Health experts have warned that excess adiposity is the most challenging risk factor for diabetes, and thus, maintaining a healthy body weight and avoiding weight gain during adulthood is cornerstone of diabetes prevention.

The experts also noted that for Nigerians to have access to quality diabetes care, government should create spacious playing grounds in schools across the country to encourage exercise and adequate physical activity among school children to reduce diabetes among children.

She said Africa has the highest proportion of death from DM. The undiagnosed cases range between 50 and 70 per cent. The prevalence of DM in Nigeria in 2018 was 5.77 per cent, greater than 12 million with highest incidence in South South geopolitical zone of Nigeria.

“With early diagnosis and access to appropriate care, DM can be managed and its complications prevented,” she said.

The consultant physician noted that people with family history of DM, some ethnic group such as African-Americans, Asians, Pacific Islanders, among others, should try to known their status by going for diabetes screening at least twice a year.
According to Okunowo, people living with polycystic ovarian syndrome (PCOS) and women with previous gestational diabetes mellitus (GDM) are at risk of having DM. Same goes for women with previous delivery of baby with weight greater than or equal to 4kg. Such babies are also at risk of DM.  Also, people with elevated serum triglyceride greater than or equal to 250mg/dl amongst others.

Okunowo said there are various ways of preventing DM even if you have a family history of diabetes mellitus, which include: healthy eating, reduced intake of refined diet, take diet rich in fiber and reduce high caloric diet that could lead to overweight and obesity causing insulin resistance.

According to her, DM can be prevented through regular exercise and avoid sedentary lifestyle. Avoid smoking and reduce alcoholic intake including energy drinks. Regular medical checkup, if a routine checkup showed prediabetes, it could be reverted to normal glucose, which good medical advice and treatment can solve.

On what government needs to do to support prevention of diabetes in Nigeria, she said continuous health education using various social media platforms such as facebook, Instagram, TikTok, podcast, radio and television to inform members of the public about diabetes.

She raised the need for government to increase tax on high sugar/energy drinks and reduce tax on low or no sugar drinks to discourage intake of high caloric drinks.

Okunowo explained that there is also need for diabetes screening and treatment to be made affordable and available for all Nigerians to access.

For Group Managing Director (GMD), Drugfield Pharmacy, Ota, Ogun State, Olakunle Ekundayo, said diabetes and high blood pressure are on the increase among blacks and the poor as a result of lack of awareness about the ailments.

He said unhealthy life style is also one of the causes of diabetes as it is more dangerous than high blood pressure. “Now, the truth is, if one has diabetes, the chances are there that the same person could develop high blood pressure, kidney and liver problems, among others.”

Ekundayo said eating habits also contribute to these health challenges especially eating sugary foods and drinks. “Consuming excess sugary foods and drinks are dangerous especially when it is free, because it will not show up immediately but sooner or later the diabetes could come up and it is very difficult to manage. Because you have to take diets, drugs every day, therefore, it is always better to prevent.”

Ekundayo pointed out that why access to diabetes care is difficult is the economy. Nigeria currently spends billions of naira to import 70 per cent of its drug needs from countries such as India, China, Germany, the United States, Pakistan, and Netherlands. Thus, he urged the Federal Government to review import duties on raw materials for the production of drugs in the country for Nigerians to have access to quality healthcare delivery.

He expressed dismay that prices of drugs have gone up as a result of the paucity of foreign exchange, and if nothing is done urgently, it could unleash hardship on the people than expected.

The Group Managing Director said: “Decayed infrastructure has not helped matters, as it makes it impossible for the movement of goods and services in the country.  Other problems that have plagued the pharmaceutical companies are multiple taxations, including government policy inconsistency and lack of funds.”

He said more than N800 billion is being spent each year on the importation of drug raw materials, antibiotics, and vaccines. This occurs in spite of the enormous number of manufacturing companies that are located around the nation.

Dr. Oluwatoyin Kemi, who works with Global Alliance for Improved Nutrition (GAIN), said diabetes is hereditary and one has to understand his/her own genetic make-up.

She said people should also be careful about the type of food they eat and ensure quality and standard of food that comes to their table to reduce the risk of diabetes. “As we know National Agency for Food and Drug Administration Control (NAFDAC) and Standard Organisation of Nigeria (SON) are the regulatory agencies ensuring that food producers are doing the right thing! GAIN also work with these regulatory agencies to ensure that Nigerians are served with adequate nutrition and be free from diabetes including other non communicable diseases.

A public health physician at the Lagos State University College of Medicine (LASUCOM), Ikeja, Lagos, Dr. Bukola Popoola, said too much sugar circulating in the bloodstream causes diabetes.

In terms of diabetes preventions, she said type 1 diabetes is currently not preventable. Type 2 diabetes on the other hand is largely preventable with behavioural and lifestyle modifications, which include increased physical activity. Avoid sedentary lifestyle. Exercise regularly.  Aim for at least 30 minutes of exercise each day at least five days a week.

“For extra motivations, go with friends, take a dance class, and relax with yoga. Reduce intake of red meat, processed, and refined carbohydrates. Increase intake of vegetables, fruits, and whole grains”.
“Maintain a healthy weight. Lose weight if your body mass index (BMI) is greater than 25kg/m2. Stop smoking. Limit alcohol consumption. Managing hypertension, high cholesterol; reduce over stress among others”.
“Get adequate sleep seven to nine hours and seek treatment for sleep disorders”.

However, she said efforts should meat be directed towards preventing children and adults from adopting harmful lifestyles, so that there will be elimination of risk factors. “This is done through mass education.”

Popoola advised government to reduce out of pocket payment in treatment of diabetes, adding the heavy economic cost of diabetes care shows that primary prevention is crucial. “There is need for government involvement in preventive programmes such as enlightenment campaigns on the risk factors of diabetes and related non communicable diseases (NCD) such as hypertension.

“Government at all levels need to provide cost-effective health care service and improve healthcare health care funding to prevent catastrophic health expenditure or spending on the part of the patients.”

She said the government should reduce health inequality through well-developed health insurance to ensure wider coverage that allows for achievement of optimum care for persons living with DM.

“There is also need for government to increase the budgetary allocation for health sector as recommended by the World Health Organisation (WHO). Legislative measures should be put in place to achieve tobacco and alcohol control, prevention of nutritional disorders and obesity.”