According to the Integrated African Health Observatory (IAHO) and World Health Organization (WHO) Africa region in March 2023, an estimated 24 million People in Africa were living with diabetes in 2021 and it is predicted that by the year 2045 there will be a 129% increase to 55 million people living with diabetes in Africa. Among that 24 million people affected in Africa, 3.6 million people living in Nigeria have Diabetes. It takes time and practice to properly adapt to living with diabetes in Nigeria. Living with diabetes in Nigeria requires a very informed and right approach to self management and this article will help to point out some important tips which will help you live well with Diabetes in Nigeria. Diabetes can affect every system in the body. Management involves managing blood sugar levels through a combination of healthy eating, regular physical activity, and when necessary, medication. It is important to talk to your Doctor about creating a personalized plan to monitor blood sugar levels. It is also important to address the emotional and mental health aspect of living with diabetes.
Diabetes Mellitus is a metabolic clinical syndrome characterised by an increase in plasma blood glucose (hyperglycaemia). There are two common types of Diabetes Mellitus; Type 1 and Type 2 Diabetes, they majorly occur as a result of Insulin deficiency (reduction in levels or absence of the hormone) and Insulin resistance (the hormone is present but is not working well) respectively. Insulin is a hormone produced in the body which helps regulate the levels of glucose (sugar) circulating in the body. Too much and too little circulating Glucose is harmful to the body and can cause several complications. Fun fact about Diabetes is that it is not caused by eating too much sugar, the risk increases with a diet high in processed sugars but obesity and family history are the main risk factors connected to type 2 diabetes. Diabetes can also develop in pregnancy and a mother with gestational diabetes will not necessarily have a diabetic baby.
Hyperglycaemia (too much circulating glucose) causes immediate and long term problems which can affect smaller vessels in the body including eye (retinopathy), kidney (nephropathy), and feet (neuropathy). Immediate symptoms of hyperglycemia include;
Hypoglycaemia (too little circulating sugar) can cause sweating, trembling, pounding heart, hunger, anxiety, drowsiness, incoordination, inability to concentrate, nausea, tiredness, headache.
Did you know? Both high and low blood sugar can cause surprising symptoms like irritability, blurry vision, and even hunger or trembling? Hence it is obligatory to keep your blood glucose levels in check.
In people living with diabetes it is very important to regularly check the blood glucose levels to make sure it is not too high or too low. It is important to know how much an activity or food can reduce or increase a person’s blood glucose level. In general, fasting glucose levels of 5-7 mmol/L (90-126 mg/dL), pre-meal values of 4-7 mmol/L (72-126 mg/dL) and 2 hour post meal values of 4-8 mmol/L (72-144 mg/dL) is optimal for normal. The importance of lifestyle changes, drugs or surgery cannot be under-estimated in improving glucose control in people living with diabetes.
Lifestyle changes that can help people living with diabetes include healthy eating; all people living with diabetes need to pay more attention to their diet. They should regularly see a dietician to get nutritional advice and plans that are specific to the them, taking into consideration culture, age, occupation, finances, and personal circumstances (as some cultures restrict what an individual can eat at a particular time, some food are age specific in some households, some occupations require a certain diet, not everyone can afford the same type of food, and personal factors respectively).
About 80% of people living with type 2 diabetes are overweight so they will require dietary plans to reduce weight. Did you know that overweight rates are commonly noticed in women compared to men. Carbohydrates have the biggest impact on blood glucose levels as most of our Nigerian foods are carbohydrates. Eat fewer processed foods like white bread, white rice, biscuits, cakes, cookies, candy, sugary cereals like coco pops, fruit flakes and also sugary fruits like pineapple, banana, mangoes, watermelon.
Learn about portion control and the plate method. Portion control involves gradually reducing the plate you use to dish your food and not taking any snacks in between and also using measuring cups to monitor what you cook, not eating more than your fist size of swallow or rice. Plate method involves using a nine inch plate, filling half of the plate with non starchy vegetables like lettuce, cucumbers, tomatoes, green beans. Divide the other half of the plate into two equal sections, in one section you fill it with healthy carbohydrates like rice (brown rice like ofada rice), yam, and potatoes. In the last small section you fill it with lean proteins like fish, beans, eggs, lean meat and poultry.
Also balance your food with your medicines, if you are using a diabetes drug called Insulin or Insulin secretagogues like Sulfonylureas and Glinides, it is important to balance what you eat and drink with your medicine. Too little food in proportion with your diabetes drug, especially insulin can lead to dangerously low circulating blood glucose which is harmful to your health. Too much food too with your diabetes drug can cause your blood glucose to increase which is harmful to your health.
Limit sugary drinks such as fruit juice and carbonated drinks as they can cause blood sugar to rise quickly. The exception is if you have low blood sugar level, sugary drinks can be used to quickly raise blood sugar level. Avoid Alcohol as it can damage your liver which will affect glucose regulation in the body. Exercise is a very important part of managing diabetes. When you are active your muscles and organs use more blood sugar for energy which can further help to reduce the blood sugar levels. Have an exercise schedule to improve consistency and also have a workout partner as it will help improve accountability. Exercise can be light and moderate even though the more strenuous your workout, the longer the effect lasts. Always stay hydrated when working out and check if you need a little snack before you exercise if you use insulin or insulin secretagogues.
Medications and lifestyle modification is an important component of managing diabetes. They are designed to lower the blood glucose levels, delay digestion of carbohydrates, increase insulin sensitivity (action), and secrete insulin. How well these medicines work depend on taking them properly at the right time and right dosage prescribed by your Medical Doctor. Store your insulin properly, do not use expired drugs. Inform your doctor if you notice any side effect that the doctor did not inform you about before starting the drugs. Stress can affect hormone secretions in the body which can further increase blood glucose levels so it is advisable to manage your stress properly and get help if needed from family, friends or a professional. You can try meditations or Yoga. Sleep cannot be over-emphasized. Make sure to get enough sleep every night, keep your televisions and phones away from the bedroom as they can distract you and affect your sleeping pattern badly. And do not miss your doctor's appointment.
Did you know? Stress and poor sleep can actually raise your blood sugar levels, making it harder to manage diabetes, so managing stress and getting enough sleep are just as important as taking your medication on time.
Diabetes is a lifelong disease with no cure, so managing the illness is very important. Lifestyle modifications and Medications work together and not alone. Seek help if you need it and do not miss your doctor's appointment. Create awareness and encourage your loved ones to live a healthy life.
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