Rising diabetes cases worry endocrinologists

Endocrinologists are alarmed over rising cases of diabetes. They are seeking better management of the disease in Nigeria and the world at large.

To achieve this, the Endocrine and Metabolism Society of Nigeria (EMSON) has organised in Lagos a two-day scientific conference for its members. It was the 37th. The theme was “New Horizons in diabetes care”.
Other issues discussed included- obesity; dabetes in the young; bone health and animal models in endocrine research’.
According to the society, with so many new technologies, diabetes can be better managed now than a decade ago. All signs are that technological developments will continue and probably accelerate, given the expected increase in the number of people with diabetes. While a miraculous cure is unlikely, advances in medical technology — both directly and indirectly related to diabetes — can make diabetes control easier, more convenient, and more accurate for everyone.
The participants were told that the use of fixed-dose combinations of dipeptidyl peptidase IV inhibitors with other oral antidiabetic agents seemed attractive to patients because of their reduced pill intake and minimised financial burden, and may improve adherence.
They were equally told that an efficient strategy to slow down diabetes must include emerging therapies and regimens, coupled with intensive patient education that includes information on treatment benefits and adverse effects, medication costs, and medication regimen complexity.
The shortage of pancreas islets has led to the research into stem cells. EMSON President, Prof Feyi Adegoke said: “We have a really long way to go before we have stem cells available. The idea of stem cells is to take a cell that is not normally a beta cell or an insulin-making cell and try to make it one. There is a lot of work going on, but it is still very preliminary. And we as clinicians must not be caught napping while the world is actively researching into better diabetes care and management. The theme and sub themes were chosen to reflect both national and global trends.”
The Chairman, Central Conference Organising Committee, Dr Abraham Osinubi put it in perspective that the innovative advances in diabetes care are evident in every dimension\- new oral medications, new insulin, nutrition guidelines and choices, new glucose monitors, computer related technology, and new administration devices and aides.
He said preventing the onset of diabetes, especially among the nation’s youth, should be a high priority of care and education. “Even more exciting is the concept of self care and management as the basis for diabetes treatment and education in this age of managed care,” he said.
Dr  Osinubi said the themes and sub-themes are timely and important to underscore the data from around the world.
According to the international Diabetes Federation (IDF 2014), the global prevalence of diabetes mellitus is 8.3 per cent, which translates to about 387 million people living with diabetes across the world,  and 46.3 per cent of these remained undiagnosed. There are also six million new diabetes sufferers in the world each year. And that every 10 seconds someone in the world dies as a result of having diabetes, i.e about three million diabetes related deaths a year.
Dr  Osinubi said diabetes is the leading cause of blindness and visual impairments in adults in the developed world. A diabetes sufferer is up to 40 times more likely to need a lower limb amputation when compared to  someone, who does not not have diabetes.
In addition, an increase of 205 million people living with diabetes is expected by 2035. The number of people with diabetes is increasing due to population growth, ageing, urbanisation, and increasing prevalence of obesity and physical inactivity.
The African region, where diabetes was once rare, has witnessed a surge in the disease. Estimates for Type 1 diabetes suggest that about 39, 000 people suffered from the disease in 2013 with 6.4 per cent  new cases occurring yearly per 100,000 in children less than 14 years old. Type 2 diabetes prevalence among 20 to 79 years old is 4.9 per cent with less than 60 years old in the majority; the highest proportion (43.2 per cent) is in those aged 40 to 59 years.
Figures are projected to increase with the numbers rising from 19.8 million in 2013 to 41.5 million in 2035, representing an 11 per cent absolute increase. Mortality attributable to diabetes in 2013 in African region is expected to be over half a million with three quarter of these deaths occurring in those less than 60 years old. The prevalence of undiagnosed diabetes remains unacceptably high at 50.7 per cent and is much higher in low income (75.1 per cent) compared to lower and upper middle income Africa region countries (46.0 per cent). The number of diabetes sufferers by 2025 is expected to double in Africa.
The Special Guest of Hounour, who is the Secretary to the Lagos State Government, Mr Tunji Bello, said introducing diabetes related topics in the schools’ curriculum is a preventive measure among the youths.
He said: “The society and the government should not take the dangers posed by this disease with kids gloves, as diabetes has shown that more ravaging effects not only among adults, but curiously among children and adolescents. I challenge the society to explore areas where it can partner with the state in sensitising people on the need to live a healthy lifestyle.
“It is important for the society to let the people know that even though diabetes might be hereditary, there are steps that can be put in place to prevent its escalation as Nigeria has the highest number in Africa of Type 2 diabetes cases.”
Three members were awarded Fellowship of the society. They were Dr Reginald Oputa, Prof Sunday Chinenye and Prof Fabian Puepet, while a renowned Reproductive Endocrinologist, Prof Oladapo Ashiru, represented by Dr (Mrs) Kemi Ailojie-Ibru, was the Keynote Speaker.

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