On this year’s World Diabetes Day, a professor of Medicine and Endocrinology with great experience in diabetes care, Prof Olufemi Fasanmade has said that eating eba, amala and fufu with vegetables was good for diabetes patients even as he advised Nigerians to eat traditional foods to prevent the disease.
The endocrinologist at the Lagos University Teaching Hospital, who spoke during a webinar organised by the Nigeria Medical Association, NMA, Lagos State Chapter on Monday lamented that as of 2021, 4 to 5 million Nigerians were affected by the disease.
Fasanmade who gave dire diabetes statistics in the country said less than a third of patients are treated to target and less than 20 per cent are on any form of insulin.
Stating that diabetes affects 1 in 10 people, especially adults, he explained that eating eba is much better than eating wheat because it contains a lot of fibre.
“A lot of fibre is present in our traditional eba. And by the time you put vegetables on top again, you are taking vegetables which is extra fibre. So eating eba is good.”
“The only caveat there is that your eba should not be as big as your head. Because some people eat like there is no tomorrow. You will see the size of the eba and you will be wondering where it’s going to disappear into.”
“So eating eba is better than eating two meat pies. Eating eba is better than eating rice. Eating eba is better than eating a loaf of bread. If you have diabetes, don’t mind the people that say eat wheat.”
“Those are done by the big, big industries that want to sell their wheat. Eating eba is very good. Amala is very good. Fufu too are good. So I think those are my questions.”
“Leave all those sweet meat pies and shawarmas, shortbread biscuits and all those sweet things alone. The best fruit juice to drink is water. Fruit juice is not even good. So don’t say, well, I don’t take soft drinks. I take fruit juice. Most of those fruit juices are highly concentrated and many of them have fructose added to them. So that is what one should do in this current economic situation.”
“If you are poor, you don’t want to go and develop diabetes because the poverty will escalate. So try to tell such people to eat healthy. Well, prediabetes is just anybody whose blood sugars are not exactly normal.”
He explained that “if your fasting blood sugar is in that range of 100 to 125, you have prediabetes. If that has been diagnosed in you or prediabetes, then you have a greater motivation to live a healthy life.”
Fasanmade said to prevent diabetes people individuals should start trying to clock 8,000 to 10,000 steps daily, exercise three to four times a week, sleep five to six hours a day, reduce weight down to the ideal body weight for height, put away alcohol, cigarettes, soft drinks, and fast foods.
Regretting that many of the affected do not know their status, he said: “usually more than half of them don’t even know that they have any such condition. If you can’t afford the medication or you can’t screen yourself then you can’t be treated to target.”
Insisting that prevention is better than cure and cheaper, he said some of their patients spend N30,000 to N40,000 monthly, adding, “That is those that don’t have any complications.”
“Those with complications can spend 10 times more. So that’s all we can do to stem the tide in diabetes and its complications.”
Further, Fasanmade who is also the Unit Head of the Endocrinology, Diabetes and Metabolism Division of the Department of Medicine in the College of Medicine, University of Lagos and Lagos University Teaching Hospital said the World Health Organisation and the IDF have shown that quite several people don’t even know they have diabetes.
On this year’s slogan, “Everybody should know their risk “he regretted that sometimes half of the people say ‘God forbid’ when the disease is already inside their body.”
Stating that the latest statistics show that about N537 million people had diabetes, only 20 million were in Africa and about a quarter of them were in Nigeria.
He said in 2017 there were 16 million people, but by 2045 there are going to be over 41 million people affected with diabetes. “It tells us that the area that is going to bear the heaviest brunt of the westernisation and increase in the number of people with diabetes are people in Africa.
“We find out that the mean HbA1c for most patient cohorts worldwide, even in the areas where they have good health insurance, covers between 8 to 9 per cent which means most people are poorly controlled. Usually, people are not on insulin because they can’t afford it or they are not educated. And in Nigeria, less than 1 percent is on pumps and just a few have continuous glucose monitoring.”
COMPLICATIONS OF DIABETES
“Unfortunately in Nigeria, there is no certified diabetes educator which is shocking. There is poor knowledge of the use of insulin; there are few or no diabetes boot camps. And because of all these inadequacies and because of this reduced level of knowledge, there is a lot of inertia to escalate treatment. Unfortunately, Nigeria still has a very low coverage of health insurance and therefore many people are not properly treated. So the number of deaths related to diabetes, I borrowed this slide from Novo Nordisk.”
“And it shows here that the people who died from diabetes, are much more than the combined number dying from HIV, tuberculosis, and malaria which are regarded as great scourges in this country. “So you can see diabetes widely killing people without people noticing. While the other communicable diseases which people shout a lot about, they are killing much less people.”
Noting that diabetes causes widespread damage, he said diabetes cheats patients as it already occurs many years before it comes to the knowledge of the patient.
He said timely control right from the time you know is very important.
He said diabetes, depending on how poorly it is controlled in patients may lead to retinopathy, glaucoma and the result or the effect of diabetes on the eye is blindness.
“Diabetes is a condition that claims many, many feet. Diabetes is the most common cause of lower extremity amputation. Again, diabetes is a condition that very often leads to kidney failure after some years. Miscarriages are another problem that patients do have. And you find out that many first-trimester abortions or miscarriages are due to body-controlled diabetes.”
“There are many people with diabetes that go on to develop heart attacks. And you find out that diabetes and hypertension if you add the two together, they are probably the cause of 90 per cent of heart attacks.”
DIABETES AFFECTS EVERY SINGLE PART OF THE BODY
“In the area of oral health, people with diabetes usually develop inflammation or swelling of their gums, bleeding gums, shaky or mobile teeth. And then sometimes the teeth start falling out. A typical person who has diabetes and is not well controlled, within a few years of diagnosis, the teeth start coming out. And before you know it, the person has become a toothless human being, not a toothless bulldog,” Fasanmade stated.
Earlier, the Associate Professor of Public Health, CMUL/Hon. Consultant Public Health Physician, LUTH, Dr. Alero Roberts in her presentation, lamented the shortage of skilled healthcare professionals and the need for continuous diabetes education and training.
Roberts said to win the fight against diabetes there was a need for massive public awareness campaigns, the development of healthcare infrastructure, and financial support for patients through insurance schemes.
“What we need is monitoring and evaluation, research and development and the need for importance of a multipronged approach.”
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