By Professor Ejiofor Ugwu
The number of persons living with diabetes in Nigeria is currently estimated at 11.4 million. This figure represents only about a third of the actual prevalence, as the majority of diabetes cases in Nigeria are undiagnosed due to the lack of routine diabetes screening.
Also, only about a third of diagnosed diabetes cases in Nigeria receive appropriate treatment, and only about a third of those on treatment achieve good control.
Diabetes kills an estimated 30,000 Nigerians annually, placing the country among those with the highest diabetes mortality globally. Accurate data on the actual prevalence of diabetes in Nigeria is lacking due to the absence of a recent national survey.
Managing diabetes in Nigeria is extremely challenging due to several factors, including poor access to care, low affordability, a shortage of trained diabetes-care personnel—especially in rural and semi-urban areas—and unhealthy cultural and religious beliefs.
Diabetes care is almost nonexistent in rural areas due to the critical shortage of diabetes healthcare professionals and a lack of basic equipment and essential medicines.
Furthermore, the prices of diabetes medications and consumables have increased by more than 500 percent over the past three years. The average monthly cost of diabetes care in Nigeria currently stands at about ₦100,000–₦120,000, making it unaffordable for most patients.
The majority of persons living with diabetes in Nigeria are therefore poorly managed, and many have resorted to prayers and alternative medicines as their only hope of survival. Consequently, diabetes-related complications and premature deaths have increased to an alarming proportion.
This year’s theme—Diabetes and Well-being, with a focus on Diabetes in the Workplace—aims to highlight the challenges of diabetes care and prevention in the workplace and to advocate for improved workplace environments to enhance diabetes care.
Facts About Diabetes
Diabetes mellitus is a chronic illness characterized by persistent elevation in blood glucose (hyperglycemia), resulting in potential damage to the body’s organs and systems. This condition occurs when there is a total or relative deficiency of insulin, a naturally occurring hormone produced by the pancreas, which performs the important function of regulating blood sugar levels.
There are three major types of diabetes:
- Type 1 diabetes, which affects mostly children and adolescents;
- Type 2 diabetes, which accounts for about 85 percent of cases globally and affects mostly adults; and
- Gestational diabetes, which exclusively affects pregnant women.
Other minor diabetes phenotypes constitute less than 1 percent of cases.
The three most important modifiable risk factors for diabetes are an unhealthy diet, physical inactivity/lack of exercise, and overweight/obesity. Controlling these factors can prevent or significantly delay the onset of diabetes. Advancing age and family history are major non-modifiable risk factors. An interplay among these factors often leads to disease manifestation.
Globally, about 589 million people—roughly 1 in every 10 adults—currently have diabetes, and the prevalence is rising rapidly. Diabetes has therefore assumed an epidemic magnitude, causing profound disabilities and leading to untold hardship and death.
Diabetes may be present for years without symptoms, underscoring the need for regular diabetes screening for all adults. When symptoms occur, the classical ones include frequent urination, excessive thirst, excessive hunger, and unintentional weight loss.
The majority of patients, however, do not present with these classical symptoms. Rather, they progress to developing diabetes complications and present with related symptoms such as blurred vision, poor wound healing, impotence, recurrent miscarriages, and others.
A definitive diagnosis of diabetes is made only by trained healthcare personnel when blood glucose exceeds internationally agreed cut-off values following standardized tests.
Poorly managed diabetes is associated with high morbidity and mortality. It is a leading cause of stroke, heart disease, blindness, kidney damage, foot ulcers, amputations, and premature death.
An estimated 6.7 million diabetes-related deaths occur annually—a figure higher than the combined mortality from HIV, tuberculosis, and malaria. The majority (75 percent) of global diabetes-related deaths occur in low- and middle-income countries, predominantly among people below the age of 60.
Recommendations to Improve Diabetes Care in Nigeria
The federal government should, as a matter of urgency, declare a state of emergency in diabetes care and assemble relevant stakeholders to formulate a national diabetes policy and strategic plan to create a clear and workable pathway for diabetes prevention and care in Nigeria. This can form part of a broader non-communicable disease prevention and management program.
There is a need for an immediate government subsidy on essential diabetes medications and consumables to make them more affordable to the large population of Nigerians living with diabetes.
The Diabetes Association of Nigeria (DAN) calls on the federal government to consider an immediate total tax waiver on the importation of essential diabetes medications and consumables to drastically reduce cost and improve affordability.
National Health Insurance coverage should be expanded—especially in rural areas—and made more comprehensive and affordable.
- Blood glucose test strips should be included in the National Health Insurance Scheme to encourage diabetes screening and glucose monitoring.
- The Sugar-Sweetened Beverages (SSB) tax, which was stopped in June 2024, needs to be revived and increased to at least ₦200 per liter (from the initial ₦10 per liter) to significantly reduce per-capita consumption of SSBs and positively impact diabetes and other non-communicable disease prevention. In addition, there should be proper legislation to ensure that funds generated from the SSB tax are channeled toward diabetes and related non-communicable disease prevention.
- There is a need for a well-conducted national survey on non-communicable diseases as soon as possible. This will provide accurate data to guide healthcare policy-making. A National Diabetes Registry is long overdue to track diabetes prevalence and treatment outcomes.
- Primary Healthcare Centres (PHCs) should be strengthened nationwide to manage uncomplicated diabetes. This includes infrastructural upgrades, provision of basic equipment, and recruitment and training of healthcare workers.
Prof. Ugwu is the National President, Diabetes Association of Nigeria. He is a professor of medicine and endocrinology; consultant physician, endocrinologist, and diabetologist. He can be reached on dannigeria555@gmail.com
Prof. Ugwu is the National President, Diabetes Association of Nigeria. He is a professor of medicine and endocrinology, consultant physician, endocrinologist, and diabetologist. He can be reached at dannigeria555@gmail.com
