Diabetes Mellitus Care in Nigeria: The Heights and the Hurdles
Keywords:
Diabetes, diabetes care, burdenAbstract
Introduction: Diabetes Mellitus (DM) is a metabolic disorder that affects millions of people all over the world. It causes irreversible damage to many organs in the body while running a silent course, thus most sufferers present late to the hospital with multiple complications that impose a huge economic burden for the restoration of health to a near-normal state. This review aims to identify the most prominent barriers (hurdles) against optimum diabetes care despite significant improvements in DM care in Nigeria and highlights evidence-based recommendations/policies that are yet to be adopted for the advancement of diabetes care in Nigeria.
Methods: A literature search was performed using google, google scholar, and academia to gather literature on the subject. Observations from various studies, review articles and reports from international bodies such as World Health Organisation were reviewed. ‘Diabetes mellitus’, ‘prevalence’, ‘Nigeria’, ‘diabetes care’, ‘complications’, ‘burden’, ‘barriers’, and ‘health care schemes’ were used as keywords for the search.
Conclusion: In spite of the advancements that have been made in promoting diabetes care in Nigeria, poverty remains a major barrier to accessing optimum diabetes care. Many other barriers that were highlighted years ago are persistent till now in this recently conducted research. Therefore, efforts should be directed towards eradicating the already established recurrent barriers to diabetes care delivery in Nigeria, by implementation of evidence-based recommendations made by experts over the years.
References
International Diabetes Federation. IDF Diabetes Atlas, 10th edn. Brussels, Belgium: 2021. Available at: https://www.diabetesatlas.org (Accessed May 17, 2023).
World Health Organization (WHO). The true death toll of COVID-19: estimating global excess mortality. Available at: https://www.who.int/data/stories/the-true-death-toll-of-covid-19-estimating-global-excess-mortality. (Accessed May 17, 2023).
World Diabetes Day: Six Million Nigerians living with disease.| The Guardian Nigerian News – Nigeria. Available at: https://guardian.ng/news/world-diabetes-day-six-million-nigerians-living-with-disease/ (Accessed May 17, 2023).
Uloko AE.; Musa M, Ramalan MA, Gezawa ID, Puepet FH, Uloko AT et al. Prevalence and Risk Factors for Diabetes Mellitus in Nigeria: A Systematic Review and Meta-Analysis. Diabetes Therap. 2018; 9(3):1307-1316.
doi: 10.1007/s13300-018-0441-1
Bashir MA, Yahaya AI, Muhammad M, Yusuf AH, Mukhtar IG. Prediabetes Burden in Nigeria: A Systematic Review and Meta-Analysis. Front Public Health. 2021; 9:762429. doi: 10.3389/fpubh.2021.762429
Overview. Nigeria. Available at www.worlddata.info/africa/nigeria/index.php (Accessed Jan 29, 2023).
Nigeria population growth. Available at https://worldpopulationreview.com/countries/nigeria-population (Accessed on Jan 29, 2023).
GDP Per Capita (current US$) – Nigeria. Available at https://data.worldbank.org/indicator/ NY.GDP.PCAP.CD?end=2021&locations=NG&start=2010 (Accessed Jan 29, 2023).
National Bureau of statistics. Unemployment statistics. Available at https://nigerianstat.gov. ng/# (Accessed Jan 29, 2023).
Chinenye S, Uloko AE, Ogbera AO, Ofoegbu EN, Fasanmade OA, et al. Profile of Nigerians with diabetes mellitus-diabcare Nigeria study group (2008): Results of a multicenter study. Indian J Endocrinol Metab. 2012; 16:558-564.
Chinenye S, Ofoegbu E, Uloko AE, National clinical guideline for diabetes management.
Standards of Care in Diabetes Abridged for Primary Care Providers. Clin Diabetes 2023; 41(1):4–31. https://doi.org/10.2337/cd23-as01
Aguocha BU, Ukpabi JO, Onyeonoro UU, Njoku P, Ukegbu AU. Pattern of diabetic mortality in a tertiary health facility in southeastern Nigeria. African J Diabetes Med. 2013; 21:1e3.
Agweye CT, Ibanga AA, Udoh MME, Enang OE, Nwajei AI, Nkanga DG. Pattern of diabetic retinopathy in a tertiary healthcare facility in Southern Nigeria. Niger J Med 2021; 30:538 42.
Koye DN, Magliano DJ, Nelson RG, Pavkov ME. The global epidemiology of diabetes and kidney disease. Adv Chronic Kidney Dis. 2018; 25:121–132.
Bradshaw D, Norman R, Pieterse D, Levitt NS and the South African Comparative Risk Assessment Group. Estimating the burden of disease attributable to diabetes in South Africa in 2000. S Afr Med J. 2007; 97(8):700-706.
Boulton AJM, Vileikyte L, Ragnarson-Tennvall G, Apelqvist J. The Global burden of diabetic foot disease. Lancet 2005; 366(9498):1719-1724. http://dx.doi.org/10.1016/S0140-6736(05)67698-2
. Girach A, Vignati L. Diabetic microvascular complications – can the presence of one predict the development of another? J Diabetes Complications. 2006; 20(4):228-237. http://dx.doi.org/10.1016/j.jdiacomp.2006.03.001
National Health Insurance Scheme. Available at: https://www.nhis.gov.ng (Accessed on 26th Nov 2023).
Alawode GO, Adewole DA. Assessment of the design and implementation challenges of the national health insurance scheme in Nigeria: A qualitative study among sub-national level actors, healthcare and insurance providers. BMC Public Health. 2021; 21:124.
Nwatu CB. Improving access to diabetes care in Nigeria – The GIFSHIP opening. Int J Med Health Dev. 2022; 27:319-25.
“Strategies for Improving Diabetes Care In Nigeria (SIDCAIN) | Devex” https://www.devex.com/organisations/strategies-for-improving-diabetes-care-in-nigeria-sidcain-99991 (Accessed November 26, 2023).
Diabetes Association of Nigeria – About. Available from: https://www.idf.org/our-network/regions-members/africa/members/20nigeria.html?layout=details&mid=143/ (Accessed May 17, 2023).
Endocrine and Metabolism Society of Nigeria Communique issued at the end of the 43rd Annual General Meeting and Scientific Conference. Available from: https://medicalworldnigeria.com/post/Endocrine-and-Metabolism-Society-of-Nigeria-Communique-Issued-at-the-End-of-the-43rd-Annual-General-Meeting-and-Scientific-Conference?pid=61899 (Accessed 26th November, 2023).
Nigeria has only 150 Trained Endocrinologists – EMSON President. Available from: https://www.premiumtimesng.com/news/99953-nigeria-has-only-150-trained-endocrinologistsemson-president.html/. (Accessed May 17, 2023).
Nigeria Has Less Than 200 Endocrinologists. Here Is A Way To Bridge This Gap. - Diabetes Africa. Available from: https://diabetesafrica.org/nigeria-has-less-than-200-endocrinologists-here-is-a-way-to-bridge-this-gap/ (Accessed November 27, 2023).
Onyemelukwe GC, Johnson TO, Chinenye S, et al (Eds). Diabetes Association of Nigeria: a member of the International Diabetes Federation – History, functions and governance. Lagos, Nigeria: Diabetes Association of Nigeria, 2012.
Fasanmade OA, Dagogo-Jack S. Diabetes Care in Nigeria. Annals of global health. 2016; 81(6):821-829.
Michael OA, Ajani OG, Akinlade AT. Prevalence, Pattern and Determinants of Myths and Misconceptions among Patients with Diabetes Mellitus in South West Nigeria. Ann Med Health Sci Res. 2018; 8:62-67.
Onyeonoro UU, Ogah OS, Ukegbu AU, Chukwuonye II, Madukwe OO, Moses AO. Urban–Rural Differences in Health-Care-Seeking Pattern of Residents of Abia State, Nigeria, and the Implication in the Control of NCDs. Health Services Insights. 2016; 9:29-36. https://doi.org/10.4137/HSI.S31865
Jackson IL, Adibe MO, Okonta MJ, Ukwe CV. Medication adherence in type 2 diabetes patients in Nigeria. Diabetes Technol Ther. 2015; 17(6):398-404. doi: 10.1089/dia.2014.0279
Raimi TH, Alebiosu OC, Adeleye OJ, Balogun WO, Kolawole BA, Familoni OB et al. Diabetes education: strategy for improving diabetes care in Nigeria. African Journal of Diabetes Medicine. 2014; 22(1):8-11.
Tella EE. Prevalence, Contributing Factors and Management Strategies (Self-Management Education) of Type 2 Diabetes Patients in Nigeria: A Review. Int J Diabetes Clin Res 2021; 8(3):148 DOI: 10.23937/2377-3634/1410148
Ogbera AO, Ekpebegh C. Diabetes mellitus in Nigeria: The past, present and future. World J Diabetes. 2014; 5(6):905-11. doi: 10.4239/wjd.v5.i6.905
Chinenye S, Ogbera AO. Socio-cultural aspects of diabetes mellitus in Nigeria. Journal of Social Health and Diabetes. 2013; 01(01):015-021.
Ugwu E, Onung S, Ezeani I, Olamoyegun M, Adeleye O, Uloko A. Barriers to Diabetes Care in a Developing Country: Exploratory Evidence from Diabetes Healthcare Providers. JAMMR . 2020; 32(10):72-83.
Chinenye S, Young E. State of Diabetes Care in Nigeria: A Review. The Nigerian Health Journal. 2011; 11(4):103-104.
Oputa RN, Chinenye S. Diabetes in Nigeria – a translational medicine approach. African Journal of Diabetes Medicine. 2015; 23(1): 7-10.
Nigeria Poverty Assessment. - World Bank. Available from https://www.worldbank.org/en/news/press-release/2022/03/21/afw-deep-structural-reforms-guided-by-evidence-are-urgently-needed-to-lift-millions-of-nigerians-out-of-poverty (Accessed May 18, 2023).
Enang O. The fattening rooms in Calabar, a breeding ground for diabesity. Diabetes Voice. 2009; 54:40-41.
Aregbeshola BS, Khan SM. Out-of-pocket payments, catastrophic health expenditure and poverty among households in Nigeria 2010. Int J Health Policy Manag 2018; 7(9):798-806.
Olamoyegun MA, Emuoyibofarhe OJ, Ala OA, Ugwu E. Mobile Phone Use in the Management of Diabetes in Nigeria: A New Potential Weapon. West Afr J Med. 2020; 37(3):201-208.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Western Nigeria Journal of Medical Sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
