Understanding Diabetes in Niger: Causes, Prevention, and Treatment

2023-11-23 22:23:52

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A chronic non-communicable disease, diabetes is, today, the 5th cause of morbidity and mortality in the world with a rapid increase in cases over the years. The WHO indicates that the number of people with diabetes increased from 108 million in 1980 to 422 million in 2014. Worse, diabetes kills 6 to 7 million people each year. According to the 2021 WHO survey conducted in Niger, the prevalence of diabetes is 2.3%, or more than 50,000 diabetic patients, many of these potential patients unaware of their status.

In Niger, access to care for diabetes patients remains increasingly difficult despite the resources provided by the State through the creation of certain structures which make it possible to effectively lead the fight once morest this disease, notably the National Program for the Fight once morest Diabetes. non-communicable diseases, the multifactorial committee to combat diabetes, etc.

For health professionals, diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin (a hormone that regulates blood sugar concentration) or when the body is not able to use effectively the insulin it produces for this purpose. This results in an increased concentration of glucose in the blood called hyperglycemia. Any person with a fasting plasma glucose level greater than or equal to 1.26g/l of blood checked twice is considered diabetic; and/or blood sugar greater than or equal to 2.0 g/l when the subject is not fasting.

To better understand this pathology, we requested the opinion of the expert, Pr. ag Mahamane Sani Mahamane Aminou, endocrinologist, diabetologist and nutritionist, Head of the Endocrinology, Diabetology and Nutrition department at the General Reference Hospital of Niamey . According to this specialist, there are four categories of diabetes. These are type I diabetes, type II diabetes, gestational diabetes and so-called secondary diabetes. And each of these categories has a specific cause. Type I diabetes, explains the associate professor, occurs in young people under the age of 30 and is linked to autoimmunity. These patients have antibodies that destroy the cells of the pancreas which, at some point, lead to insufficient insulin secretion in the body. However, it is the hormone that allows sugar to be used in the body.

Non-insulin-dependent type II diabetes, or mature-onset diabetes, occurs in people over 40 years old. Its main cause is firstly genetic, therefore linked to heredity, then lack of physical activity, obesity, nutritional factors (very high-calorie diet, especially rich in sugar or fat). The third category of diabetes called gestational diabetes is that which occurs in pregnant women. It is linked to hormonal changes during pregnancy. The last category or secondary diabetes manifests itself when the subject suffers from diseases of the pancreas, liver, hormonal or genetic diseases or the taking of certain medications (orexigenic corticosteroids likely to increase appetite).

80% of diagnosed cases of diabetes are type II.

To the question of whether we can prevent the disease, the specialist answers in the affirmative while qualifying that prevention only concerns the most common diabetes, that is to say type II, that linked to our diet, our way of life. It is a type of diabetes to watch out for, especially if you know that a member of your family suffers from this disease. Today this type of diabetes represents almost 80% of diagnosed forms. However, it is the form that can be prevented. This is why Pr. Ag Mahamane Sani advises individuals potentially at risk to control their diet by eating foods with fewer calories, less rich in sugar and fat. It is also recommended to have a balanced, varied diet rich in vegetables and cereals with a moderate amount of fruit, but also to practice regular physical activity such as walking. “For the rest of diabetes, prevention is not guaranteed, because they are not linked to our lifestyle,” clarified the endocrinologist.

Multiple health consequences

According to the Professor, sugar is a harmful product for all blood vessels. “When its level is high in the body, it damages the blood vessels of the eyes, kidneys, nerves, heart, lower limbs,” he explains. Sugar, he maintains, is the cause of complications in all organs. Diabetes can therefore lead to vision problems or even blindness, kidney failure which can lead to dialysis, coronary or heart failure, and high blood pressure. In the lower limbs, sugar can block the blood vessels in these limbs to cause what is called ischemia or reduced blood flow. “The real complication of diabetes is linked to an interruption of blood circulation to the foot leading to an infection that is difficult for the body to fight. This can lead to amputation of the limb,” he warned.

Individual blood glucose measuring device

In terms of signs and treatments, it should be noted that we are talking regarding diabetes when the blood sugar level is above 2 or 2.5g/l of blood. There are certain signs that allow doctors to detect the disease. It is generally polyuria, that is to say a massive emission of urine which can reach 10 times in one night or during the day. There is also polydipsia, an intense thirst felt despite drinking water. “The patient loses his water, he drinks frequently and cannot do without it. This causes weight loss, weight loss, fatigue and the occurrence of infections (boils, whitlows, genital, urinary, skin, itching of the feet, visual disturbances). An analysis can confirm the disease. When the level is greater than 1.26 g on an empty stomach then this person is declared diabetic,” explained Pr. Mahamane Sani Mahamane Aminou

The diabetologist warned that at present, there is no medicine that can cure diabetes, whether modern or traditional. “Medications help lower blood sugar levels. But, it is a disease that one can live with for a long time if the patient follows the instructions. Modern medications make it possible to stabilize sugar levels. This will prevent the patient from any kind of complications if he takes his medication regularly and consults his doctor,” he insisted.

What a person with diabetes should do

This health professional advises a balanced diet, regular taking of medications for those who already suffer from type II diabetes, taking insulin for those who suffer from type I diabetes, eating vegetables and certain cereals, do physical activities (walking, football, swimming for 30 to 45 minutes per day). “If blood sugar levels persist despite diet and physical activity, oral antidiabetics must be taken. Finally, you must follow insulin therapy,” recommends Pr. Ag. Mahamane Sani Mahamane Aminou.

The endocrinologist, diabetologist and nutritionist noted that diabetics are often destitute people living with a chronic illness whose care strips them of what little they have. According to him, it is desirable that the State, given the increasingly high rate of cases and the cost of care, provide more support for the care of patients. He believes that this will be done by subsidizing medicines, access to hospitals, and reducing the cost of additional examinations like other diseases such as cancer or AIDS. Knowing the difficulties well, Pr. Mahamane Sani Mahamane Aminou also urges the State to facilitate examinations and make blood glucose self-monitoring devices available. The endocrinologist especially encourages the population to prioritize the detection of signs by being screened, once or twice a year, especially people who have passed the thirties because, he assures, “if the disease is detected early, it will be better treated or supported.”

It should be noted that November 14 of each year is established as World Diabetes Day. This day dedicated exclusively to diabetes is an opportunity to recall the efforts made and the challenges to be taken up, above all to raise awareness among patients and decision-makers regarding the management of this disease, to make pleas to accentuate prevention, mobilization of funds to finance treatment and early diagnosis. This year in Niger, the day was celebrated with a hike at the FENIFOOT center. The day is dedicated to “access to diabetes care”.

Mamane Abdoulaye (Official Video)

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