All posts by The Nigeria Diabetes Online Community

The Nigeria Diabetes online Community (@thengdoc) is an online social media support system for People with Diabetes, Health Care Providers, Caregivers, Family and Friends. We are here to support and assist through education providing online platform for interactions.

Nigeria’s Health Minister Inaugurates Diabetes Awareness Committee

Prof. Isaac Adewole, Nigeria’s health minister has recently inaugurated the National Steering Committee for the Diabetes Awareness and Care Project (DAC) in Abuja.

At the inauguration, he said the federal government was committed to safeguarding the health of Nigerians and improving diabetes care in the country.

He said: “The Non Communicable Disease Division of the Federal Ministry of Health in Collaboration with the Health Strategy and Delivery Foundation (HSDF), with the support from the World Diabetes Foundation (WDF), has embarked on this project, which will first be implemented in two states of the country namely FCT and Imo Sates,” he added .

Adewole said the aim was to increase diabetes awareness and improve the two way referral state between Imo state and the Federal Capital territory.

He emphasized that “the finalization of the National Guideline for prevention and control of diabetes in Nigeria which took place earlier this month is an integral part of this project”

“It is expected that the Guideline will ensure standardized protocol for medical care and patient self – management education to prevent acute complication and reduce the risk of long term complications among Nigerians living with the disease”.

Adewole said that the project was to last for three years- from 2018 to 2021. He also commended the World Diabetes Foundation and Health Strategy and Delivery Foundation for the support and efforts to ensure the project becomes a reality.

In his welcome address, the Permanent Secretary, FMOH, Mr. Abdallahi Mashi, who was represented by the Director, Public Health, Dr. Evelyn Ngige, said that the prevalence of diabetes in Nigeria was increasing with current WHO figures estimates at 3.4 per cent, while local studies carried out by researchers have figures from 3-10 per cent.

This is a step in the right direction and we hope it improves diabetes awareness and gets proper implementation.

 

Free foot checks for people with diabetes

As Rainbow Specialist Medical Centre celebrates her  anniversary, they’ve organized a training for health workers on skills in diabetes care as well as free foot checks for patients living with diabetes.

 

This would be during the 5th Annual Diabetes Foot and Podiatry Workshop organized at Dover Hotel, Lekki.

 

Medical Director of the centre and coordinator of the Diabetes Podiatry Initiative Nigeria (DPIN), Dr. Afoke Isiavwe, in a statement, said the workshop, the 5th edition, is being organised to address the high rate of amputation among Nigerians living with diabetes, which has been reported to be as high as 53.2 per cent of the number of people with foot ulcer in some centres. This makes diabetes foot the most common cause of non-traumatic amputation in the lower extremities in Nigeria and elsewhere in the world.

International training faculty from the World Walk Foundation, Jamaican Chapter, will conduct the 2018 edition of the workshop, according to the release.

The focus of the training would be on primary health care workers as they are the first point of call in diabetes care.

“It is important to equip these group of healthcare workers with necessary skills in these two common conditions to detect initiate correct treatment and also know when to refer patients for further care,” the release further said.

 

World BreastFeeding Week; Mothers who breastfeed for 6 months have 48 percent less risk of diabetes

The world breast feeding week just wrapped up and theme was  “Breastfeeding: the foundation for life”

NgDOC is excited to promote and celebrate with the rest of the world.

“There could be greater health benefits for women from breastfeeding than previously recognized,” said lead study author Erica Gunderson of the Kaiser Permanente Division of Research in Oakland, California.

Compared to women who didn’t breastfeed at all, mothers who nursed babies for at least six months were 48 percent less likely to develop diabetes. Mothers who also breastfed for fewer than 6 months had 25 percent lower risk of developing diabetes.

In the past, it has been well known that aside from promoting good brain development because of some specific proteins like cysteine and taurine in breast milk, breastfeeding reduces the risk of a child developing allergic reactions, respiratory infections and now even diabetes!

It was a 30 year long study analyzed by researchers in the US from women in a heart health study and monitored throughout that time.

Scientists believe that there are good biological reasons why breastfeeding may protect against diabetes. For example, it is known to boost hormones which control blood insulin levels and lower blood sugar. It can also help new mothers lose pregnancy weight.

“We found a very strong association between breastfeeding duration and lower risk of developing diabetes, even after accounting for all possible confounding risk factors,” said lead author Dr Erica Gunderson, senior research scientist with the Kaiser Permanente Division of Research in California.

“The incidence of diabetes decreased in a graded manner as breastfeeding duration increased, regardless of race, gestational diabetes, lifestyle behaviors, body size, and other metabolic risk factors measured before pregnancy, implying the possibility that the underlying mechanism may be biological.”

“Breastfed babies are also less likely to become overweight later in life, reducing their risk of developing cancer in the future as well.”

Breastfeeding also reduces the risk for breast cancer in the mother.

This makes breastfeeding protective for both mother and child.

Only about 36% of infants aged 0-6 months worldwide were exclusively breastfed over the period of 2007-2014. The lives of over 820,000 children could be saved every year among children under 5 years, if all children 0-23 months were optimally breastfed.

WHO recommends exclusive breastfeeding starting within one hour after birth until a baby is 6 months old to promote health.

In spite of the benefits of breastfeeding, some women may face barriers to success, including lack of social support, lack of paid leave and lack of onsite childcare. Since breastfeeding provides a tremendous benefit for the child, mom and society, we want to keep encouraging women to breastfeed and create environments that support success.

The research was published in the journal JAMA Internal Medicine.

 

The Kim Kardashian-style keto diet can increase risk of diabetes, new study warns.

The keto diet, favoured by Kim K , has become increasingly popular in the Nigerian space for a few years now . In a recent report by researchers in the Journal of Physiology, keto diet is said to be linked with an increasing risk of developing type 2 diabetes.

Keto diet became popular for its perceived ability to cause weight loss and reverse type 2 diabetes but ironically, a study by ETH Zurich and University Children’s Hospital Zurich found that this low carb but high fat diet contributes to insulin resistance, making it difficult for the body to respond to normal level of insulin, increasing the blood glucose level and causing your pancreas to get to do more work.

Insulin is an hormone released into the blood by the pancreas and used to control blood sugar levels , it also signals the liver to stop producing sugar. If this mechanism is impaired, the liver would no longer respond and would continue sugar production. This is called insulin resistance.

This increased risk was noticed during the early stage of the diet, according to the study which compared different diets; a high fat diet and a ketogenic diet in two groups of lab mice.

Keto diet was invented in the 1920s as a way to cure epilepsy.

The difference between keto diet and regular low carb diet is that it restricts both carbohydrate and protein intake instead of just carbohydrate intake. It is said to create a lower insulin environment and ultimately reduce fat stores.

Researchers however say more research has to be done in this area.

 

 

 

Source : Eurekalert

How Real Madrid’s Nacho did not let Diabetes Stop Him

Heartbreak is an overused word in football, tagged on to every last-minute defeat, relegation or omission from a squad list. Real Madrid and Spain defender Nacho Fernandez Iglesias knows what it really means.

Real Madrid and Spain defender Nacho. Picture: Instagram / Nacho Fernandez Iglesias
Real Madrid and Spain defender Nacho. Picture: Instagram / Nacho Fernandez Iglesias

 

‘I was about 12 years old and had been at Real Madrid for a couple of years. It was a dream come true for a young boy to play in that shirt,’ he says.

‘I was about to go off and play a tournament with Real Madrid but I didn’t feel right.

‘I had this constant need to pee and I was drinking lots and lots of water. My mother was worried.

‘She decided to call the hospital. They carried out some tests and my blood-sugar levels were through the roof. I was diagnosed with (type 1) diabetes.

‘On the Friday the doctor told me there was no way I could go on playing football. Imagine any 12-year-old kid being told that. It was awful.’

Real Madrid and Spain defender Nacho. Picture: Instagram / Nacho Fernandez Iglesias
Real Madrid and Spain defender Nacho. Picture: Getty Image

It was 2002 and as well as playing in the club’s boys’ teams, Nacho was a Madrid fan who idolised Fernando Hierro and Zinedine Zidane. His dream of following Zidane into the first team had been crushed but the heartbreak would be short-lived.

‘On the Monday I went back into the hospital and I saw a different doctor, Dr Ramirez,’ he explains, and there is warmth in his voice when he says that second doctor’s name.

‘I was so happy because he said the opposite was true. He said sport was the most important thing for me and I had to carry on playing and competing. It wasn’t true that my condition meant I couldn’t be a sportsman. And here I am still fighting.’

Nine years later Jose Mourinho gave Nacho  his Real Madrid debut. Zidane is now his manager. He’s on his way to Kiev for his third Champions League final and then off to Russia with Spain.

The 28-year-old may be Madrid’s ‘fifth’ defender but many supporters would have him in the team. He is one of their own. They idolise him as the anti-galactico who still lives in the Madrid town of Alcala de Henares where he grew up and not in a gated millionaires-only neighbourhood.

If he does start on the bench on Saturday there will be no devastation. After being told he would never have a career, he is just happy to be there. Happy to have proved a player can cope with diabetes and still reach the top. ‘Diabetes doesn’t mean as a young kid you can’t have a normal life and practising sport is the most important thing in combating it,’ he says.

‘I have to give myself injections every day and I have to take care with food and drink that have a high sugar level. But sport for a person with diabetes is fundamental.’

When his debut came, it was Mourinho who gave it to him. He says: ‘I’ve only got good things to say about Mourinho. It’s not true that he doesn’t give young players a chance. He gave my brother Alex (now at Cadiz) his debut too, before me. In our family there is a lot of love for Mourinho.’

Nacho’s progression is not just an example for kids with medical conditions, he is also a beacon for homegrown players.

‘The canteranos (youth-team graduates) can be the soul of the club. Madrid is a difficult club to break through at because they have always had the best players. But the presence of homegrown players alongside the superstars has been fundamental.’

Zidane will hope that combination can deliver against Liverpool on Saturday night.

‘They have three spectacular players up front,’ says Nacho. ‘They are quick and they score goals. They will make it difficult but we have the defenders to deal with the threat.’

Late-night snacking: Why you should quit this habit NOW

LATE-NIGHT snacking can be very indulging but not only does it increase our waist lines, it affects our sleep.

It also puts us at risk of diseases such as diabetes and increases the level of the stress hormone cortisol in our bodies.

Here’s why you should ditch the habit. 

Our bodies crave high-sugar, high-fat and high-salt foods, with typical late-night snack foods including fizzy drinks, juice, chocolate, ice cream and alcohol, some people even take major heavy meals like ‘a bowl of rice’ or ‘eba’ late in the night.

It can be a really difficult habit to stop especially in urban areas like Lagos where heavy traffic might cause you to get in late hungry and necessarily need to eat.

Drinking alcohol also makes us more likely to make bad food choices and indulge our cravings for greasy takeaway food such as deep fried chicken, chips and pizza.

Here are five reasons you should give up the bad habit of snacking before bedtime.

Weight gain

Eating in the hours just before we go to sleep leaves us little time to burn off those extra calories. We eat and then head on to bed without having to use the food for any activity and so we get to store up fat. There is a significant relationship between late-night snacking and a higher body fat percentage.

Impaired hormone response

This is a disturbing effect of late night eating over a long period of time.  Eating late at night can reduce the ability of insulin to remove glucose from the blood.

Over a prolonged period of time, late-night eating may lead to an increased risk of diabetes.

 

Poor sleep

Eating or drinking just before bedtime can negatively affect your sleep quality and quantity, There is a significant association between high intakes of sugary foods and caffeine before bed and poor slow-wave sleep and rapid eye movement (REM) stages of sleep.

Your body spends some of the energy it needs to help repair the worn out body tissues to digest your ingested food. Taking alcohol at night can also cause you to be sleepy the next day.

Increased food intake the following day

Ironically, eating a big meal late at night doesn’t mean you will consume less the next day. You’ll want to eat more!

Eating late at night may enhance the amount of food you consume the following day due to the impaired insulin response and poor blood sugar control leaving you feeling hungrier overall

Increased cortisol

Interestingly, researchers have found a link between eating late at night and higher levels of the stress hormone, cortisol. As well as being an overall health hazard, high levels of cortisol in the body pose a risk factor for increased abdominal fat.

The findings may also suggest that the more stressed individuals are, the more likely they are to eat late at night rather than earlier on in the day.

To break the habit of late-night snacking, its good to eat a balanced dinner with a focus on protein to keep us fuller for long, and de-stressing with a bath, a walk or a movie to give ourselves time to wind down from the day.

Everyone is different, identify your own triggers for late night eating and avoid them. If you can’t, then you can get healthier snacks options e.g bananas, an apple, greek yoghurt , carrots or even water!

 

TAKING DIABETES TO HEART SURVEY

Taking Diabetes to Heart is a new multi-country study, developed by the International Diabetes Federation (IDF) in partnership with Novo Nordisk, focused on Cardiovascular disease (CVD) awareness and knowledge among people living with type 2 diabetes. The purpose of the study is to help IDF better understand people living with type 2 diabetes.

There is a low data input from the African region and to avoid data misinterpretation, there is an extension of the deadline to accommodate more data especially from Africa.

We encourage everyone  Africans especially Nigerians living with type 2 diabetes to  take the survey.

It would only take a few minutes of your time.

Click here to take the survey

There are several ways that you can get involved with Taking Diabetes to Heart:
If you are living with type 2 diabetes, we encourage you to take the Taking Diabetes to Heart
survey here here
If you know someone with type 2 diabetes, please invite them to take the survey. If you are a clinician, kindly share to your network.

If you are active online and on social media, you can promote the survey to your network by
using the hashtag #TD2♥ or #T2DH

DIABULIMIA; The Deadly Eating Disorder Affecting Women With Diabetes

On August 4, 2017, Ms Megan Davidson, 27, commited suicide after battling with diabetes and diabulimia.

Megan was driven to suicide after her battle with her eating disorder and diabetes.

She died three days after she was discharged from mental health services after they thought she did not to have clinical depression and had full capacity according to the inquest.

On the morning of her death she had texted therapist, Renata Harris, saying: ‘Please make sure the emergency services find my body so my parents don’t have to.’

The 27-year-old’s body was found by police who had eventually been alerted by the therapist who received Ms Davison’s text message.

Ms Davison had previously tried to kill herself at the end of 2016 through an overdose.

The therapist decided the text had no ‘immediate implications’ and so did not tell anyone about it for almost an hour.

When police were contacted they went to Ms Davison’s home in Cheshunt, Hertfordshire, and found her body.

 

Megan is not alone,

The word diabulimia is a merger of the word diabetes and bulimia.

Though this word is not officially recognized, Diabulimia describes the situation where somebody deliberately and regularly reduces the amount of insulin they take due to concerns over their body weight and/or shape.

The American Diabetes Association indicates that 30-40 percent of female teenagers and young female adults with diabetes alter or skip insulin to control their weight. “If you have diabetes, then the risk of developing an eating disorder is about twice as likely than if you didn’t,” says Ronald Steingard, M.D., of Walden Behavioral Care in Waltham, MA and research consultant for Harris Center for Eating Disorders at Harvard University.

 

Individuals suffering from diabulimia intentionally misuse insulin for weight control, including:

  • Decreasing the prescribed dose of insulin
  • Omitting insulin entirely
  • Delaying the appropriate dose
  • Or, manipulating the insulin itself to render it inactive

 

On the long term, there is severe hypoglycemia and weight loss because the body would break down fats for energy since there is no insulin to help the tissues utilize glucose effectively.

Diabulimia is a mental health issue and health care providers should be able to recognize this and refer appropriately for psychological help if need be.

Although, this might not be popular among Nigerians, it just might  be because we do not have enough statistics and so many people with mental health issues do not regularly reach out for help.

Warning signs and symptoms of diabulimia

Emotional and behavioural

 

  • Secrecy about diabetes management
  • Increased neglect about diabetes management
  • Avoiding diabetes related appointments
  • Fear of low blood sugars
  • Fear that “insulin makes me fat”
  • Extreme increase or decrease in diet
  • Extreme anxiety about body image
  • Restricting certain food or food groups to lower insulin dosages
  • Avoids eating with family or in public
  • Discomfort testing/injecting in front of others
  • Overly strict food rules
  • Preoccupation with food, weight and/or calories
  • Excessive and/or rigid exercise
  • Increase in sleep pattern
  • Withdrawal from friends and/or family activities
  • Depression and/or anxiety
  • Infrequently filled prescriptions

 

Physical 

  • A1c of 9.0 or higher on a continuous basis
  • A1c inconsistent with meter readings
  • Unexplained weight loss
  • Constant bouts of nausea and/or vomiting
  • Persistent thirst and frequent urination
  • Multiple DKA or near DKA episodes
  • Low sodium and/or potassium
  • Frequent bladder and/or yeast infections
  • Irregular or lack of menstruation
  • Deteriorating or blurry vision
  • Fatigue or lethargy
  • Dry hair and skin

It would be of immense help if

  • Psychological factors should always be considered, assessed and excluded in all episodes of DKA.
  • Sufficient time, resources and training must be in place to enable diabetes healthcare professionals to identify and support people with diabulimia effectively.

References

1) Colton, P. A., Olmsted, M. P., Daneman, D., Farquhar, J. C., Wong, H., Muskat, S., & Rodin, G. M. (2015). Eating disorders in girls and women with type 1 diabetes: a longitudinal study of prevalence, onset, remission, and recurrence. Diabetes care, 38(7), 1212-1217.

2) Svensson, M., Engström, I., & Åman, J. (2003). Higher drive for thinness in adolescent males with insulin‐dependent diabetes mellitus compared with healthy controls. Acta Paediatrica, 92(1), 114-117.

  1. http://www.dailymail.co.uk/news/article-5554981/Patient-27-killed-asked-therapist-note-send-Dignitas.html
  2. Nationaleatingdisorders.org

Herbalist defrauds diabetes patient of 190 million for cure in Lagos

 

 

Diabetes is a condition that sadly has no cure but what is even more saddening is that there are people out there who are exploiting innocent people just in the bid to get them cure.

This was the case of Adeniyi Adewunmi, a self-acclaimed herbalist who allegedly swindled a businessman of 190 million claiming he’ll cure his diabetes.

The case was brought before an Igbosere Magistrates’ Court in Lagos where the accused, aged 43, is standing trial on a four count charge on conspiracy, fraud and stealing.

The Prosecutor, Friday Mameh said before court that the offences were commited between Feburary 2016 and January 2018.

“The accused and others still at large approached the complainant, one Mr Lawrence Akanbi, and told him that he is suffering from diabetes, asthma and spiritual attack”.

“The complainant believed because he was actually suffering from the ailments stated by the accused”.

“The accused used the opportunity to ask the complainant for money till the money amounted to N190m,” Mameh said.

The complainant, hoping for a cure, noticed his symptoms were rather getting worse and the accused arrested by the police.

The accused however denied the allegations.

The Magistrate, Mrs F.O. Botoku, granted him bail in the sum of N20m, with two sureties who must not be less than grade 16 in the civil service  in like sum.

The case was then adjourned the case until Feb. 12 for trial.

 

 

 

Source : The Punch Newspapers

Baby’s Coming; Coping With Diabetes in Pregnancy.

Before the discovery of insulin, the chances of having a baby with diabetes was really slim, but thanks to Banting and Best, the discovers of insulin, this century has seen better outcomes for mothers living with diabetes and their children. In Nigeria 1.7 percent of pregnant women have diabetes out of which 61 percent is gestational diabetes.

Pregnancy in itself is a diabetogenic state i.e pregnancy raises blood sugar levels in normal conditions . Diabetes may complicate pregnancy because a woman had diabetes before pregnancy  (pregestational diabetes which can be type 1 or type 2)or she developed diabetes during the course of her pregnancy (gestational diabetes). Gestational diabetes usually resolves few weeks after the baby is born. However, in about 60-70 percent of women, there is a recurrence in subsequent pregnancy.

 

The challenge

The body is more resistant to insulin during pregnancy to allow more glucose available to sustain the growth of the baby. This makes the body require more insulin production. In people with gestational diabetes, the pancreas can’t keep up with the production of insulin required and so the blood has excess glucose.

The main effects of diabetes in pregnancy is that it increases the risk of miscarriages in early pregnancy it increased risk of babies with congenital malformations e.g with cardiac problems . This is in people with poorly controlled diabetes. It is not uncommon to see people with diabetes developing hypertension and infections in pregnancy.

Too much glucose gets into the baby’s blood and causes accelerated growth of organs especially in the middle and late stages of pregnancy.  This results in big babies, too big to enter the birth canal and can cause the baby’s shoulder to be stuck (shoulder dystocia) making caesarean section necessary in some cases.

Shortly after birth, your baby may have low blood sugar (hypoglycemia) because his body will still be producing extra insulin in response to your excess glucose.

The baby is at risk of hypoglycemia immediately after birth because the baby was used to having excessive insulin action while in the womb. It is recommended that the mothers breast feed their babies shortly after birth to help reduce this.

There is also a a higher risk of having breathing problems because the lungs do not mature well enough and the baby might have neonatal jaundice.

Who should be more concerned?

Women above 35 years

People whose immediate relatives have diabetes

People who have had big babies (4.5kg and above) in the past.

People who weigh beyond 90kg or have a BMI above 30.

People who have had stillbirths without a known cause.

People who have had babies with birth defects

People with polycystic ovarian syndrome.

 

What to do?

Mums-to-be  need to check their sugar levels early in pregnancy during their first trimester.

A woman with diabetes or impaired blood sugar levels should consult with a doctor- both an obstetrician and a physician- even before the start of pregnancy. A dietician also plays a role of helping to maintain a healthy diet.

A diet of someone with gestational diabetes should be between 1500-2000 calories and there should be good combination of carbohydrates with protein and fats.  An HbA1c of between 4-6 is the usual target.

It is also important to take folic acid (5mg) before aiming at pregnancy for people at risk.

People living with diabetes before pregnancy would need to really monitor their sugar levels closely has pregnancy can alter their feeding patterns and they might require higher levels of insulin.

A woman who has had diabetes in previous pregnancy is advised to have yearly medical checks as she’s at risk of developing type 2 diabetes in the future.

The pre-pregnancy states are very important. A woman with good glycemic control before pregnancy is more likely to have a better outcome.