LESOTHO this week joined the rest of the world in commemorating World Diabetes Day on 14 November.
World Diabetes Day was first commemorated in 1991 as an initiative of the International Diabetes Federation (IDF) and the World Health Organisation in response to growing concerns about the escalating health threat posed by diabetes.
Former Health Minister, ‘Molotsi Monyamane (MM) – a medical doctor, this week spoke to the Lesotho Times (LT) on the importance of initiatives to prevent or at least manage the condition which is regarded the world over as a silent killer. Below are excerpts of the interview.
LT: Should we be worried about diabetes in Lesotho?
MM: We have to be worried because diabetes is increasing in low and medium income countries.
The other problem is since diabetes is not painful, people don’t feel it, and therefore it becomes a silent killer.
It’s not the sugar which kills us but it is the consequences of having diabetes that kill us. It is a lifestyle disease and we have to be worried because people are dying from complications of diabetes.
However it is very easy to manage and fortunately in Lesotho people have access to care and treatment at primary care level at clinics at no cost but we do emphasise prevention.
LT: What is the current situation in Lesotho with relation to diabetes? Do we have a diabetes policy or do we need one?
MM: Fortunately, access to quality health care and access to education are a primary policy of the government of Lesotho. Government policy is to decentralise services and primary healthcare is where you actually have your first contact with the health system within your community.
However, the problem is that the focus has been communicable diseases like HIV/AIDS and non communicable diseases have been neglected over the years and we are now seeing the consequences.
Non communicable diseases are a package and in Lesotho that package consists of diabetes, cancer, mental illness, inter personal violence, motorcycle accidents and they consume much of our health budget.
It is very costly to treat non communicable diseases. For example it might cost as much as M200 000 to treat a cancer patient which can be for the whole treatment or per session. One tablet of chemotherapy is M30 000. However, our health system is highly subsidised and we really salute the government for that.
LT: What is it that Basotho must know and do about diabetes?
MM: It’s very important to empower patients and their families on prevention and management of diabetes by the individual and the support structures.
Government cannot do it alone, the health system cannot do it alone because prevention starts with understanding what diabetes is, understanding the risk factors, symptoms and complications.
It is team work and the captain of the team should be the patient himself.
Diabetes should not be considered in isolation. Diabetes is part of five risk factors for cardio vascular disease. Diabetes goes with hypertension. If someone has hypertension they must test for diabetes because in 80% of people of African extraction, diabetes symptoms may not register.
90 percent of people with diabetes are type 2 diabetes and every type of diabetes is dangerous.
Type 2 diabetes affects the large blood vessels which supple the brain, the heart which in turn supply the internal organs.
So people die from the complications of diabetes because it doesn’t go alone, it goes with hyper tension it goes with high cholesterol. Smoking is another risk factor, lack of exercise is another risk factor and if we manage them well we can delay all the onset of diabetes.
People must test for blood pressure, blood cholesterol, weight and measure the body mass index as part of the fight against diabetes. People must be encouraged people to lose 10 percent of their weight if they are overweight.
In Lesotho research shows that 4 percent of our people have diabetes but 24 percent have hypertension so it is very important to manage all that together.
It starts with diet and contrary to popular belief, there is nothing like a diabetes diet, or a cholesterol or high blood sugar diet.
There is only a healthy diet which we all must follow.
Eating healthy does not mean eating expensive foods: there should be more vegetables and proteins and less of carbohydrates in the plate.
Reduce on bad fats from processed meats and reduce on fizzy drinks that contain sugar.
We should also exercise and that does not mean going to the gym.
Exercise can be getting off the taxi three or four stops before your house so that you can walk at least 30 minutes until you break sweat.
LT: How often should people test for diabetes?
MM: At least once a year you make sure that you should take the opportunity to pass through the chemist to test your blood sugar and your weight.
It is very important for people above the age of 35 but we are also seeing diabetes even in very young people.
That is why we are emphasising that diabetes does not depend on age as we are having young people who are obese because of their lifestyles.
People don’t live in isolation they have a support structures. They are very scared of hospitals so it is very important to educate them so that they can use those support structures to take better care of themselves even at home.
We need to give them enough information so that they are able to test themselves.
And we are fortunate that in Lesotho the government has allowed us access to affordable medication.
Even five year olds can inject themselves as long as we are comfortable as healthcare professionals that we have empowered our patients with the knowledge of insulin because weather you are type one or type two diabetes you will need insulin.
A lot of people are scare of needles but the current ones will only feel like a mosquito bite.