_____________

When you see two diabetics there is one other diabetic who doesn’t know that they have diabetes.

Half of the people living with diabetes do not know that they have the disease, says Dr William Lumu, the president of the Uganda Diabetes Association.

“In 2014, out of the people screened 650,000 Ugandans had diabetes, but nearly 350000 people did not know they had diabetes. Cases are increasing." 

“From studies done last year whose results will be released soon, the numbers have tripled,” reveals Lumu.

Diabetes is a chronic, metabolic disease. It is 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.

So why the surge?

The increase in diabetes is as a result of physical inactivity, to consumption of refined sugars and processed foods.

“People are using motorcycle taxis (boda boda’s) and not walking enough,” says Lumu.

“There is a lot of refined sugars in the market, processed juices, lots of bread, wheat based food, posho, rice, a lot of food with very high starch content that makes us put on weight.

“We have run away from our organic food such as matooke, sweet potatoes, yams, cassava and embraced refined foods that makes us put on weight.

"This weigh is around the waist; it is called central obesity. When that weight comes in, you have the risk of developing diabetes, hypertension, lung diseases and so much more," explained Lumu.

Diabetes is one of the leading causes of blindness, kidney failure, heart attack, stroke, and non-traumatic lower limb amputation in Uganda, a meeting convened in Kampala disclosed.

In March, Ministry of Health, with support from World Health Organization (WHO), convened the meeting to raise awareness and commitment on implementing sustainable priority interventions to prevent and control diabetes.

According to the International Diabetes Foundation (IDF), in 2021, an estimated 716,000 adults in Uganda had diabetes.

About 89% of Ugandans with diabetes are neither on medication nor aware of their status and therefore present to the health system with difficult to treat complications.

The burden

According to a WHO report, the global age-standardized prevalence of diabetes doubled from 4.7% in 1980 to 8.5% in 2021 among the adult population 18 years and older.

In 2019, diabetes was the direct cause of 1.5 million deaths worldwide, 48% of which occurred prematurely, before the age of 70 years.

In Africa, there were 24 million people living with diabetes in 2021. This is projected to increase to 55 million by 2045, an increase of 129%, the highest increase of all regions.

Globally one in 10 adults have diabetes, according to IIDF.  It says over 90% of the affected have type 2 diabetes.

IDF estimates that as many as 212 million people, or half of all adults currently living with diabetes, are undiagnosed. Most of these have type 2 diabetes.

Dr. Susan Nakireka who represents Uganda in the East Africa Non Communicable Diseases (NCD) Alliance Initiative says the recent statics are worrying, and what is projected for Africa is so high compared to other continents, regions.

“The biggest gap we are seeing is the lack of knowledge. Many of the people who have diabetes have no clue that they have it.

“Screening has been a problem. Many patients who come to us have never screened for diabetes.

“They come with complications to the eye clinic because of visual problems, come with kidney problems and they have no clue.

“There has been a gap in screening and it’s a gap that we are trying to bridge,” says Nakireka, Saeed Hernandez Head of Business Development Rene Industries Ltd.

Involving everyone

Diabetes remains a pivotal global health challenge, but once a year on November 11, the world unites to raise awareness and foster change.

This year World Diabetes Day 2023, was marked under the global theme “Empowering Global Health.”

It not only centres on individual health but also stresses the importance of communities working together to combat this global issue.

At national level World Diabetes Day 2023 will be marked on November 23, in Atutur, Kumi District, East of Uganda under the theme “Empowering Families to Fight Diabetes and its Consequences.”

Lumu says having one member of the family with diabetes means it’s just a matter of time before another individual gets diabetes, that’s why it needs empowering families with the right information

 “When you empower people by creating awareness, they will screen early for diabetes, modify their lifestyle, diets, do physical activity, regulate alcohol consumption and stop smoking. This is at prevention level.

“When you empower the family and equip a member of family with right information they can screen early for diabetes,” says Lumu,

Early screening means early treatment and prevention of complications which are fatal and expensive to treat but Lumu believes more can be done to raise awareness communally.

“We need religious leaders and institutions to create awareness, with guidance from professionals. Also, the media houses.  We are not using these means enough,” says Lumu.

“There is need to exercise, have good nutrition, reduce on alcohol intake, smoking. There are so many things people smoke these days.

“There is also need to eat right. Eat vegetables, as much fish as you can, regulate the red meat, move away from refined carbohydrates, those flours.

“If you want to eat flour, use maize flour, use grade three instead of one, eat rice when you have no other option, otherwise we should go back to our traditional (organic) foods,” says Lumu.

He says people in the past used to feed from the garden, 

"It may be difficult now to go to the garden to get food but we still have markets that are representative of the garden.

“When you go there (in the market) buy some organic foods matooke, yam, cassava, sweet potatoes those are things to think about.

“Sixty percent (60%) of the glucose in the blood stream comes from the carbohydrates, starch we eat, if the starch component of the diet is regulated, you will have already started the journey of controlling diabetes,” says Lumu.