How education can improve diabetes management
Sub-Sahara Africa has traditionally been viewed as plagued with communicable diseases; malaria, schistosomiasis, tuberculosis, HIV/Aids to mention a few.
In fact, neglected tropical diseases are all communicable diseases. However, data on the causes of mortality in developing countries in Africa over the last 15 years have revealed a change in the contribution of communicable diseases to mortality.
The prevalence of non-communicable diseases — such as hypertension, diabetes mellitus and obesity — has been steadily increasing across sub-Saharan Africa, Kenya inclusive.
Experts are now discussing an “epidemiological shift/transition” in Africa in view of the contribution of stroke and myocardial infarction to hospital fatalities, conditions that are recognised complications of these non-communicable diseases.
Diabetes mellitus is a state of chronic elevations in blood glucose (hyperglycaemia).
It is responsible for the clinical presentations of diabetes mellitus and contribute largely to the development of complications of the disease, such as nephropathy, retinopathy, dermopathy, cardiomyopathy, arthropathy and diabetic foot ulcer, the leading cause of non-traumatic leg amputations globally.
But the onset of hyperglycaemia is usually unnoticed by many persons who develop diabetes.
Studies have shown that hyperglycaemia persists for months to years before it is eventually detected, enough time to initiate the processes that result in complications.
Even in pregnant women, undetected hyperglycaemia leads to complications for the mother and unborn child.
According to the International Diabetes Federation, it was estimated that 537 million people aged 20-79 years worldwide were living with diabetes as of 2021 (10.5 per cent of the global population).
This number is projected to increase to 783 million (12.2 per cent of the global population) by 2045.
But the staggering thing about this projection is that Africa would contribute the most to the increase. It is estimated that the prevalence of diabetes would increase by 134 per cent in Africa, by far the highest increase compared to other regions of the world (South and Central America 50 per cent, Middle East and North Africa 87 per cent, Southeast Asia 68 per cent, North America and Caribbean 24 per cent, Europe 13 per cent, Western Pacific 27 per cent).
One in five people living with diabetes in Africa is undiagnosed, the highest proportion of all the International Diabetes Federation regions.
Since diabetes is largely asymptomatic, the best way of detecting it is by doing a blood glucose check.
November 14 of every year has been designated by the World Health Organisation to be World Diabetes Day (WDD).
The scary statistics emanating from Africa have contributed to the choice of the theme for WDD 2022 which is ‘Diabetes: Education to protect tomorrow’.
Improving access to health education on diabetes is empowering people with information that would help in changing lifestyle choices as well as the health-seeking behaviours of people living in Africa.
These changes would contribute to reducing the prevalence of diabetes and its complications as well as reducing attendant healthcare costs.
If diabetes is detected early through regular blood glucose checks, it would lead to improved blood glucose control and retard the onset of complications which are expensive to treat and contribute significantly to the low quality of life and increased mortality seen in people living with diabetes.
Access to diabetes care starts with access to education on diabetes.
— The writer is Consultant Endocrinologist, Department of Internal Medicine, Aga Khan Hospital
