An appeal has gone out to the Federal and state Governments in Nigeria to do something urgently about accessibility of Nigerians with diabetes to Insulin.
The appeal was made by Dr Olubiyi Adesina, the Chief Consultant Diabetologist at the Federal Medical Centre, Abeokuta and the Chairman, Diabetes Association of Nigeria (D.A.N), Ogun State Chapter yesterday in his response to a questionnaire sent to him by the Independent Newspapers Association of Nigeria (INAN) to probe into the issue of diabetes in the country on the occasion of the World Diabetes Day 2021 which is being marked today.
Dr Adesina pointed out that in some instances in Nigeria, insulin may not be available and in other instances when it is available, it cannot be afforded by those who require it as they have no health insurance and have to pay out of pocket for this insulin.
He explained that now is the time for both federal and states governments to act to ease the burden of access to medication carried by diabetics monthly as an average person with diabetes on insulin will need about Twenty thousand Naira (N20,000) per month to buy this medication.
Dr Adesina urged Nigerian governments to follow the path of Cameroon and Egypt who have solved this problem for their people living with diabetes as it has been difficult in the past and remains difficult now for people with diabetes in Nigeria to access diabetes care noting that the vast majority of those living with diabetes that I see are elderly retirees with a pension that cannot support diabetes care.
He noted that it is a shame that a century after its discovery, insulin and other fundamental components of diabetes care remain beyond the reach of many who need them insisting that this must change, the medical expert begged for support for “our call to action to ensure it reaches the people who need to hear it.”
The Chief Consultant Diabetologist who explained that the 2021 WORLD DIABETES DAY’s theme, “ACCESS TO DIABETES CARE: IF NOT NOW, WHEN?” will run from 2021 to 2023 as the theme was brought about by the fact that exactly 100 years after the discovery of insulin which is the most effective treatment for diabetes by Banting and Best in Toronto, Canada, this insulin which is a life-saving drug is still not widely and freely available to millions of people who need it especially in sub-Saharan Africa.
He pointed out that the problem is even more acute in Nigeria which has a high burden of diabetes with 2.4% of the population (about 4 million Nigerians) living with diabetes.
“Elsewhere in the world (Europe and the Americas) insulin is widely available to people living with diabetes through health insurance”, Dr Adesina noted.
The Chief Consultant Diabetologist said more modern, safe and efficacious types of insulin called “insulin analogs” are even available to them abroad compared to the older versions of insulin called “human insulin” which is the most available type in Nigeria.
He said despite that the human insulin which is the most available type in Nigeria is cheaper than the more modern ones, it is still unaffordable to the vast majority of Nigerians living with diabetes.
The Chief Consultant Diabetologist explained that diabetes occurs when an hormone called insulin which is produced by an organ in the human abdomen called pancreas is either no longer producing (Type 1 Diabetes) or it produced is no longer effective (Type 2 diabetes).
He said Insulin is released whenever we eat to ensure that the glucose (sugar) released from the ingested meal is kept under control and that when insulin is unavailable or ineffective, the blood sugar level rises leading to symptoms such as excessive urination, excessive thirst, and excessive hunger pangs/eating.
According to Dr. Adesina, other after-effects include weight loss, blurring of the vision, non-healing wounds especially on the feet, poor erection of the penis in males and frequent pregnancy miscarriages in females.
He said causes of diabetes include heredity/familial causes as diabetes tends to run in families, excessive weight/obesity, sedentary life style, consumption of a more westernized diet rich in pastries as opposed to the traditional African diet rich in fruit and vegetables and excessive alcohol consumption which damages the pancreas.
The expert Diabetologist noted that diabetes can also occur as a sequel of treatment of hypertension with drugs called thiazides in high doses, it can also occur as a consequence of abuse of steroid drugs like prednisolone which is now being seen increasingly in Nigeria.
He warned that diabetes may also be seen for the first time during pregnancy which is referred to as Gestational diabetes which leads to increased maternal and child mortality if not quickly recognized and treated.
The doctor said diabetes prevention steps are very clear: maintain an healthy weight/avoChiefesity, consume a diet high in fruits, vegetables, nuts and avoid energy dense foods like pastries and sugar sweetened drinks. Water is the best drink to take. Regular exercise/reduce sedentary lifestyle. Exercise at least thirty minutes daily. Alcohol in moderation: not more than one bottle a day of regular beer for males and half a bottle for females. Blood sugar checks at least once a year for early detection of abnormal levels.
