Fighting diabetes, hypertension

Forty-year-old Khama Samalani from Traditional Authority (T/A) Mazengera in Lilongwe resorted to energy drinks at work to stay awake.

He says: “The more sugar I consumed, the more I was hurting myself. I kept at it for years such that what looked like a sleep remedy became a daily routine.”

Samalani, who was working at one of the social outlets in Lilongwe, recalls how a night experience ended in a diabetes diagnosis.  

He says: “I would take an energy drink, but 10 minutes later, I would have the urge to pee. In addition, I would have excessive thirst.

“One night at work, my vision got blurry such that I could barely see across the casino floor. I thought it was just fatigue.”

This, he says, forced him to seek medical attention at Kamuzu Central Hospital where a blood test showed that his blood sugar was beyond the normal levels.

He says the levels had spiked over 600 milligrammes per decilitre, far beyond the normal level of between 70 and 140.

Samalani’s situation, according to the International Diabetes Federation, is not unique.

In fact, the federation estimates in its 2021 National Diabetes Statistics Report that the number of people that have diabetes but are unaware are in millions.

“That was the beginning of my battle with diabetes. I remained at the hospital until the doctor brought my blood sugar level back to normal with an insulin injection,” he says.

The federation says 537 million people globally aged between 20 and 79 have diabetes. This represents a 16 percent rise from the previous estimates in 2019.

In its 10th edition published in 2021, the federation says out of the estimated figures, the majority of them live in middle and low-income countries like Malawi.

According to Samalani, his body mass index was 105 kilogrammes and he could wear an large pair of trousers.

This, he says, was because of the too many sugars he was taking which, in turn, led to frequent urination.

Diabetes, according to World Health Organisation (WHO), is a serious, chronic condition that affects lives and well-being of people at different stages. It is characterised by excess levels of sugar in the blood.

WHO says type one diabetes often begins from childhood when the pancreas is damaged, making it unable to produce insulin responsible for regulating the blood sugar level.

On the other hand, type two occurs mostly in adults aged between 20 and 79. This is when the pancreas produces insulin which is either insufficient or not good for the body cells.

There is also gestational diabetes which is a high blood sugar level that appears only during pregnancy and usually goes away after delivery.

According to WHO, type two diabetes accounts for about 90 percent of all diabetes cases across the globe and is the major cause of blindness, kidney failure, heart attacks, stroke, hypertension and lower limb amputation.

Global Burden of Disease Study also considers diabetes as the fifth leading cause of deaths  ahead of stroke, heart disease, congenital birth defects and chronic liver diseases.

Ministry of Health spokesperson Adrian Chikumbe says Malawi, just like other countries, is not spared from diabetes which is one of the common non-communicable diseases.

He says District Health Information System (DHIS) 2 of 2021 which is used for reporting, analysing and disseminating data for all health programmes, established that 20 per 100 000 people are diagnosed with diabetes annually in Malawi.

Says Chikumbe: “However, there are more people that are diagnosed but, some facilities do not report. This, in turn, displays challenges in diagnosis.

“Furthermore, private hospitals, Christian Health Association of Malawi facilities and other entities do not report.”

He encourages people aged between 18 to 65 to regularly go for Diabetes testing.

Diabetes specialist, Chilungamo Chingwanda, who owns Alidziwa Health Private Clinic, says diabetes is manageable if there is drug compliance, lifestyle modification and physical exercises.

He says: “It is better to start changing lifestyle, including losing weight, doing regular exercises and avoiding processed foods as much as possible.

“It is advisable to eat lighter starches at night like boiled potatoes or reduce the quantity of nsima at night. It is also good not to eat so late at night like after 8pm.”

Chingwanda, who is also a lecturer at Kamuzu University of Health Sciences, says failure to comply with diabetes treatment and lifestyle advice may lead to complications such as strokes, heart attacks, hypertension, nerve damage, sexual dysfunction, blindness and kidney failure.

Diabetes Association of Malawi president Clement Mandala says they will continue intensifying sensitisation campaigns to raise awareness  about the disease, especially on healthy lifestyle and the importance of early diagnosis.

He says: “So far, more people are becoming aware of the disease, especially in the urban areas. However, some people still come after suffering from the symptoms for a few months.

“From talking to them, you see that they suspected they may have had the disease, but were in denial or were just afraid to know with certainty what it was.”

With collaborative efforts to wage war against diabetes, their cases could be reduced.