Waging war against diabetes

Diabetes testing

Forty year-old Khama Samalani from Traditional Authority (T/A) Mazengela’s area in Lilongwe, central Malawi took solace in various bottled energy giving drinks at work to stay awake.

Samalani who was working at one of the Casinos in Lilongwe, remembers how a night experience ended in a diabetes diagnosis.   

Unknown to him, the more sugar he consumed, the more he was hurting himself. He kept at it for years such that what looked like a sleep remedy became a daily routine.

Samalani confessed: “I would take an energy drink but 10 minutes later, I would have the urge to pee. In addition, I would have excessive thirst.

“One night at work, my vision got blurry such that I could barely see across the Casino floor. At that moment, I thought I was just tired.”

This, he says, forced him to seek medical attention at Kamuzu Central Hospital where a blood test showed that blood sugar was beyond the imaginable.

He disclosed the levels had spiked over 600 milligrams per decilitre (mg/dl), far beyond the normal level which ranges between 70 to 140 mg/dl.

Samalani’s situation, according to the International Diabetes Federation (IDF), is not as unique.

In fact the Federation estimates in its 2021 National Diabetes statistics report, the number of people that have suffered diabetes but are unaware they have the disease are in millions.

“That was the beginning of my battle with diabetes. I remained at the hospital until the doctor brought my blood sugar level back with an Insulin injection,” Samalani says.

A diabetic patient at Queen Elizabeth central Hospital. Pic by MANA

IDF says 537 million people between the ages 20 to 79 have diabetes across the globe. This represents a 16 percent rise from its previous estimates in 2019.

In its 10th edition published in 2021, IDF says out of the estimated figures, the majority of them live in middle and low-income countries like Malawi.

According to Samalani, his Body Mass Index (BMI) was 105 kilograms and he could wear an extremely large pair of trousers.

This, he says was because of the too many sugars he was taking which in turn lead to frequent urination.

Diabetes, according to the World Health Organization (WHO) is a serious, chronic condition that affects lives and well-being of people at different stages. It is characterized by excess levels of sugar in the blood.

WHO says Type 1 diabetes often begins from childhood when the pancreas is damaged making it unable to produce insulin responsible for regulating the blood sugar level while Type 2 occurs mostly in adults in the age range of 20 to 79.

This occurs when the pancreas produces insulin which is either insufficient or not good for the body cells to use it.

Gestational diabetes is referred to as a high blood sugar level that appears only during pregnancy and it usually goes away after delivery.

WHO says Type 2 diabetes accounts for about 90 percent of all cases across the globe and is the major cause of blindness, kidney failure, heart attacks, stroke, hypertension and lower limb amputation.

Global burden of disease study also considers diabetes as the fifth leading cause of deaths others being stroke, heart disease, congenital birth defects and chronic liver diseases.

Chikumbe: There are more people that are diagnosed but in some facilities, they do not report cases

Ministry of Health Spokesperson, Adrian Chikumbe says Malawi just like any other countries is not spared from Diabetes which is one of the common non communicable diseases.

He says the District Health Information System (DHIS) 2 of 2021 which is used for reporting, analyzing and disseminating data for all health programs established that a total of 20 per 100,000 people are diagnosed with diabetes annually in Malawi.

“However, there are more people that are diagnosed but, in some facilities, do not report. This in turn displays challenges in diagnosis of diabetes.

“Furthermore, private hospitals, Christian Health Association of Malawi facilities and other entities do not report in the DHIS2, thereby affecting the number of people per 100,000 that are diagnosed with diabetes,” he emphasizes

He encouraged people between the ages of 18 to 65 to regularly go for diabetes testing at their nearest health facilities to know their status.

“Of course, some of the noticeable symptoms include excessive thirst, frequent urination, weight loss and excessive hunger,” he highlights.

A Diabetes specialist who owns Alidziwa Health Private Clinic, Dr. Chilungamo Chingwanda assured diabetes is a manageable condition if drug compliance, lifestyle modification and physical exercise are followed.

Insulin vials and needles 

"It is better to start now making lifestyle changes, including losing weight, doing regular exercise, and avoiding processed foods as much as possible.

"It is advisable to eat lighter starches at night like boiled potatoes or reduce the quantity of nsima at night. It is also good not to eat so late at night like after 8pm," says Chingwanda

Chingwanda who is also a lecturer at Kamuzu University of Health Sciences (KUHES) says failure to comply with diabetes treatment and lifestyle advice may lead to complications such as strokes, heart attacks, hypertension, nerve damage, sexual dysfunction, blindness and kidney failure among others.

Diabetes Association of Malawi President, Clement Mandala therefore says the Association will continue intensifying mass sensitization campaigns to raise awareness  about the disease especially on healthy lifestyle and also importance of early diagnosis.

“So far, more people are getting aware of the disease especially in the urban areas. However, some people still come after suffering from the symptoms for a few months.

"From talking to them you see that they suspected they may have had the disease but were in denial or were just afraid to know definitively what it was,” he says.

He adds that the Association will also continue working with the Ministry of Health to advocate for the better care for diabetic patients in Health facilities.

With collaborative efforts to wage war against diabetes, cases could be reduced.