Tag Archives: Diabetes

Africa: Diabetes – Ticking Time Bomb

It is estimated that more than 500 million people worldwide will have diabetes in 20 years’ time. As World Diabetes day was commemorated last week, people have been warned to take better care of their health by reducing their risk of getting diabetes.

About six million people in South Africa have diabetes and most of these people are unaware that they have this condition. Internationally, it is estimated that about 347 million people in the world have diabetes, up from 153 million 30 years ago. Experts in the medical field warn that the numbers will double in 20 years’ time if people do not actively take responsibility for their health.

“If things continue as they are the numbers of people with diabetes will go up by 50%. The current projection is about 550 million people in the world will have diabetes, but we think that things are probably going to change. By informing patients about decreasing diabetes, the chances of diabetes and the consequence of diabetes through better control, exercise and diet, hopefully those numbers will change significantly”, says Professor Gerald Brock from the University of Western Ontario, Canada.

Professor Block says unhealthy lifestyle is a major contributing factor to diabetes.

“This has become a trend. We are seeing increasing rates of diabetes and obesity in South Africa. It probably relies largely on decreasing exercise, higher rates of food consumption. Lack of physical exercise and diet are the two main drivers for the increasing rates of both adult and childhood obesity”, she says.

Diabetes is a chronic illness where the body cannot control its blood glucose levels properly. About 85% of the population with diabetes in the country has what is called Type 2 diabetes, meaning it is more of an acquired condition and it’s reversible.

“The Type 2 diabetic patient is typically over-weight, lacks physical exercise and the important message there is that it is something they can change by changing their diets and begin to exercise. Those people will no longer be diabetic. The insulin resistance or lack of the insulin doing its job in that individual is because they are not exercising, hence, they have obesity problems”, says Professor Block

Courtesy AllAfrica News


Diabetes Myths:- Liberia

Lucy Dollokieh, a mother of four from Liberia’s Nimba County, developed severe pains when urinating and thought she had been cursed by a witch, but when a volunteer came to her village describing diabetes symptoms she recognized them, went to a nearby hospital and was diagnosed with diabetes. She now injects herself daily with insulin.

With low awareness of the disease’s symptoms and only one hospital in the country that can diagnose it  – Ganta Methodist Hospital in Nimba County – the vast majority of the estimated 50,000 cases in Liberia go undiagnosed, according to the World Diabetes Foundation (WDF). Many sufferers who seek treatment do so when the disease is well developed and they are already losing their eyesight or limbs, staff at Ganta Methodist Hospital, where Lucy was diagnosed, told IRIN.

John Dowee, a diabetes victim, 45, told IRIN he had no idea he was suffering from diabetes until he was told by a doctor at the hospital. “I suffered a lot. Whenever I urinate I go through severe pain. It hurt me a lot, but I never knew I was infected.”

Many diabetes sufferers think they have been cursed by a witch, said Viktor Tayror, an administrator at the hospital. They visit witch doctors, offering them kola nuts to decipher the curse, he said. Many are instructed to sacrifice animals to get better. One patient recently treated at Ganta hospital went into a diabetes coma that she thought had been inflicted by witches.

Misdiagnosis in clinics compounded these beliefs, said Tayror. “If they come to a clinic they may get treatment for different things – for a UTI [urinary tract infection] or something else. So people don’t get better and they consider it to be a witch,” he told IRIN. “They don’t know what to do.”

Diabetes, which the UN World Health Organization says causes about 6 percent of deaths worldwide every year, is a chronic condition that occurs when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. (See WDF’s diabetes facts).

While infectious diseases are the biggest killers in the developing world, non-communicable diseases, including diabetes, will become the biggest killers in the next 25 years, according to the World Health Organization.

To raise awareness of diabetes, WDF-trained practitioners run regular radio shows on local radio stations on what they call the “sugar sickness”, said Nora Keah, a nurse and diabetes supervisor at the hospital.

Health staff keep the message simple: “We tell them,` this is what happens, and we can help you’,” added Tayror.

WDF also trains nurses and midwives at Ganta Hospital in proper diabetes care, including running regular screenings at the hospital and around the county to teach them how to manage the disease, including injecting themselves with insulin, and taking their own blood tests. Taking a train-the-trainers approach, practitioners teach community volunteers to encourage people to get tested.

All testing is free, but patients must pay for treatment: US$3 for a vial of insulin, to be injected daily, versus the $20 market rate. Most patients use one vial a day.

Some 200 people have been diagnosed and treated in the two months since the programme began, far higher than previous numbers, said nurse Keah.

While WDF covers training it does not finance staff salaries or drug supply, to try to encourage the project to be sustainable, according to Hanne Strandgaard, programme coordinator at WDF. The Ganta Hospital runs a revolving fund for drug purchase – “people have to get used to buying,” said Tayror – “but $3 per day is still a lot for many Liberians.” Some 83 percent of Liberians earn less than $1.25 a day according to the World Bank’s most recent statistics.

To move forward, the government needs to subsidize diabetes treatment – it currently gives the disease no support because it is low on the health agenda, said Strandgaard. All diabetes care is currently funded by two donors: the WDF and Insulin for Life though Ganta Hospital staff are trying to encourage the US Agency for International Development to come on board.

It is now up to the hospital to persuade the government to adopt the project’s model and to show that it is working, to try to elicit some longer-term funding, Strandgaard told IRIN.

Tayror said hospital staff plan to extend the project further into communities, even into schools, if they can secure more funding, which officially runs out at the end of the year.

While many patients were grateful to finally receive relief from their suffering, some are not optimistic they will be able to keep up treatment. “My condition is very critical,” said patient Zokeh Suah. “I would prefer to die and stop suffering from this disease. I sometimes wonder how my life will turn out.”

[Courtesy IRIN News]

Thailand: Poor Struggle to Access Diabetes Care

Ineffective or insufficient diabetes treatment can be fatal for millions worldwide, according to a new study by the US-based Institute for Health Metrics and Evaluation.  

Of the areas evaluated – the United States, Iran, Mexico, Scotland, England, Colombia and Thailand – only in Thailand did the poorest have more trouble accessing diabetes care than the general population. 

Thai chronic disease specialists say screenings, high-quality labs and treatment for the risk factors that can lead to diabetes – high blood sugar, blood pressure and cholesterol – are lacking outside big cities. 

Using data from 2004, the study found more than eight out of 10 Thai men and women were not adequately treated for these risk factors. Some had never been screened: of 3.2 million people nationwide with diabetes in 2004, 1.8 million people were unaware of their condition.

While Thailand has been lauded for its performance in HIV care, reaching near universal coverage, chronic disease care lags behind. 

“Having a system in place for one condition does not necessarily translate into good care for other conditions,” said Stephen Lim, a former research fellow in Thailand’s Ministry of Health from 2004 to 2007 and one of the authors of the new diabetes management study. 

“For HIV, awareness and advocacy for treatment… has been very high, ie. there is a very public face to the disease. In general there is not the same movement behind combating chronic diseases like diabetes.” 

Unlike infectious diseases, which have a culprit “agent”, chronic diseases have multiple causes, which make them harder to find, treat and wipe out”.

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CAMBODIA: Diabetes – The Silent Killer


Rapid lifestyle changes over the past two decades combined with poverty in Cambodia (according to government statistics, a third of the population lives below the national poverty line of 75 US cents a day) mean diabetes has become a major health problem.

The number of people with the disease is rising: Of the country’s 14.5 million inhabitants, about 352,000 adults live with diabetes, according to the 2009 Diabetes Atlas published by the Belgium-based International Diabetes Federation.

In 2005, about 255,000 people suffered from diabetes, according to an article published that year in the Lancet, a UK-based medical journal. Two-thirds of all cases went undiagnosed before the survey.

In 2010, Cambodia had about 8,000 diabetes-related deaths, according to the International Diabetes Federation. By contrast, the government records more than 200 malaria deaths per year, and has calculated over 1,000 HIV/AIDS-related deaths each year since the most recent prevalence data were collected in 2006.

“It’s a silent killer,” said Lim Keuky, an author of the 2005 study and head of the Cambodian Diabetes Association. “You don’t know about it until the symptoms appear, and then it might already be too late.”

Keuky’s study found a surprisingly high prevalence (5 percent) in Siem Reap, a province in the northwest, and surprising, the study said, that the country is poor, and lifestyles are still fairly traditional.

However, economic growth and urbanization mean many of Cambodia’s poor are eating processed food and not exercising enough.

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