Diabetes in Africa is a silent killer.
By Lydia Nobert, Sokona Sy, Serge Bataliack
Diabetes: Among the non-communicable diseases (NCD) responsible for premature deaths in the African Region.
Diabetes is defined as a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys, and nerves. Globally, an estimated 537 million adults aged 20–79 years are currently living with diabetes. This represented 10.5% of the world’s population in this age group in 2021. Moreover, an estimated 24 million people were living with diabetes in Africa in 2021, and the number is predicted to increase by 129% to 55 million by 2045.
Diabetes of all types can lead to complications in many parts of the body and can increase the overall risk of dying prematurely. In 2019 in the African Region, 37% of deaths were attributed to NCDs where cardiovascular disease accounts for the largest number of deaths among which diabetes is associated with 1.9 million deaths . Countries with the high number of people with diabetes in African region are South Africa 4.2 million people, Nigeria 3.6 million people, Tanzania 2.9 million people, Ethiopia 1.9 million people and Democratic Republic of Congo 1.9 million people. The estimated prevalence of diabetes in 2021 shows that more adult women live with diabetes than men. For attaining SDG 3.4 of reducing by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being, diabetes is among the key priority diseases to fight on.
Different types of diabetes
Diabetes is categorized into four types: type 1, type 2, gestational diabetes and ketosis-prone type 2 diabetes.
Diabetes type 1
This is characterized by lacking insulin production in the body. People with type 1 diabetes require regular managing of insulin to control the amount of glucose in their blood. In the absence of insulin, people with type one diabetes cannot survive. The cause of type 1 diabetes is not known, and it is currently not preventable. The main symptoms of this type are thirsty, excessive urination, constant hunger, fatigue, vision change and weight loss.
Diabetes type 2
Outcomes of the body’s ineffective use of insulin. Symptoms may be like those of diabetes type 1 but are often less marked or absent. As a result, the disease may not be known for years, until complications have already arisen. In the African Region 95% of people were diagnosed with this type of diabetes. Previously, this type of diabetes was observed among adults but currently it is also noticed in children.
Gestational diabetes (GDM):
This is a temporary condition that occurs in pregnancy and carries long-term risk of type 2 diabetes. Occurs when blood glucose is above normal but still below the diagnostic of diabetes. Women with gestational diabetes are at risk of some complications during pregnancy and delivery, as are their infants. During the prenatal screening is when this type can be diagnosed.
Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG):
These are middle conditions in the transition between normality and diabetes 3, though the transition is not inevitable. People with this type are at high risk of heart attacks and strokes.
Common consequences of diabetes.
Diabetes can lead to the following effects on the human body: Increased risks of heart attack among adults, reduced blood flow and nerve damage leads to high chance of foot ulcers, infection, and eventual need for limb amputation, Kidney failure, Blindness as the result of accumulated damage of small blood vessels in the retina. Moreover, people with diabetes are more likely to incur catastrophic personal health expenditure.
Acting upon diabetes
If diabetes is detected early, it can be treated. if not, there are ways to help reduce its consequences. Those includes diet and physical activity along with lowering blood glucose, end tobacco use, insulin for type 1 diabetes and oral medication for type 2 diabetes, controlling blood pressure, lowering the level of other risk factors that damage blood vessels.
Possible ways to prevent diabetes.
Most the world’s diabetes cases are type 2 diabetes. Some risk factors such as being obese or overweight, insufficient physical activities, unhealth diets and smoking can be modified though environmental and behavioral changes. Regular and adequate level of physical exercise and health diets through limiting saturated fatty acid intake to less than 10% of total energy intake can help reduce the risk of diabetes. Multisectoral, Population-based approaches and effective policies should be made viable to facilitate behavioral change and create a supportive health lifestyle. The key behavioral changes to be driven by policy include increase the fibre intake of more than 15g per 1000 kcal, reduce alcohol intake to less than one drink per day and quit smoking. Moreover, improving early childhood nutrition through improving maternal health and nutritional status can prevent future diabetes.