Diabetes care in Nigeria: Gaps and way forward

By Abiemwense Moru

When 52-year-old Sarah Sani first noticed a small sore on her foot, she dismissed it as a scratch.

Weeks later, the wound deepened, threatening her leg and her life.

Doctors diagnosed her with advanced diabetic foot ulcer, a condition she had unknowingly worsened by walking barefoot at home; it was a painful lesson that changed her forever.

“Diabetes nearly took my foot; I never knew a simple wound could turn deadly; now, I always wear slippers, even indoors,” she said.

Her story mirrors that of many Nigerians silently battling diabetes complications.

Experts warn that ignorance, late treatment, and unsafe habits continue to endanger thousands across the country every year.

An Endocrinologist from Bauchi, Dr Ayuba Mugana, said foot care remained crucial for diabetic patients, as minor injuries often led to serious infections and eventual amputations if neglected.

He explained that diabetic foot complications ranked second only to road accidents as causes of amputation in Nigeria, yet many cases were preventable with early detection and hygiene.

“Check your feet regularly; if you notice pain or any injury, consult your doctor immediately.

“Never walk barefoot or wear tight footwear that restricts blood circulation.”

He warned that walking barefoot exposed patients to sharp objects they might not feel due to nerve damage.

“Prevention is always easier and cheaper than treatment.”

Mugana also recommended using nail clippers rather than blades for trimming toenails, saying that even small cuts could trigger infections in people with poor blood sugar control.

Beyond foot care, he advocated a healthy diet and hydration.

“Drink plenty of water, adhere to prescriptions, and maintain clean feet to avoid dehydration and infections,” he said.

In addition, pharmacist Joshua Akindele of the Lagos University Teaching Hospital (LUTH) raised alarm over another silent threat worsening Nigeria’s diabetes crisis, self-medication.

He described self-medication as widespread and dangerous, noting that many Nigerians took prescription drugs without supervision, increasing their risk of chronic diseases, including diabetes.

“People share or buy drugs from uncertified vendors, not knowing the side effects.

“This ignorance is slowly destroying organs vital to metabolism and blood sugar control.”

He explained that unprescribed medications, especially steroids and unregulated herbal mixtures, often damaged the liver and pancreas, organs essential for insulin production and blood sugar regulation.

Akindele warned that pharmacotherapy misuse was rampant due to weak regulation and poor health literacy, making millions vulnerable to preventable illnesses across Nigeria.

Citing World Health Organisation (WHO) data, he revealed that self-medication caused nearly half of all preventable healthcare harm globally and over three million avoidable deaths each year.

“In Nigeria, poor oversight allows unsafe drinks, noodles, and supplements to circulate freely.”

He urged authorities to strengthen food and drug safety standards nationwide.

Akindele condemned the cultural habit of recommending drugs to friends or family, saying it perpetuated unprofessional advice and contributed to long-term health complications.

“Drug misuse reduces therapeutic value, causes treatment failure, or even organ failure.

“The solution lies in education, professional guidance, and strict medical compliance,” Akindele said.

To complement medical therapy, Mugana encouraged diabetic patients to include Doum fruit in their diet, describing it as a natural, affordable source of antioxidants and fibre.

“Doum fruit helps stabilise sugar levels and lower blood pressure.

“It aids digestion, prevents constipation, and relieves bloating for diabetic patients when consumed regularly.”

He advised that the fruit could be eaten raw, mixed with tea, or combined in meals, offering a nutritious supplement to prescribed medications for improved wellbeing.

Mugana, however, cautioned against replacing medical treatment with natural remedies.

“Use Doum fruit as support, not substitution; always follow medical advice,” he told patients in Bauchi.

While individuals struggled daily with treatment, Nigeria is taking bold steps to improve access to life-saving drugs like insulin, which remained vital for diabetes management.

The National Biotechnology Research and Development Agency (NBRDA) recently partnered with Shanghai Haiqi Industrial Company Ltd to establish Nigeria’s first insulin production plant.

According to NBRDA spokesperson Mrs Toyin Omozuwa, the agreement marks a historic step toward self-sufficiency, potentially saving the country billions spent annually on imported insulin.

She said the facility would ensure accessibility and affordability of quality insulin, serving as a lifeline for millions who depended on the drug to survive daily.

Signing on behalf of the Federal Government, NBRDA’s Director-General, Prof. Abdullahi Mustapha, described the partnership as transformative for Nigeria’s health and biotechnology sectors.

“For the first time, Nigeria will produce standardised insulin locally.

“This ensures affordability, creates jobs, and positions us as a pharmaceutical hub for Africa,” Mustapha said.

Former Minister of Innovation, Science and Technology Uche Nnaji, commended the move, saying it would boost health security, foster innovation, and reduce the nation’s dependency on costly imports.

He said that the initiative could save Nigeria up to one billion dollars annually, while empowering families affected by diabetes through more affordable healthcare access.

The Chinese partner, Mr Bokai Zhai, said the firm was committed to technology transfer, capacity building, and job creation through the insulin manufacturing project.

“This cooperation will reduce reliance on imported drugs and promote Nigeria’s pharmaceutical industry,” Zhai said.

He called the project a milestone for Africa’s health development.

As institutional capacity grows, health advocates are pushing for stronger policy frameworks to address the rising tide of non-communicable diseases (NCDs) nationwide.

The Non-Communicable Diseases Alliance recently urged the National Assembly to dedicate a budget line for hypertension and NCD prevention in Nigeria’s annual health allocation.

Prof. Dike Ojji of the Yakubu Gowon University, Abuja, told lawmakers that 38.1 per cent of Nigerian adults live with hypertension, while 5.7 per cent suffer from diabetes, mainly type two.

He linked rising cases to poor diet, inactivity, and weak healthcare access.

Ojji said there was need for early screening and consistent treatment across primary health centres.

He urged the inclusion of hypertension under the National Health Insurance Authority to ease the financial burden of long-term care for millions of patients.

The academic called for stronger oversight on policies regulating excess salt, sugar, and trans fats in processed foods, which contributed to cardiovascular and metabolic diseases.

Ojji, the Lead Investigator at the Cardiovascular Research Centre, said NCDs caused nearly a third of all deaths among Nigeria’s most productive citizens.

He revealed that cardiovascular diseases, particularly hypertension and stroke, lead NCD-related mortality, with 29 out of every 100,000 Nigerians suffering fatal complications annually.

Ojji added that about 24 per cent of household food spending went into NCD treatment, illustrating the economic weight of chronic illness on families nationwide.

In response, Speaker of the House of Representatives, Mr Tajudeen Abbas, commended the experts, pledging legislative support for improved healthcare funding and stronger regulation of processed food industries.

At the professional level, awareness and collaboration continue to grow.

In Kano, more than 500 specialists gathered for the 14th Annual Conference of Clinical Endocrinologists of Nigeria (ACEN).

Delivering the keynote, Prof. Zubairu Iliyasu of Aminu Kano Teaching Hospital revealed that more than 11 million Nigerians live with diabetes, with many more still undiagnosed.

He said the theme “Endocrinology and Public Health” reflected the urgent need for collective action against the dual threat of diabetes and obesity across the country.

The event’s chairman, Prof. Musa Borodo, lamented the rising cost of healthcare and urged more preventive strategies, especially lifestyle interventions and nutrition education.

ACEN President, Dr Williams Balogun, reaffirmed the group’s commitment to research, public enlightenment, and policy advocacy to curb the growing burden of metabolic diseases.

“This meeting will unveil innovative ideas and practical solutions to ensure diabetes and obesity are tackled from all possible fronts nationwide,” he said.

Declaring the conference open, Gov. Abba Yusuf of Kano pledged his government’s support for collaboration with medical associations in the fight against NCDs.

He urged participants to develop actionable strategies to address the alarming rise in diabetes and obesity, promising state-level policy backing and implementation.

For survivors like Sani, every small lifestyle adjustment matters.

“I now walk carefully, eating right, and checking my feet daily; my health is finally back on track,” she said

The experts agreed that combating diabetes required a multifaceted approach, education, local drug production, lifestyle change, and strict regulatory enforcement.

(NANFeatures)