Diabetes: inaccurate, poor blood glucose monitoring escalating complications, deaths

Poor self-monitoring and inaccurate blood glucose result are parts of the major reasons Nigeria is recording increasing complications and diabetes-related deaths, experts reveal.

According to them, 70% of Nigerians living with diabetes do not achieve control of their blood glucose, and this is largely due to poor self-monitoring and inaccurate blood glucose result by patients.

The experts said doctors need an accurate blood glucose report to help with patient care.

In a chat with journalists on the current situation on diabetes management in Nigeria, the Marketing Manager of Roche Diabetes Care, Mr Adeniyi Adeola said many people living with diabetes are not achieving and maintaining recommended target glucose level due to ignorance both on the part of patients and caregivers.

According to him, people living with diabetes in Nigeria are faced with peculiar problems which make the management of the condition and expected blood sugar control (referred to as glycemic control in medical parlance) rather difficult.

For instance, he said, the financial constraint has been recognized as a major factor for poor glycemic control as the nation’s Health Insurance Scheme does not currently cater for a majority of patients and they have to pay out-of-pocket for their drugs and blood glucose tests at a price they can hardly afford.

He added that many diabetes patients do not adhere to their therapy while some will not accept that they have to live with the condition for the rest of their lives until they develop complications. For others, they find daily insulin injections and pricking their finger for self-monitoring too painful and would therefore not comply.

Adeola also noted that caregivers in Nigeria have developed “therapeutic inertia” in diabetes management. According to him, because of their heavy schedule, doctors rarely spend enough time with patients and this affects those living with diabetes most as they are denied the opportunity to have enough information that would help them achieve glycemic control.

The communication gap between caregivers and patients, he said, is also responsible for poor personalized diabetes management in the country as only a few patients practice self-monitoring, an essential part of the management.

Also, he noted, caregivers sometimes, do not initiate treatment for diabetes on time while many still do not recommend the use of insulin. For now, he said, decision support is lacking on the part of caregivers while the nation itself lacks a disease registry.
He expressed the company’s concern on the current poor glycemic control by Nigerians living with diabetes and pledged that Roche Diabetes Care would continue to support both patients and caregivers to change the situation.

He said the company currently supplies the world’s best blood glucose monitoring devise, the Accu-Chek Active and will also launch the latest brand, the Accu-Check Instant System later this month.

“Our goal is to change the way diabetes is being managed and reduce therapeutic inertia,” he said.

In another presentation, the Regional Sales Manager, Roche Diabetes Care, Mubarak Gyedu disclosed that current diabetes management should focus on personalized care and should include data assessment, structured education, therapy evaluation, self-monitoring of blood glucose and decision support.

He noted that many caregivers in Nigeria, after Data Assessment progress straight to Therapy, leaving out education and patient involvement through self-monitoring of blood glucose and will not give much information on what the patient needs to know such as whether or not his blood glucose is under control and what to do if it is not.

“If self-monitoring of blood glucose is well done, a lot of money can be saved while the patient will be saved the ordeal of being placed on a therapy they may not need,” he said.