Posted by: davidjolson | 09/30/2010

Diabetes is on the rise in Africa

This guest blog was written by Jeanette Strydom, the relationship officer at Africa Health Placements, a member of GHC based in Johannesburg, South Africa.

JOHANNESBURG, South Africa — Experts predict that diabetes is set to become a huge health issue in Africa in coming years. The WHO and the International Diabetes Federation (IDF) estimate that the diabetes population will double over the next 25 years in Africa. And according to the IDF, not only is the prevalence of diabetes increasing at an alarming rate, it is a two-edged sword, known to affect indigenous and poor people living in slums or informal settlements disproportionately. To intensify matters, chronic illnesses like diabetes only serve to perpetuate poverty, which creates and fuels a vicious cycle.

If critical changes are not introduced soon, explained South African Minister of Health Aaron Motsoaledi at the Diabetes Leadership Forum that ends Friday, non-communicable diseases (NCD) will increase by 19% in developing nations by 2015, and the greatest increase will be in Africa, with 24%. “This is not a good picture, but it is evident that we must all sit up, take note and take action.”

Almost 80 percent of diabetes deaths occur in low- or middle-income countries, such as those in Africa, according to the WHO. This stat is frightening when one takes into account that “most African countries do not have up-to-date, standard guidelines for treatment of diabetes and education of people with diabetes. They also lack the resources to create it”, says Sanne Frost Helt, programme manager at the World Diabetes Foundation.

This means that the countries with the greatest need are those with very limited resources and to make matters that much worse, whatever meager resources exist are being pumped into the fight against HIV/AIDS, TB and malaria. This fact does not make the need to manage diabetes any less urgent.

Diabetes as a disease is generally more prevalent in urban areas. Traditional meals in Africa are being replaced in urban areas by Western food – high in fat and sugar. Such diets also involve a great deal more eating out, consumption of fried and take-away foods which are now consumed more often than proper grain-based meals to which these groups are accustomed.

The global increase in Type 2 diabetes in African populations is linked to the increase in obesity and other factors such as an increase in development, increase in disposable income, urbanization, mechanization, globalisation of food markets, along with the changes in lifestyles and behaviours. Dr. Motsoaledi has blamed the increasing number of people with diabetes on “high fat, low fruit and vegetable diets, and weak health systems”.

There is some evidence that certain ethnic populations have genetic predispositions that increase their risk for diabetes. For example, the “thrifty gene” hypothesis proposes that populations from areas that commonly experienced famines and food shortages have more efficient fat storage to improve survival chances. While existence of such genes remains a point of debate, this adaptation would provide an advantage when food resources are scarce but would predispose individuals to increased obesity and risk for diabetes in response to a Western lifestyle and diet.

Rising diabetes rates in Africa serve as yet another barrier to survival for those who fall in to the lowest income bracket. This means that access to insulin and testing equipment is severely limited. How will this insurmountable issue be tackled in the future? Please share any thoughts or ideas you have below.

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