Wednesday, October 27, 2010
The Prevalence of Diabetes mellitus in Nigeria updates and challenges
Diabetes mellitus is a metabolic disorder that affects the way the body handles basic food components like carbohydrates, protein and fats. This is mostly due to lack or abnormaly in action or effect of the hormone insulin.
Diabetes mellitus is old with man. Globally, there are different prevalent levels varying from country to country, race and ethnic groups. The International Diabetes Federation in its recent publication came up with prevalence and incidence values around different regions and countries of the World.
Nigeria with over 250 tribes and different culture and food values, the prevalence values has not been uniform though the International Diabetes Federation recorded 3.9% in its current Diabetes Atlas.
Over the past 30years the prevalence of Diabetes has been increasing steadily. In 1971, a hospital survey by Osuntokun et al in Ibadan estimated a prevalence of 0.4%; In 1989, while screening for Diabetes during a World Diabetes Day(November 14) in Lagos metropolis, Ohwovoriole et al found a prevalence of undiscovered Diabetes of 1.6%; A national survey in 1992 by the Non-communicable Disease Expert Committee of the FMOH recorded a prevalence of 2.2% (National)- Lowest 0.5% in Mangu, Plateau State and highest 7% in Lagos Island; A survey by Puepet 1994, in urban adults in Jos metropolis discovered a prevalence of undiscovered Diabetes to be 3.1%; by 2004, a second survey in Jos recorded a prevalence of 10.3%.
The progressive increase in the prevalence rates of Diabetes is associated with lifestyle changes; overweight and obesity, physical inactivity, alcohol consumption, dietary changes and cigarette smoking- factors that are potentially modifiable.
So much attention is being given even recently to Communicable diseases like HIV, Tuberculosis and Malaria at the detriment of the emerging epidemic of Non-Communicable disease like Diabetes, hypertension and heart disease. Over 30% of our elite population including decision-makers is Diabetic. More painfully so, the majority of the Nigerian Diabetic population cannot afford meaningful treatment; and over 80% of the healthy population are ignorant about Diabetes.
There is a need for more sponsored independent studies on prevalence and incidence rates around the different states of the Federation or geopolitical zones in collaboration with the Federal Ministry of Health, to ensure proper documentation for future references and to provide proper policy framework and guidelines for legislators. This is to help formulate appropriate health policies towards prevention and care for people living with diabetes and also to regularize and standardize the treatment guidelines. This is important and urgent because presently there is no nationally accepted guideline for management of diabetes in Nigeria like we have for malaria or Hiv infection.
These standards will help the patients because presently there are pools of information and misinformation even among health care professionals who have not been in touch with current realities and publications on diabetes management.
In some parts of this great country Nigeria, some health care professionals still advice persons living with diabetes not to eat any carbohydrate but only proteins when current research findings advocates use of complex carbohydrates and other food groups in moderate quantity.
The Federal government of Nigeria through the Federal Ministry of Health needs to quickly act through the Diabetes Association of Nigeria which have chapters in many states of the Federation and other stake holders associations and non governmental organizations to ensure uniformity of standards of care and practice.