Diabetes in Nigeria: Signs, Causes, Prevention and Treatment

Diabetes is one of Nigeria’s fastest-growing health problems. Once seen as a “rich man’s disease”, it now affects people of every income level, in cities and villages alike. The International Diabetes Federation estimated that about 3.6 million Nigerian adults were living with diabetes in 2021, and many more do not know they have it.

The good news is that diabetes can be detected early with a simple blood test, and it can be managed well. This guide explains what diabetes is, the early signs to look out for, what causes it, how it is diagnosed and treated, and how to lower your risk.

What is diabetes?

Diabetes (diabetes mellitus) is a long-term condition in which there is too much sugar (glucose) in the blood. Normally, the hormone insulin, made by the pancreas, moves glucose from the blood into your cells to be used for energy. In diabetes, the body either does not make enough insulin, or the cells do not respond to it properly. Glucose builds up in the blood and, over time, damages blood vessels, nerves and organs.

The main types are:

• Type 2 diabetes: the most common type, usually in adults. The body becomes resistant to insulin and may not make enough. It is strongly linked to weight, diet, physical activity and family history.
• Type 1 diabetes: an autoimmune condition in which the body destroys the cells that make insulin. It usually starts in childhood or young adulthood, and people need insulin for life.
• Gestational diabetes: high blood sugar that develops during pregnancy. It usually goes away after birth but raises the mother’s risk of type 2 diabetes later.

For a deeper look at how diabetes develops and how stress affects blood sugar, read Sugar and Stress: Understanding Diabetes Mellitus in Modern Life.

Learn more about each type: type 1 diabetes, type 2 diabetes and gestational diabetes.

Early signs and symptoms of diabetes

Type 2 diabetes often develops slowly, and many people have no symptoms for years. When symptoms appear, they can include:

• Increased thirst and frequent urination. The kidneys try to get rid of excess sugar through urine, which pulls water from the body and leaves you thirsty.
• Tiredness and weakness. Your cells are not getting the energy they need from glucose.
• Unexplained weight loss. When the body cannot use glucose, it burns fat and muscle for energy instead. This is more common in type 1 diabetes.
• Increased hunger.
• Blurred vision. High blood sugar can make the lens of the eye swell.
• Slow-healing cuts and sores, and frequent infections such as skin, gum or vaginal yeast infections.
• Tingling, numbness or burning in the hands or feet.

If you notice any of these, ask a doctor for a blood sugar test. Do not wait for symptoms to get worse.

What causes diabetes? Risk factors

Anyone can develop diabetes, but your risk is higher if you:

• Have a parent, brother or sister with diabetes
• Are overweight, especially with extra fat around the waist
• Are physically inactive
• Are over 40 (though type 2 diabetes is appearing in younger people)
• Have high blood pressure or high cholesterol
• Had gestational diabetes, or gave birth to a baby weighing over 4 kg
• Have polycystic ovary syndrome (PCOS). Read what is PCOS?

In Nigeria, the rise in diabetes is linked to changes in how we live: more time sitting at desks and in traffic, less physical activity, more sugary drinks and processed foods, and large portions of refined starches such as white rice, white bread and swallows without enough vegetables and protein. Many people also never get screened, so diabetes is found late.

How diabetes is diagnosed

Diabetes is diagnosed with simple blood tests. Your doctor may use:

• Fasting blood sugar (FBS): taken after not eating for at least 8 hours. A result of 7.0 mmol/L (126 mg/dL) or higher on two occasions suggests diabetes.
• HbA1c: shows your average blood sugar over about three months. A result of 6.5% or higher suggests diabetes.
• Random blood sugar: a result of 11.1 mmol/L (200 mg/dL) or higher, together with symptoms, suggests diabetes.
• Oral glucose tolerance test (OGTT): often used in pregnancy.

Results between normal and diabetic levels may mean prediabetes. This is a warning sign, and lifestyle changes at this stage can often stop diabetes from developing. Adults over 40, and younger adults with risk factors, should have their blood sugar checked regularly.

Diabetes and high blood pressure

High blood pressure is common in people with diabetes, and the two conditions make each other worse. Having both greatly raises the risk of heart attack, stroke, kidney disease and eye damage. If you have diabetes, have your blood pressure checked at every visit. Doctors often aim for a reading below 130/80 mmHg, but your target may differ. Cutting down on salt, staying active, keeping a healthy weight and taking prescribed medicines help control both. Read our guide to high blood pressure.

Complications of diabetes

Poorly controlled diabetes can damage many parts of the body over time, leading to:

• Heart attack and stroke
• Kidney disease and kidney failure
• Eye damage (diabetic retinopathy) and blindness
• Nerve damage, foot ulcers and, in severe cases, amputation
• Erectile dysfunction and frequent infections

Most complications can be prevented or delayed by keeping blood sugar, blood pressure and cholesterol under control.

How diabetes is treated and managed

Healthy eating. Build meals around vegetables, beans, fish, eggs and lean meat, with smaller portions of starchy foods. Choose whole grains and high-fibre options, and cut down on sugary drinks, juices and pastries. See foods to avoid with diabetes and whether amala is good for people with diabetes.

Regular physical activity. Aim for at least 150 minutes a week of moderate activity, such as brisk walking. Activity helps your body use insulin better.

Medicines. Many people with type 2 diabetes need tablets such as metformin, and some need insulin. Everyone with type 1 diabetes needs insulin. Take your medicines exactly as prescribed, and do not stop or switch to herbal remedies without speaking to your doctor.

Monitoring. Check your blood sugar as advised, and have regular HbA1c, blood pressure, kidney and cholesterol checks.

Eye and foot care. Have your eyes checked every year, check your feet daily for cuts or sores, and never walk barefoot.

Manage stress, sleep and smoking. Stress and poor sleep can raise blood sugar, and smoking greatly increases the risk of complications.

How to lower your risk of type 2 diabetes

• Keep to a healthy weight. Even losing 5–7% of your body weight can lower your risk.
• Move more and sit less.
• Swap sugary drinks for water.
• Fill half your plate with vegetables.
• Get your blood sugar checked regularly, especially if diabetes runs in your family.

Read more about why too much sugar is bad for you.

Diabetes and your health plan

Ongoing diabetes care means regular check-ups, tests and medicines, so it helps to know what your plan covers. Many plans treat diabetes you already had before joining as a pre-existing condition. Check whether your plan covers it before you join. Learn more about pre-existing conditions.

Frequently asked questions

What are the first signs of diabetes?
Common early signs are increased thirst, frequent urination, tiredness, blurred vision and slow-healing sores. Many people have no symptoms, so regular testing is important.

What is a normal blood sugar level?
A normal fasting blood sugar is below 5.6 mmol/L (100 mg/dL). Between 5.6 and 6.9 mmol/L may mean prediabetes, and 7.0 mmol/L or above may mean diabetes. Your doctor will confirm with repeat or additional tests.

Can diabetes be cured?
Type 1 diabetes cannot be cured but can be managed well with insulin. Type 2 diabetes is lifelong, but some people can bring their blood sugar back to normal levels with weight loss and lifestyle changes, with their doctor’s support.

Can I eat swallow if I have diabetes?
Yes, in smaller portions and with plenty of vegetable soup and protein. Some options affect blood sugar less than others. Ask your doctor or a dietitian for advice that fits you.

Planning ahead? An HMO plan can cover regular check-ups, tests and medicines for long-term conditions. See what an HMO is and how it works and how much it costs.

This article is for general information and does not replace advice from your doctor.

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