Dr. Damian Avar is a General Practitioner from the
College of Medicine, University of Lagos (CMUL). Avar, the founder and CEO of
DoctorsHub Nigeria, in this interview with CHIOMA UMEHA, discusses growing
cases of diabetes in Nigeria and how the trend could be checked. Excerpts:
What is the current situation of diabetes in
Nigeria?
According to the World Health Organisation, over
1.7 million new cases of diabetes in Nigeria were recorded in 2016. And with
about five million Nigerians, according to the Diabetes Association of Nigeria
(DAN) currently living with the disease, Nigeria comes top on the list of
countries in Africa with the highest incidence and prevalence of diabetes.
Sadly, this value has been projected to double by
2030. So really, the fact that diabetes is on a rapid rise in Nigeria is
incontestable.
Why is diabetes on the rise in Nigeria?
There are certain risks factors which predispose
people to developing diabetes. While there is often a genetic link to the
disease, the rise in its incidence and prevalence as noticed in Nigeria today
is primarily due to the many factors. Lifestyle is the chief reason for the
rise in diabetes cases in Nigeria.
Under lifestyle, we have the issue of adoption of
western diets as evidenced by our rapacious appetites for junks and other
unhealthy western diets. In ignorance, we often think we are ‘enjoying life’ by
consuming these diets.
But, the truth is that we are harming ourselves
unknowingly. Junks contain a lot of refined sugars which have been found to be
associated with the development of diabetes and other chronic diseases.
Next is lack of physical activity/exercise. More
and more Nigerians are taking jobs that require them to sit for long hours
inside air-conditioned offices. Often times, they don’t get to stand up until
closing time or whenever they are visiting the rest room. People need to be
physically active. Occasionally climb the stairs, instead of using the elevator.
Walk down the restaurant for lunch, instead of driving.
All these, although not as effective as the daily
vigorous 30 minutes exercise as recommended by the world health body can
accumulate and prove very helpful in preventing the disease.
Describe the link between diabetes and obesity?
There is a strong link between diabetes and
obesity. Unfortunately, majority of Nigerians have this belief that being obese
is okay. It is not. As a matter of fact, obesity comes with several other
potentially deadly conditions apart from diabetes.
What about the issue of rural-urban migration?
Thousands of Nigerians are migrating from villages
to the cities, on a daily basis, to seek white collar jobs. After migration to
cities, they are forced to adopt urban lifestyles so as to survive. So they
start drinking soft drinks and eating junks and other refined foods. With this,
it is only a matter of time before diabetes, hypertension or kidney disease
results.
How does poor health awareness and health-seeking
behaviours contribute?
Nigeria has one of the worst health awareness
indexes in the world. The level of ignorance of basic, pertinent health issues
is staggering. For example, some people still believe that it is okay for men
to have fat bellies (abdominal fat) as it portends enjoyment (evidence of good
living).
Some others believe that there is absolutely no
reason for them to go for routine health checkups when they are not having
symptoms of disease.
In fact, it interesting to note that over 60 per
cent of Nigerians who are diabetic still don’t know they are. Why? This is
because they are waiting for that day when they start having symptoms and it
cripples their daily routines. Sadly, Diabetes is a chronic disease that takes
years before symptoms manifest- at which point complications would have
occurred.
What are ways to prevent Diabetes?
Diabetes is very preventable, especially type 2
diabetes. This is because it is mostly the result of unhealthy lifestyle, so
the disease can be prevented by lifestyle modification.
In fact, even people who have a genetic risk (
that is one or two of their parents or siblings had or have the disease) of
having the disease can prevent it by modifying their lifestyles to include
healthy eating, physical exercise, conscious loss of weight, cessation of
smoking and alcoholism, etc.
Are vaccines available for prevention of diabetes?
The answer to this question depends on the type of
diabetes in question. For type 2 diabetes, which accounts for over 90 per cent
of all diabetic cases, the answer is NO.
There are no vaccines for preventing type 2
diabetes. For now, the only way to prevent it is through lifestyle
modification- eating right, exercising, avoiding cigarette smoking, etc.
However, because the disease weakens the immune and predispose sufferers to
several infections, diabetic patients are advised to get vaccinated with
influenza, pneumococcal and hepatitis B vaccines.
However, there is a vaccine for reversing and
preventing Type 1 diabetes. The work of Dr. Denise Faustman on the Bacillus
Calmette – Guérin (BCG) vaccine as a possible antitode for type 1 diabetes has
received global applause and has received approval from powerful and notable
organisations like the Food and Drug Administration (FDA) agency.
However, the vaccine is still in its clinical
trial phase and is not yet commercially available for treating diabetes. Though
BCG is a cheap and common vaccine against tuberculosis, incorporated into the
immunisation schedule of most developing countries, Nigeria included. The truth
is that, the dose of the BCG vaccine as currently used to prevent tuberculosis
may not be the same dose required to prevent type 1 diabetes.
So the vaccine still has to go through the
clinical trial phase before it becomes commercially available.
Can you further explain the advancement of Dr.
Denise Faustman and her team of researchers on diabetes?
The 75th Scientific Session of the American
Diabetes Association held in February 2017 announced the successful phase 1
clinical trials of the type 1 diabetes vaccine and the commencement of the
phase 2 clinical trials of the vaccine.
Before this, the FDA (Food and Drug
Administration) had in August 2016 approved the request by Dr. Denise Faustman and her team
of researchers at the Massachusetts General Hospital to go ahead with the phase
2 clinical trials of the vaccine. All these have been met with wild jubilation
worldwide as type 1 diabetes patients can now picture a life devoid of daily
insulin injections for life.
The vaccine trials has scaled through to the phase
2 clinical trial where the optimum dose with the least side effects would be
ascertained.
Contrary to popular belief that the vaccine will
cure all types of diabetes, the vaccine has only be shown to be effective in
treating type 1 diabetes- which accounts for about five to 10 per cent of
diabetes in the world. So as it stands, only type 1 diabetes patients can use
this vaccine when it becomes commercially available.
