• Tuesday, June 18, 2024
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Preventive medicine, precursor to reducing global NCD burden


No doubt, the globe is confronted with chronic diseases which have become major causes of death, disability and one of the most challenging health problems in 21st century. According to the World Health Organization (WHO), 60 percent of deaths globally are attributable to chronic non-communicable diseases (NCDs) such as diabetes, cardiovascular diseases, renal disorders, etc.

Diabetes mellitus is becoming one of the most common NCDs globally with an estimated 366 million people living with the disease in 2011. It is projected that the number of people living with diabetes will increase to 552 million by 2030 globally. In Africa, Nigeria has the largest number of diabetes sufferers with three million people suffering from the diseases, according to recent statistics. It is projected that by 2030, 4.8 million Nigerians will develop diabetes.

The diabetes pandemic has evolved in association with rapid cultural changes, ageing population, increasing urbanisation, dietary lifestyles, and unhealthy behavioural patterns without prevention and control preparedness. Although the prevalence of infectious diseases has a major effect on the economy of developing countries, diabetes appears to be the globe’s most threatening epidemic.

In the wake of this development, continuous medical education and preventive medicine, experts say, remains an antidote in reducing the diabetes burden in Nigeria and beyond.

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Speaking with BusinessDay, Alick Richard, diabetologist at Vedic LifeCare Hospital, Lekki, said that the primary prevention of Type 2 diabetes (T2D) has shown to be possible in susceptible individuals by healthy diet and physical activity.

Richard stated that in individuals who already suffer from diabetes, diabetes self-management education (DSME) has been shown to have positive effects on knowledge, frequency, and accuracy of self monitoring of blood glucose, self-reported dietary habits, and glycaemic control.

“There may also be beneficial effects on lipids, physical activity, weight, and blood pressure. Prevention of complications of diabetes is also possible by DSME since improved glycaemic control is associated with reduction in the long-term complications of diabetes,” Richard stated.

The diabetologist explained that diabetes creates an increased risk of cardiovascular disease with at least 65 percent of individuals with diabetes dying from heart disease or stroke.

“It also has multiple side effects for untreated diabetes for the eyes, kidneys, nerves, gum and teeth. Diabetes can be prevented by 30 minutes of moderate intense physical activity on most days and a healthy diet can drastically reduce the risk of developing type 2 diabetes,” Richard explained.

Manjinder Bhatti, a certified six sigma physician and centre manager, Vedic LifeCare Hospital, revealed that the hospital decided to institute a diabetes club giving the growing number of patients that throng the hospital to access medicare in this area.

“In the last one year, 100 diabetes patients have throng the hospital to access care. Following projections that show that diabetes is set to become a major health challenge, the hospital with state-of-the-art multi specialty facilities, decided to set up a diabetes club for continuous diabetes self-management education and utilize social media platforms to better educate Nigerians on the need to live a healthy lifestyle and what can be done to manage the disease. The hospital (Vedic LifeCare) decided to declare the month of November to riase awareness on diabetes,” Bhatti explained.

Bhatti continued: “Giving the growing disease burden, the hospital decided to set up a state-of the art medical comprehensive facility with diagnostics, diagnosis and treatment under one roof as well as preventive and curative services. In association with Manipal Hospital, Bangalore, India which has over 60 years in healthcare expertise, Vedic LifeCare hospital offer 13 medicine sub-specialty (nephrology, gastroenterology, cardiology, orthopaedics, ophthalmology, etc.) all in a bid to offer medicare and reduced medical tourism out of Nigeria for medicare.”

A peep into diabetes care in Nigeria reveals that dearth of diabetes educators is a major limiting factor against education of patients in the country hence the clinician also doubles as the diabetes educator, and sometimes as the dietician. It has been shown that other healthcare givers (nurses, laboratory scientists, pharmacists, etc.) also play a valuable role in educating patients with diabetes.

Besides strengthen diabetes club activities at primary care level, public and private sectors for impact of education to be felt nationally, experts believe that the education given should be culturally acceptable for it to achieve its intended goals.

Most Nigerians living with diabetes have suboptimal glycaemic control, are hypertensives, not meeting blood pressure and lipid targets and have chronic complications. With improved quality of care and treatment to targets recommended to reduce diabetes related morbidity and mortality, equitable, universal access to care as well as development and implementation of a National Diabetes Programme remains key in reducing the diabetes scourge in Nigeria.