Blog Details

How Can We Tackle Diabetes in Nigeria? Revealing 4 Smart Strategies on How to Conquer the Disease


It is clear that diabetes is a growing health issue, but how do we fight this chronic condition, especially in a developing region? 

What strategies can we use to help manage the current burden of diabetes and prevent a devastating future upsurge? 


What is diabetes?


Diabetes is a health condition that is of tremendous concern across the globe. However, it is of particular concern to a much higher degree in developing countries (1).    

The staggering prevalence of the condition in Nigeria is an issue of concern that requires urgent attention as it ranks as the highest statistically in Africa (2). 

Type 1 Diabetes occurs when the pancreas fails to make insulin, whereas Type 2 diabetes occurs when the body is resistant to insulin and as a result, the level of insulin in the body drops (3). 

The root of Type 1 diabetes is uncertain, however, type 2 diabetes is associated with a number of factors which can increase risk, including weight, age & lifestyle (3).

The rural regions of Nigeria see about 0-2% of diabetes cases in contrast with the urban regions which have a greater proportion of cases ranging from 5-10% (4-6).

Shockingly, a terrifying 2 million cases of diabetes are unidentified in Nigeria. In addition, over 100,000 deaths could be associated with diabetes in 2013 (7). 


The health impact & distribution of diabetes in Nigeria 


Detrimental health effects can arise as a consequence of diabetes, for example, it has been connected with the re-emergence of other health conditions in Nigeria such as stroke, erectile dysfunction, tuberculosis, and the final stage of kidney disease (8-11). Some of this could potentially be attributed to diabetes having the ability to destroys tissues as it escalates over time (2). Type 2 diabetes makes up most of the cases in Nigeria (12-14). Many type 1 cases go unidentified therefore, they are sadly undiagnosed due to factors such as deprivation and people not having medical insurance (12-14).


With the general state of income in Nigeria and with around 62% of Nigerians earning less than $1000 US dollars per year, it does not come as a shock that only a small percentage of Nigerians engage in monitoring their blood glucose levels (15). In some medical institutions, patients were even unaware of the medication they were consuming (1,15). In Nigeria, although diabetes is not particularly prevalent in children, there has been some evidence suggesting that the proportion of children and teenagers suffering from this condition is increasing moderately with time (16).


With the introduction to the condition out of the way, one could say the massive elephant in the room is probably - so what now? You are probably curious, how can we slay this dangerous dragon?

Here are four approaches outlined below: 


1. Dietary Management


One aspect which can be considered very important in attempting to combat the onset of diabetes is managing diet (17). Maintaining optimally healthy dietary practices can help to regulate glucose levels which consequently can reduce the risk of issues associated with diabetes in both short and long-term circumstances (1). For example, it has been pointed out by the American Diabetes Association that individuals who are classified as having diabetes or are prediabetic should be informed about nutrition as a part of medical nutrition therapy (17).  They should also cooperate with a medical professional to regulate health levels and create a personalised diet for the patient. Also, taking into consideration some of the food they are fond of to allow them to continue to enjoy eating and help keep up the prolonged continuation of these practices (17). 


The Diabetes Association of Nigeria (DAN) emphasises actions that can be taken such as delivering education to people early on in life, explored in a book they released (18). For example, incorporating learning about health in schools, in particular, drawing focus on elements including exercise and nutrition (18). The strategy of informing people in this area has the potential to help people understand better how their diet and lifestyle can affect their risk of diabetes (18). 


2. Telemedicine 


The umbrella called ‘telehealth’ encompasses a wide area called ‘telemedicine’ which focuses on the administration of information about health and giving medical care remotely by utilising technology (19). Telemedicine is a concept that has been proposed as a possible solution for helping to tackle and manage diabetes, especially to bridge the gap in gaining access to facilities and medical professionals (20). More specifically, it can be utilised as a way of serving communities within developing countries by providing them with fundamental healthcare services and aiding the process of bridging the gap between rural regions and the larger cities which typically have more specialised medical institutions (21). 


Research studies investigating telemedicine as a management tool for diabetes for type 2 diabetes have generally used similar processes to those used for the management of type 1 diabetes as well, such as consultations through the phone (20). In addition, processes involve sending over glucose data to healthcare providers and receiving an interpretation based on the information (20). The results of a research study looking into the effectiveness of an educational initiative to spread diabetes awareness and regulation of blood sugar in people with type 2 diabetes, showed a decrease in blood sugar after participation in video consultations straight after the educational initiative (22). In addition, the same result was maintained after the last conference for 3 months (22).


Furthermore, telehealth has been recognised as being useful for helping unique populations of people who have diabetes (19). For example, the results of a telemedicine program which involved examining the eyes via remote screening showed positive results by decreasing the necessity for high-risk patients to consult eye specialists and additionally lowered the wait times in a Los Angeles healthcare system (23). Overall, these results help shed a positive light on the idea that telemedicine has the potential to successfully improve the standard of medical services delivered as a result of the plethora of tools that now exist (20). However, it is important to bear in mind that its success relies on the cooperation of healthcare professionals and the optimism of patients to embrace innovation (20). 


3. Physical Activity


Another area which can be considered important in trying to help manage and prevent the onset of diabetes is engagement in physical activity (24). Participation in physical activities can result in a variety of positive alterations in the body which can impact important factors including sensitivity to insulin and overall glycemic control (25, 26). A variety of apps have been created to help the process of keeping track of physical activity easier, for example, pedometers and wristbands that incorporate technology such as sensors (24). The apps help provide a way for individuals to monitor activities, set targets and obtain useful feedback so they can understand how they are doing (27). Both research and the promotion of exercise tools help to emphasise the significance of physical activity in helping to prevent long-term conditions in general, as well as its added benefit on other aspects such as mental health (28, 29). 


4. Online Education


The availability of online portals and educational resources can be used as a method to deliver important information to help individuals understand diabetes better (24). This enhanced understanding can then lead people to understand how to manage the condition better. These methods can be considered as beneficial as they are not typically difficult to use, can help save money and are usually more readily available to access from different locations at a convenient time for the individual (24). 


In summary


Ultimately, tackling diabetes and attempting to manage the current burden in Nigeria is a complex process. There are multiple layers to effectively tackling the disease and a multifaceted approach is likely required, with the integration of key aspects of technology and education. Education is likely to play a significant part in a variety of approaches, especially in a developing environment. Furthermore, cooperation with health professionals, educators and bodies/organisations such as The Diabetes Association of Nigeria (DAN) is necessary to facilitate change. There is great hope for the future with more research and technological development which can unveil new possibilities along with added enthusiasm to push for a healthier Nigeria. 


by Tasnim Tayo



1. Ogbera AO, Ekpebegh C. Diabetes mellitus in Nigeria: The past, present and future. World journal of diabetes. 2014 Dec 12;5(6):905.

2. Oputa RN, Chinenye S. Diabetes in Nigeria–a translational medicine approach. African journal of diabetes medicine. 2015 May;23(1).

3. Roglic G. WHO Global report on diabetes: A summary. International Journal of Noncommunicable Diseases. 2016 Apr 1;1(1):3.

4. Sabir A, Isezuo S, Abubakar S, Ohwovoriole AE, Fasanmade OA, Iwuala SO. Type 2 diabetes mellitus and its risk factors among the rural Fulanis of Northern Nigeria.

5. Enang OE, Otu AA, Essien OE, Okpara H, Fasanmade OA, Ohwovoriole AE, Searle J. Prevalence of dysglycemia in Calabar: a cross-sectional observational study among residents of Calabar, Nigeria. BMJ Open Diabetes Research and Care. 2014 Jun 1;2(1):e000032

6. Nyenwe EA, Odia OJ, Ihekwaba AE, Ojule A, Babatunde S. Type 2 diabetes in adult Nigerians: a study of its prevalence and risk factors in Port Harcourt, Nigeria. Diabetes research and clinical practice. 2003 Dec 1;62(3):177-85.

7. Federation ID, Atlas ID. International Diabetes Federation. IDF diabetes atlas, 6th edn Brussels, Belgium: International Diabetes Federation. 2013.

8. Ogbera AO, Kapur A, Odeyemi K, Longe-Peters K, Adeyeye OO, Odeniyi I, Ogunnowo BE. Screening for diabetes mellitus and human immunodefiency virus infection in persons with tuberculosis. Journal of Preventive Medicine and Hygiene. 2014 Jun;55(2):42.

9. Arogundade FA. Kidney transplantation in a low-resource setting: Nigeria experience. Kidney International Supplements. 2013 May 1;3(2):241-5

10. Shaeer KZ, Osegbe DN, Siddiqui SH, Razzaque A, Glasser DB, Jaguste V. Prevalence of erectile dysfunction and its correlates among men attending primary care clinics in three countries: Pakistan, Egypt, and Nigeria. International journal of impotence research. 2003 Apr;15(1):S8-14

11. Danesi M, Okubadejo N, Ojini F. Prevalence of stroke in an urban, mixed-income community in Lagos, Nigeria. Neuroepidemiology. 2007;28(4):216-23.

12. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, AlMazroa MA, Amann M, Anderson HR, Andrews KG, Aryee M. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. The lancet. 2012 Dec 15;380(9859):2224-60

13. Schwarz PE, Li J, Lindstrom J, Tuomilehto J. Tools for predicting the risk of type 2 diabetes in daily practice. Hormone and metabolic research. 2009 Feb;41(02):86-97.

14. Jaffiol C. The burden of diabetes in Africa: a major public health problem. Bulletin de l'Academie nationale de medecine. 2011 Jun 1;195(6):1239-53.

15. Awodele O, Osuolale JA. Medication adherence in type 2 diabetes patients: study of patients in Alimosho General Hospital, Igando, Lagos, Nigeria. African health sciences. 2015;15(2):513-22.

16. Oluwayemi IO, Brink SJ, Oyenusi EE, Oduwole OA, Oluwayemi MA. Fasting blood glucose profile among secondary school adolescents in Ado-Ekiti, Nigeria. Journal of Nutrition and Metabolism. 2015 Jan 1;2015.

17. Khazrai YM, Defeudis G, Pozzilli P. Effect of diet on type 2 diabetes mellitus: a review. Diabetes/metabolism research and reviews. 2014 Mar;30(S1):24-33.

18. Onyemelukwe GC, Johnson TO, Chinenye S, et al (Eds). Diabetes Association of Nigeria: a member of the International Diabetes Federation – History, functions and governance. Lagos, Nigeria: Diabetes Association of Nigeria, 2012

19. McDonnell ME. Telemedicine in complex diabetes management. Current diabetes reports. 2018 Jul;18:1-9.

20. Franc S, Daoudi A, Mounier S, Boucherie B, Dardari D, Laroye H, Neraud B, Requeda E, Canipel L, Charpentier G. Telemedicine and diabetes: achievements and prospects. Diabetes & metabolism. 2011 Dec 1;37(6):463-76.

21. Combi C, Pozzani G, Pozzi G. Telemedicine for developing countries. Applied clinical informatics. 2016;7(04):1025-50.

22. Izquierdo RE, Knudson PE, Meyer S, Kearns J, Ploutz-Snyder R, Weinstock RS. A comparison of diabetes education administered through telemedicine versus in person. Diabetes care. 2003 Apr 1;26(4):1002-7.

23. Daskivich LP, Vasquez C, Martinez C, Tseng CH, Mangione CM. Implementation and evaluation of a large-scale teleretinal diabetic retinopathy screening program in the Los Angeles County Department of Health Services. JAMA Internal Medicine. 2017 May 1;177(5):642-9.

24. Shah VN, Garg SK. Managing diabetes in the digital age. Clinical Diabetes and Endocrinology. 2015 Dec;1:1-7.

25. Sigal RJ, Kenny GP, Wasserman DH, Castaneda-Sceppa C. Physical activity/exercise and type 2 diabetes. Diabetes care. 2004 Oct 1;27(10):2518-39.

26. Toledo FG, Menshikova EV, Ritov VB, Azuma K, Radikova Z, DeLany J, Kelley DE. Effects of physical activity and weight loss on skeletal muscle mitochondria and relationship with glucose control in type 2 diabetes. Diabetes. 2007 Aug 1;56(8):2142-7.

27. Conroy DE, Yang CH, Maher JP. Behavior change techniques in top-ranked mobile apps for physical activity. American journal of preventive medicine. 2014 Jun 1;46(6):649-5

28. Blumenthal JA, Babyak MA, Doraiswamy PM, Watkins L, Hoffman BM, Barbour KA, Herman S, Craighead WE, Brosse AL, Waugh R, Hinderliter A. Exercise and pharmacotherapy in the treatment of major depressive disorder. Psychosomatic medicine. 2007;69(7):587.

29. Hayes C, Kriska A. Role of physical activity in diabetes management and prevention. Journal of the American Dietetic Association. 2008 Apr 1;108(4):S19-23.