FG Should Make Access To Insulin Seamless For Diabetic Patients - Dr Adesina - THE DAILY CRUCIBLE



Sunday, November 14, 2021

FG Should Make Access To Insulin Seamless For Diabetic Patients - Dr Adesina

                           •Dr Adesina


The Daily Crucible | Published Sunday,  November 14, 2021

Dr Olubiyi Adesina is the Chief Consultant Diabetologist at the Federal Medical Centre, Abeokuta and the Chairman, Diabetes Association of Nigeria (D.A.N), Ogun State Chapter. He bares his mind to The Daily Crucible on diabetes and some issues surrounding this health condition as the world marks 2021 WORLD DIABETES DAY today, November 14. 

Globally, today is designated as diabetes day. What is unique about this year edition of the celebration? 

 Today is World Diabetes Day and the theme is : ACCESS TO DIABETES CARE: IF NOT NOW, WHEN? This theme will run from 2021 – 2023. This theme was engendered because exactly 100 years after the discovery of insulin which is the most effective treatment for diabetes by Banting and Best in Toronto.
It is worth repeating here that a century after its discovery, insulin and other fundamental components of diabetes care remain beyond the reach of many who need them. This must change. Support our call to action to ensure it reaches the people who need to hear it

What role does insulin play in diabetes management ? 

The insulin is a life-saving drug, though, it is still not widely and freely available to millions of people who need it, especially in sub-Saharan Africa, particularly Nigeria which has a high burden of diabetes with 2.4% of the population (about 4 million Nigerians) living with diabetes. The term ‘access to care’ means the availability and the affordability of care. In some instances in Nigeria, insulin may not be available, and in some instances when available, it cannot be afforded by those who require it, particularly those that have no health insurance and have to pay out of pocket for this insulin. 

What is the cost implication on a patient ?

An average person with diabetes on insulin will need about twenty thousand Naira per month to buy this medication. Now is the time for both State and Federal Governments to do something about the accessibility of Nigerians with diabetes to Insulin and follow the path of Cameroon and Egypt who have solved this problem for their people living with diabetes - through National Diabetes and Hypertension Programme. It has been difficult in the past and remains difficult now for people with diabetes in Nigeria to access diabetes care. The vast majority of those living with diabetes that I see are elderly retirees on a pension that cannot support diabetes care. 

How is access to insulin elsewhere like in relations to Nigeria ?

Elsewhere in the world (Europe and the Americas) insulin in widely available to people living with diabetes through health insurance. More modern, safe and efficacious types of insulin called insulin analogs are even available to them compared to the older versions of insulin (called human insulin) which is the more available type in Nigeria, which though cheaper than the more modern ones is still unaffordable to the vast majority of Nigerians living with diabetes. 

What should we know about diabetes and how does the condition kick - start? 

Diabetes occurs when an hormone called insulin which is produced by an organ in the human abdomen called pancreas is either no longer produced (Type 1 Diabetes) or it is no longer effective (Type 2 diabetes). Insulin is released whenever we eat to ensure that the glucose (sugar) released from the ingested meal is kept under control.When insulin is unavailable or ineffective, the blood sugar level rises leading to symptoms such as excessive urination, excessive thirst, and excessive hunger pangs/eating, weight loss, blurring of the vision, non-healing wounds especially on the feet, poor erection of the penis in males, frequent pregnancy miscarriages in females.

The likely causes? 

Causes of diabetes include heredity/familial causes as diabetes tends to run in families, excessive weight/obesity, sedentary life style, consumption of a more westernized diet rich in pastries as opposed to the traditional African diet rich in fruit and vegetables, excessive alcohol consumption which damages the pancreas, diabetes can occur as a sequel of treatment of hypertension with drugs called thiazides in high doses, it can also occur as a consequence of abuse of steroid drugs like prednisolone which is now being seen increasingly in Nigeria. 
Diabetes may also be seen for the first time during pregnancy which is referred to as Gestational diabetes which leads to increased maternal and child mortality if not quickly recognized and treated. 

Are there preventive measures against the disease ? 

Diabetes prevention steps are very clear: maintain an healthy weight/avoid obesity, consume a diet high in fruits, vegetables, nuts and avoid energy dense foods like pastries and sugar sweetened drinks. Water is the best drink to take. Regular exercise/reduce sedentary lifestyle. Exercise at least thirty minutes daily. Alcohol in moderation: not more than one bottle a day of regular beer for males and half a bottle for females. Blood sugar checks at least once a year for early detection of abnormal levels. 

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