decrease the [number of] days spent in the hospital,” Block says.
Treatment for hyperglycemia usually includes the administration of insulin—either given intravenously (directly into your vein) or under the skin—to bring down high blood sugar levels.
