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BLOOD FLOW IN NORMAL NIGERIA AND PATIENT WITH DIABETIC MELLITUS
Abstract
Diabetes mellitus (DM) is a diverse group of metabolic disorders that is often associated with a high disease burden in developing countries such as Nigeria. In the early nineties, not much was known about DM in Nigeria and traditionally, people related DM to “curses” or “hexes” and diagnosis was made based on blood or urinary tests for glucose. Currently, oral hypoglycaemic agents but not insulin are readily accessible and acceptable to persons with DM. The cost of diabetes care is borne in most instances by individuals and often payment is “out of pocket”-this being a sequel of a poorly functional national health insurance scheme. An insulin requiring individual on a minimum wage would spend 29% of his monthly income on insulin. Complementary and alternative medicines are widely used by persons with DM and form an integral component of DM care. Towards reducing the burden of DM in Nigeria, we suggest that there be concerted efforts by healthcare professionals and stakeholders in the health industry to put in place preventative measures, a better functioning health insurance scheme and a structured DM program.
Core tip: This manuscript at best is a critical appraisal of earlier knowledge and data on diabetes mellitus (DM) in Nigeria. It also highlights the changes that have occurred in terms of prevalence and also in terms of diagnosis and management techniques. Challenges in provision of DM care and the roadmap for the future of DM care are documented in this manuscript.
INTRODUCTION
Diabetes mellitus (DM) is a chronic disorder that is not only assuming pandemic proportions worldwide but also poised to affect the developing countries of the world much more than their developed counterparts. As far back as the beginning of the twentieth century, DM was described by Dr. Cook as being an uncommon disorder in the African. There is however, compelling data to show an increasing incidence and prevalence of DM in the continent[1] . The estimated prevalence of diabetes in Africa is 1% in rural areas, and ranges from 5% to 7% in urban sub-Saharan Africa[1] .
Nigeria, with a population of 158 million people, is the most populous country in Africa and accounts for one sixth of Africa’s population. Approximately 50% of Nigerians are urban dwellers and the country has a cultural diversity and 398 documented ethnic groups[2] . Health care delivery as in most developing countries of the world is at best sub-optimal and this may be responsible for the dismal health indicator statistics such as reduced life expectancy at birth and increased maternal mortality. Health care provision in Nigeria is a concurrent responsibility of the three tiers of government with private providers of health care also playing a notable role in in health care delivery. Health insurance is still taking tottering steps despite having being inaugurated about two decades ago and healthcare payment is largely “out of pocket”.
In this review, we attempt to document the present and past data on DM in Nigeria, and highlight the challenges of DM care. This article aims to appraise the present status of DM in Nigeria and the roadmap for the provision of DM care for the future.
