AS Nigeria today joins the rest of the world in celebrating the World Diabetes Day (WDD), there is growing concern about the surge of the degenerative disease in the country. According to experts, no fewer than 10 million Nigerians are living with the disease.

World Diabetes Day is celebrated yearly on November 14. The International Diabetes Federation (IDF) and the World Health Organisation (WHO) started the celebration in 1991 in response to the worries that the disease now poses to health. It also became an official United Nations Day in 2007, following the passage of United Nations Resolution 61/225.

November 14 is chosen for the celebration in commemoration of the birthday of Frederick Bating, who together with Charles Best conceived the idea that led to the discovery of insulin in 1922, a major medication in the treatment of diabetes.

The World Diabetes Day (WDD) theme for the period 2009-2013 is "Diabetes Education and Prevention" while the campaign slogan for 2009 is " Understand Diabetes and Take Control". The IDF in its campaign calls on all those responsible for diabetes care to understand diabetes and take control. It calls on government to implement effective strategies and policies for the prevention and management of diabetes as to safeguard the health of their citizens with and at risk of the disease.

The campaign also calls on the general public to understand the serious impact of the disease and know, where possible, how to avoid or delay it and its complications.

According to report, the disease imposes life-long demands on the 285 million people now living with it and their families. IDF also estimates that over 344 million people around the globe are at risk for Type 2 diabetes. Type 2 diabetes experts say can be prevented in various ways by helping and encouraging those at risk to maintain a healthy weight and engage in regular exercise.

Though there are many types of diabetes, Type 1 and Type 2 are two major ones. Type 1 is caused by the body's failure to produce insulin, whereas Type 2 is caused by the body's resistance to insulin. It is diagnosed that most of the diabetic patients in Nigeria have Type 2.

Recent studies conducted in the country also show that one out of every five patients have diabetic leg ulcers, a situation which resulted in some losing their limbs. The studies also indicate that 50 per cent of the diabetic patients have hypertension and will likely have renal failure and blindness, if proper care is not taken. Of more concern is that 50 per cent of the adult male diabetic patients have Erectile Dysfunction (ED) or impotence.

This was disclosed recently by the Diabetes Association of Nigeria (DAN), Endocrine and Metabolism Unit/Diabetes Clinic of Lagos State University Teaching Hospital (LASUTH), Ikeja and the Nigerian Society of Endocrinology and Metabolism (NSEM).

The groups held its free screening and treatment from Monday, November 9 to Thursday, November 13, at Ikpada and Orile Agege markets and at the Diabetes Clinic, LASUTH, Ikeja, to mark this year's WDD.

The Secretary General of NSEM, Dr. Anthony Ogbera said: "The commonest cause of impotence or ED currently among adult Nigerians is Diabetes Mellitus (DM). One in two of the men with diabetes have ED. The unfortunate thing is that most men who come to the clinic are not ready to discuss it until they are asked".

"So we did a survey by asking people and we discovered that the scope of the problem is really large. Over 50 per cent of our men with diabetes, especially aged above 50, have the problem with ED".

Explaining the upsurge, way out

Experts largely blame the scourge of diabetes on the lifestyle of individuals in the country, saying that our eating habits, especially on junk food have to be checked.

"In fact, most of us actually practice sedentary habits, and with these high-energy drinks, fast foods, we take calorie-dense foods. We do not exercise. And so there is a tendency to obesity, and there is a link between obesity and diabetes", said Ogbera, NSEM secretary general.

Contributing, Dr. Cauis Ezinna of Good Hope Specialist Hospital, Onitsha, said one of the major causes of the ries in the number of Nigerians afflicted by diabetes is eating habit. He however added that the most basic cause lies in hereditary traits vis-à-vis the amount of insulin the body produces.

"Said he: "When you talk of diabetes, you are talking of excess sugar being stored up in the body. This is sugar that should normally have been converted to energy to enable the body function. This disease condition is very common in Nigeria and one remarkable factor behind this is the eating habit of Nigerians. Consumption of too much carbohydrate which in turn produces sugar is simply a very easy way of inviting diabetes.

"However, it must be emphasised that most basically, diabetes comes as a result of low insulin productivity by the body. This is usually as a result of hereditary factors and that explains why diabetes on certain occasions appears as a family sickness afflicting everybody in the home including children."

He said the upsurge of the ailment can be controlled through regulation of eating habit and proper management when the disease has been noticed.

"Though we may not have much to offer in terms of controlling the disease when the cause is hereditary, but still cultivating healthy dietary habit is a viable way out. Even when the hereditary factor of low insulin productivity is there, avoiding much sugar and carbohydrate and rather opting for more balanced diets are very reliable, prophylactic wise," he said, adding that when the sickness has set in, "there are medically established ways of managing the situation to a good extent.

"One of them is through insulin injection to support sugar to energy conversion activity of the body. In children, this is done mainly in the afternoon when they are more active so that such energy produced could be used up. Of course, the ever indispensable diet control is also to be observed. The basic rule is that a diabetic patient has no choice than to be selective, diet wise", Ezinna said.

Contributing, Mrs. Cecilia Omaghe, a volunteer health worker said though the emergence of the disease is at times apparently inevitable, "many Nigerians are architect of their own problems." She said most people are yet to appreciate the need for periodic check of their blood sugar level which is the only way of detecting vulnerability to diabetes.

"I have discovered over the years that many of our people are not alive to this need. But worse still, indications are that many don't even know that a thing like that exists. In the course of my work, I have come across people who are totally ignorant of the blood sugar test let alone its purpose. But with such test, signs of diabetes are detected even before the disease arrives. So the patient could receive proper medical advice and so effectively ward off the sickness," she said.

Omaghe said though much campaign has gone on regarding going for blood sugar test, much is required still to "impress it on our people the need not to wait until their physicians recommend blood sugar test before they go for one.

Voluntary testing is the rule for a safer living. We should not emphasise voluntary testing only as regards HIV/AIDS. We should also do so as regards diabetes because just like AIDS, diabetes has no cure basically, but it's like we have tended to concentrate more on AIDS because it has been termed a terminal disease. Who does not know that millions have also died of diabetes?" she queried.

Chika Ugonna, a Lagos-based businessman who admitted his father is diabetic, however, said the greatest challenge in the management of the disease is its economic implication. He said such challenge also confronts persons who seek to prevent the disease through controlling their diet as such selective diets amount to "extra-expenses" in the face of the unfavourable economy of the country.

He said the better way out lies in more vigorous campaign towards preventive measures.

"For instance, I only became aware of the fact that I could always check my blood sugar level to prevent diabetes only when my father was diagnosed of the disease two years ago. It was at the hospital that I witnessed the test first," he said, arguing that the situation could have been different were there more vigorous campaign to that effect.

Dr. Olufemi Fasanmade, consultant physician and endocrinologist with the Department of Medicine, Lagos University Teaching Hospital, Idi-Araba, Mushin while speaking with Saturday Champion called for more publicity and funds in stemming the upsurge of diabetes in the country just as is being applied in the fight of infectious diseases such as the Human Immunodeficiency Virus Acquired Immunodeficiency Syndrome (HIV/AIDS), tuberculosis and malaria.

He further suggested that the government should ensure the availability and affordability of essential medicines for people living with diabetes, immediately address the issue of financing for management of diabetes in the country, integrate diabetes prevention in the nation's health system and establish a national diabetes centre in Nigeria to manage diabetes programme.

He also advised Nigerians to avoid simple sugars, fried carbohydrates, soft drinks, honey except when recommended and embrace traditional foods and lifestyle.

Contributing, Dr. Anthony Nwosu, director, Mount Olivet Clinics, Surulere- Lagos called for legislation that would ensure free insulin and/ or subsidise treatment for patients and control the sale of fast foods.

"Aside what the government has to do, individuals should adopt lifestyle changes if the upsurge in diabetes is to go down. This includes avoiding eating habits that promote weight gain, simple sugars, among others. Regular exercise is also key to curbing diabetes", he maintained.