Home-based self-care for diabetic patients key to better livelihoods

An elderly woman undergoing a screening for non-communicable diseases at Githongo Hospital in Meru on Tuesday, November 15, 2022. [Standard]

Many families in Kenya rue having a member suffering from diabetes mellitus as the costs of managing the condition from going for treatment, buying drugs and direct patient care perpetually eat into their wealth. The non-communicable disease poses a significant public health burden and is a challenge for health insurers who must identify ways to improve diabetes management, thereby controlling the dynamics of diabetes-related spending.

According to the World Health Organisation, the prevalence of diabetes in Kenya stands at 3.3 per cent and is projected to rise to 4.5 per cent by 2025, thanks to a rising middle-class that drives more, eats processed foods often and spends hours on end in binge parties.

The worrisome increase in diabetes cases is mostly attributable to lifestyle changes- increased intake of unhealthy foods, physical inactivity, which subsequently culminates in obesity. Last year, the International Diabetes Federation ranked Kenya as the 31st African country in terms of diabetes with a prevalence of about 460 diabetic cases per 10,000 population, out of which 3 per cent are adults.

However, two-thirds of diabetic patients are undiagnosed since Kenyans usually visit hospitals only when unwell and rarely for any kind of medical check-ups. With such a laid-back health seeking behaviour, the country’s efforts towards fighting and possibly eradicating diabetes is arduous.

Complications linked to diabetes have been blamed as leading causes for renal failure, lower limb amputation, and blindness. These complications if undetected and untreated are often serious and cause huge human suffering and disability. Diabetes also triggers cardiovascular disease which is the leading cause of death among diabetic patients.

Despite evidence that most diabetes cases can be prevented and reversed through adoption of lifestyle changes such as increasing physical activity and dietary modification, the primary focus of management of type 2 diabetes in Kenya is on medication. This has resulted in large increases in expenditure on drugs and at the individual level it is catastrophic as it eats into out of the pocket expenditure.

There is a high likelihood of exponentially increased health expenditure on the same chronic disease in the years to come. The good news is that it is possible to lessen the financial burden of diabetes and improve the health of the population by increasing local production of medicines and providing access to affordable health services like diabetes management education, routine blood glucose screening programs, among others.

In recent years, there has been a focus on patient education as diabetes is a chronic illness whose management depends on patient self-care, and it mostly focuses on how to appropriately self-administer insulin shots and injection sites. Unlike in the past when patients had to visit clinics for checks, a patient can check their blood glucose levels, change lifestyle choices, engage in physical exercises, and manage the disease at home.

To deepen uptake of home-based care, diabetics management knowledge is shared among family members by the patients' healthcare provider at the point of service.

Mr Adamjee is the head of Medical-Novartis, East Africa Cluster