More effort needed towards awareness on diabetes

Diabetes, a non-communicable lifestyle disease usually associated with the wealthy, is quickly becoming a problem in the developing world. 

Statistics from International Diabetes Federation (IDF) show that  developing countries account for three out of every four of the world’s 537 million adults with diabetes. Diabetes poses a serious challenge to developing world healthcare systems, with the total number of diabetes patients expected to rise to 643 million by 2030.

In Kenya, data by the National Strategic Plan for the Control of Non-communicable Diseases indicates that the diabetes burden was expected at 3.1 per cent of the population in 2019. The prevalence is expected to rise to 4.4 per cent by 2035 without immediate and effective remediation

Diabetes is divided into two  broad categories: Type 1 and type 2 . While both are chronic diseases that affect the way our bodies regulate sugar and lead to serious complications, they work in very different ways.

Type 1 diabetes is caused by an autoimmune process that attacks insulin producing  pancreatic cells, leading to partial, in most cases, absolute insulin deficiency. Type 1 diabetes cannot be prevented due to its unknown cause.

Type 2 diabetes, on the other hand, means that your body sensitivity to insulin is reduced or unable to produce enough insulin  the body demands. This is the most common type of diabetes.

DF statistics reveal that there were an estimated 1.1 million children worldwide with type 1 diabetes in 2019, with the figure rising by 132,000 each year. This is especially concerning given that the only treatment for type 1 diabetes is a lifelong reliance on insulin, without which survival is unlikely.

The World Health Organisation’s Global Report on Diabetes, excess body fat, as a summary measure of multiple aspects of physical activity and diet, is the most significant risk factor for type 2 diabetes. Active smoking is also a major risk factor.

While treatment options for type 2 diabetes include a change in lifestyle, medication, and even insulin use, all these are dependent on the patients’ knowledge of diabetes and access to diagnosis and treatment options.

IDF Diabetes Atlas shows approximately 54 per cent of Africans with diabetes are undiagnosed. A  STEPwise survey conducted in 2015 says more than 88 per cent of Kenyans have never had their blood sugar tested, indicating a concerning lack of awareness or access to care. 

Given that diabetes is responsible for 416,000 deaths in Africa, and Kenya leads East Africa in the number of diabetes-related fatalities, there is plenty of room for improvement in diabetes awareness, diagnostic and treatment access.

Effective diabetes control will be critical if we are to slow or even halt the rise in related complications. The healthcare system must prioritise increasing public awareness of the disease, as well as its prevention, detection and treatment.

The theme of the World Diabetes Day, observed on November 14 each year, was “access to diabetes care” between 2021 and 2023. This year’s emphasis is on increasing access to high-quality diabetes education in order to improve diabetes management and outcomes for people living with the disease.

The National NCD Strategic Plan recognized the importance of advocacy, communication and education in preparing the country for success when dealing with diabetes and other noncommunicable diseases. As part of the response, it suggests strengthening community knowledge and social mobilisation for prevention and control.

The missing link at the moment, however, is investment in these strategic areas. It is understandable that allocating funds to diabetes response at this time is difficult due to the economic challenges caused by drought, Covid-19 pandemic, and a global economic downturn.

In comparison to strengthening healthcare professional training and increasing diagnostic and treatment capacities, increasing public awareness is a financial low hanging fruit because it prioritizes enabling diabetes patients to manage the disease and other people to avoid getting it.

When all is said and done, the scourge of diabetes is oblivious to current economic conditions. There is an urgent need to rethink our approach to diabetes if we are to effectively control, diagnose and treat it for a healthier nation.

—The writer is a paediatric endocrinologist at Getrude’s Children’s Hospital