Awareness about treatment and control of diabetes is extremely low among developing nations like Ethiopia although available evidence suggests an increasing prevalence of diabetes and its risk factors not only on adults but among children. With more children being diagnosed with the illness in the country, EBR’s Menna Asrat took a look at what could be behind the growing rates of diabetes, and what people can do every day to protect their health.
Blen Alemayehu, an 11 year old student, is a vibrant and funny, girl. She had always been that way, except for a time when she was five. Her charismatic behaviour changed suddenly. Her family took her to the doctor, where she was diagnosed with type 1 diabetes, a disease she will have to deal for the rest of her life. Her father Alemayehu Abraham remembers taking her to the clinic. “She was listless and irritable, complaining of feeling tired, different from the playful personality we knew,” Alemayehu told EBR. “After a series of tests and going from doctor to doctor, we got the diagnosis that would change our lives.”
Type 1 diabetes, which is the most common form diabetes observed in children and teens, is caused when the pancreas, the organ in the body responsible for producing insulin, stops doing its job. There are various reasons for this, but usually, the body mistakenly attacks the insulin-producing cells in the pancreas as it would a virus or bacteria. Insulin is the chemical that helps the body to convert glucose into energy. Formerly known as juvenile diabetes, type 1 diabetes is incurable, but manageable with medications and better lifestyle choices.
It took Blen and her family some time to adjust to their new normal. “We have to be careful of what she eats sometimes,” explains Alemayehu. “It’s difficult to cope, but we’re making it work somehow.” Blen’s family also had to inform her teachers about what do if they saw any signs of hypoglycemia, or low blood sugar, which could potentially be dangerous if not caught in time.
But the biggest problem is finding medicines on time at reasonable prices. “The medications are expensive, and sometimes you can’t find what you need on the local market, so you have to try and find people to bring it for you sometimes from abroad if necessary,” her father says.
Like Blen, there are thousands of other children affected by Type 1 diabetes in Ethiopia. Although there is no exact figure regarding the accurate number of children affected by type 1 diabetes in the country, according to study conducted by Tinsae Alemayehu (PhD), a physician at Tikur Anbesa Hospital and his colleague in 2017, 2.81 children between the age of seven to nine were diagnosed with Type 1 diabetes out of a thousand children.
Even though there is a shortage of age specific studies, experts on the ground have seen a marked difference in the number of cases. “There is definitely an increase in the number of children I see who are diagnosed with diabetes,” says one endocrinologist at Black Lion hospital. “I suspect that it is because of improving screening and diagnostic techniques. Although it was always there, we can detect it better now.”
On the other hand, there has also been a marked increase of people being diagnosed with the type 2 variation of the disease. Type 2 diabetes, is most often related to lifestyle issues, and genetics. The most common cause of type 2 diabetes is insulin resistance: the body stops responding to insulin in the way it should. The body may also stop producing insulin all together. Like type 1, there is no cure.
This is the variation that Meseret Amare lives with. “I was diagnosed around 4 years ago,” the 27 year old told EBR. “It was a shock. I didn’t think that I was at risk for it, because I didn’t eat a lot of junk food, or western food. It hit me hard, but I managed to start looking after my health, and now my diabetes is well managed.”
Since her diagnosis, Meseret has been trying to fight some of the myths that crop up about diabetes in her daily life. “Many people don’t really understand what the disease means,” she says. “Some people tell me to try traditional medicines. But I try to make it clear that medication, a good diet and proper follow up is the best way to manage diabetes.”
“It’s obvious that diabetes rates are going up,” explained Yoseph Mamo, a doctor of internal medicine. “More people are starting to move to urban areas and with that come more sedentary lifestyles, changes in diet and increased obesity. All of which contributes to more cases of type 2 diabetes.”
This is a worrying trend, according to experts, because like in many developing countries, the prevalence rates of non-communicable diseases, such as high blood pressure, high cholesterol and diabetes are increasing in Ethiopia. Diabetes accounts for an estimated one percent of the total deaths in the country according the World Health Organisation.
“Of course, diagnostic capacity has increased, so we are finding cases that we would have missed,” explained Yoseph. “However, when children start living more urbanised lifestyles, they reduce exercise, and eat drink more, all of which raises the risk for diabetes.”
All of this begs the question of what children and their families can do to reduce their risk of developing diabetes. “There isn’t a culture in Ethiopia taking children to the doctor for regular checkups, or even going themselves,” argues Yoseph. “That is the first step. Checking glucose levels regularly can help children before it gets worse.”
While type 1 diabetes can present with symptoms including increased fatigue, thirst, increased urination, and increased irritability and fruity breath, sometimes type 2 diabetes can be present without any symptoms for years. Allowing it to go unchecked can lead to issues such as kidney failure, blindness and nerve damage.
Alemayehu says he will always be grateful for the recovery that Blen has made. Even though she will have the disease for the rest of her life, managing it well has made her the outgoing and funny child she always was.
“Sometime people think that diabetes is a disease for mature people, and children and their family don’t have to worry about it,” comments Alemayehu. “That’s not true. People should try and become more educated about it; the government should try and spread awareness of the issue, so children can get treatment on time.”
6th Year . June 16 – July 15 2018 . No.63