How to manage diabetes in populations, by experts

As World Diabetes Day (WDD) was observed recently, health experts have advised Nigerians to always ensure they are physically active. They stressed the need to ensure brisk walking for 30 minutes every day or five times per week, avoid calorie-dense foods, choose foods with less fat, eat smaller portions, eat lots of vegetables, lose weight and drink water instead of fizzy drinks.

The aim of the WDD celebration is to create more awareness about the ailment to reduce the number of people coming down with diabetes on daily basis.

Consultant Endocrinologist at the Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, Dr Olufunmilayo Adeleye, said diabetes is common but potentially fatal. 

She said that with 537 million people currently living with diabetes globally, one in 10 people worldwide have diabetes.

Adeleye said this year’s theme is a clarion call on policymakers and governments to ensure maximised access to affordable care by the diabetic patient through the provision of motivated healthcare professionals, drugs, devices and education. 

She explained that people with diabetes require ongoing care and support for the effective management of the condition and to prevent the development of complications such as blindness, kidney failure, foot ulcers and amputation, reduced quality of life and reduced life span among others. Insulin in particular needs to be provided free of charge for younger people without which they cannot survive.

Adeleye stated that diabetes can be caused by lifestyle-related factors or it could be inherited. The risk of becoming diabetic is high in those who are inactive, and those who are overweight or obese.

Abuja-based medical doctor, public health physician and health promotion specialist, Dr. Obinna Ebirim, said the theme reminds everyone that the diagnosis and treatment of diabetes have undergone significant scientific and technical advancements, which have decreased the burden of the disease and improved outcomes, yet many people still lack access.

He explained that this is due to barriers such as socioeconomic status, education, and health-seeking behaviour. “For instance, there are devices that let people manage their blood sugar levels on their own. Continuous subcutaneous insulin infusion is beneficial for people who experience frequent, severe hypoglycemia,” he said.

Ebirim noted that continuous real-time glucose monitoring improves blood sugar levels and lessens the risk of hypoglycemia. “There are newer, more effective anti-diabetic medications. The theme for this year’s celebration is a call to action for the removal of these obstacles in order to increase access to care that lowers complications from diabetes, lessens disease burden, and improves quality of life.”

Reacting to claims that eating the raw peel of plantain is capable of curing diabetes, he said: “The public must be cautious of the ongoing infodemic, which means the presence of widespread disinformation and misinformation online. To cure diabetes is different from reducing blood sugar levels. A diabetic patient’s blood sugar level can be reduced or temporarily normalised, but that does not mean that a diabetic cure has been achieved. So what is the available evidence-based information around plantain peel and diabetes?”

Ebirim disclosed that a study by Tsado and colleagues in 2021 suggests that a 100g of plantain peel has about 7.76g of the essential amino acid leucine. Then, a study done by Zhang and colleagues as far back as 2007 found out that dietary leucine consumption has health benefits such as a reduction in diet-induced weight gain, high blood sugar level and high blood cholesterol levels.

He, however, said this must be hygienically prepared as you do not want to reduce your blood sugar level and come down with infections due to ingestions of micro-organisms from plantain peels. Umeh and colleagues in their study in 2017 isolated different species of bacteria and fungi from plantain peels.

He said: “I would advise Nigerians to prioritise their health. First, Nigerians should adopt healthy behaviours that prevent diabetes such as stop smoking, especially shisha smoking, which is rife among young people, maintaining a healthy weight, exercising more such as going for frequent walks, and eating a healthy diet of fewer carbohydrates and more plant-based foods.”

He stated that second, visit a medical facility to get checked if you have symptoms suggestive of diabetes like frequent urination, thirst, hunger, or weight loss.

“Thirdly, efforts to guarantee that Nigerians have more access to these developments in diabetes care should be backed by the government, donors, and the private sector. The media should continue to educate and empower the public with information because if they are not aware, they are unlikely going to access these newer and better options for the diagnosis and treatment of diabetes,” he added.

Former Chief Medical Director, of Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, Prof. Akin Osibogun said there is an urgent need to make available medicines, technologies and care to people with diabetes.

“A main focus of the 2022 campaign is on the need for improved access to quality diabetes education for both healthcare workers and people living with diabetes. If untreated or improperly controlled, diabetes can become complicated by diabetic ketoacidosis, cardiovascular disease, stroke, chronic kidney disease, foot ulcers, and damages to the eyes, the brain and peripheral nerves.”

Osibogun noted that members of the public should know their family history, watch their diet, adopt physically active lifestyles or exercise and know their blood glucose numbers through periodic checks so as to seek medical attention if required.

National President Health Care Providers Association of Nigeria (CPAN), Dr. Adeyeye Jimmy Arigbabuwo, said there is a need for well-meaning Nigerians to embrace a healthy lifestyle in order to prevent diabetes and other related health conditions, such as losing a small amount of weight, engage in physical exercise, stop smoking, eat more nuts, fruits and vegetables to stay healthy

He said parents should monitor their children in order to make positive and healthy changes to give their children the best chance to prevent type 2 diabetes because children also have diabetes.

He said: “When the whole family makes changes together, it would be easier to create healthy habits that stick. Parents should get started with these simple but effective tips for healthy eating and being active family style engage in physical exercise, weight control among others.”

Arigbabuwo said many people who have diabetes also have high blood pressure, and hypertension, adding that eating too much salt in your diet can cause high blood pressure which causes damage to the kidneys, heart, brain, and eyes.

He noted that high blood pleasure has no signs or symptoms, therefore the only way to know if you have it is to check at every visit to your doctor or nurse.

He said: “Reducing salt in your diet can help to reduce your blood pressure therefore, do not add too much salt or salt-containing spices to your food cooking. Use spices that do not contain salt, for instance, herbs, pepper, onions, garlic, curry, powder, chili, lemon juice, vinegar, and ginger among others.

“Being active and taking regular exercise lowers blood pressure by keeping your heart and blood vessels in good condition. Regular exercise can also help you lose weight, which will also help lower your blood pressure.

“Adults should do at least two hours and 30 minutes of moderate-intensity aerobic activity, such as cycling or fast walking, every week. Physical activity can include anything from sport to walking and gardening.”