Challenges and opportunities in managing Type 2 Diabetes Mellitus in Sub-Saharan Africa : the cases of Nigeria and South Africa

Abstract

Background: Diabetes mellitus is a chronic, non-communicable, and metabolic disease characterized by elevated levels of blood glucose due to insulin deficiency/defective action, leading to severe damage of the heart, eyes, blood vessels, kidneys, and nerves, and conditions that make walking painful. While diabetes was considered the disease of the affluent, populations from low socio-economic communities are also affected. So, while diabetes is rising worldwide, its prevalence has risen faster in Sub-Saharan Africa and other low-and middle-income countries than in high-income countries. Diabetes prevalence in Africa underlines the need to understand its causes, magnitude, and management challenges. Aim: This study's specific objectives were to analyze the challenges in the detection and diagnosis of diabetes in Nigeria and South Africa and to offer recommendations to overcome some of the management challenges. Methods: This search entailed an exploration of the PubMed, EMBASE, Scopus, Medline, and Lancet Diabetes & Endocrinology databases. Additionally, desk research was conducted in African Journals Online, the International Diabetes Federation and the World Health Organization open access sources. Google and countrywide health surveys, including reports from health regulatory bodies such as the Society for Endocrinology, Metabolism and Diabetes of South Africa, the Endocrine and Metabolism Society of Nigeria, and the Diabetes Association of Nigeria were undertaken. Results: The analysis indicates that high dependence on complementary and alternative medicine, treatment, and cost of T2DM, the low capability of healthcare systems to tackle diabetes, and poor adherence to diabetes guidelines correlate highly with diabetes prevalence in Nigeria and South Africa. Conclusions: The study underscores the need: (1) to increase the budgetary allocation for health, and integrate generic medicines into diabetes care (2) to inform health care practitioners about the simultaneous use of herbal and conventional medicine, and understand the biological effects of herbal medicines (3) for a concerted effort to be put in place to ensure that optimal care for diabetes patients is attainable, and (4) for more extensive implementation of diabetes guidelines and collaboration between policymakers, healthcare providers, the pharmaceutical industries, herbalists, and users of anti-diabetic medication to ensure adequate regulation of the importation of diabetes medicines.