Is Nigeria On a Sugar Rush?
What I Learnt in My First Month as a Clinical Student
After the hustle and bustle of preclinical school, I finally got to walk the floors and corridors of the teaching hospital and to practically appreciate and apply some of the things we had been taught in theory up to this point.
My excitement, however, was dampened when I saw the distributions of the postings and discovered that I had been posted to the endocrinology unit of internal medicine which focuses on diagnosing and treating hormone-related diseases and conditions. I had been hoping to be posted to a unit like cardiology, which deals mainly with the heart, or neurology, which focuses on the brain and everything else relating to the nervous system. I felt that there would be so much more to learn in these two fields and hopefully many interesting things to experience. With endocrinology, there was not so much to expect, or so I thought. Was it going to be anything more than diabetic feet and a few cases of thyroid disorders?
It turns out no aspect of medicine is less important than another; every field is significant and vital in the maintenance of whole health among families and in the society at large.
To my utmost surprise, the endocrinology unit is very busy, and unlike I thought, there is so much to learn. It turns out no aspect of medicine is less important than another; every field is significant and vital in the maintenance of whole health among families and in the society at large. I was surprised to find that we had to deal with not a few but A LOT of cases of diabetic feet. It was shocking to discover the extent to which diabetes prevails in my community. The daily influx of patients to the endocrinology unit daily, the domination of the male and female medical wards by patients whose diabetic disease has progressed into complications like foot ulcers, the number of people who were on the verge of losing their sight, their legs, or some other part of their body to diabetes was alarming to me.
At one point, it seemed as though almost every person above the age of forty was either a diabetic or a prediabetic. I was always shocked, every time we met a patient, every time a patient was diagnosed in front of me as diabetic or prediabetic, even those who looked relatively healthy, who came into the clinic with a complaint not directly related to diabetes. After a hectic day in the clinic, I would pass through my street and notice an elderly or middle-aged woman sitting in her stall where she sold everyday provisions, a bottle of coke in her hands, and I'd begin to wonder when last she checked her sugar levels, and if she also was diabetic.
After a hectic day in the clinic, I would pass through my street and notice an elderly or middle-aged woman sitting in her stall where she sold everyday provisions, a bottle of coke in her hands, and I'd begin to wonder when last she checked her sugar levels, and if she also was diabetic.
Diabetes looked to me like that subtle epidemic that was silently but steadily taking over my community, bringing upon as much damage, if not more, than COVID-19 but not getting as much attention, probably because it is not communicable like COVID-19, or because it ran more of a chronic, progressive and gradually destructive course, unlike COVID-19 which more often runs a rapid and fatal course under a short time.
After clerking more than a few cases of people whose history of presenting complaints, signs, and symptoms more often than not pointed to diabetes as compared to other endocrine disorders, I got interested in the subject of diabetes and the reason for its drastic prevalence in my community.
Research over the years has shown a drastic increase in the prevalence and a demographic transition in the epidemiology of diabetes in recent years, such that populations previously unaffected or minimally affected by diabetes are now reporting soaring figures. And this is no surprise. There are quite a number of factors as regards our general makeup and lifestyle that tend to put us at risk of developing diabetes.
For one, there's the factor of obesity. Research shows that about one in four Nigerians are obese and that the prevalence of obesity in Nigeria can be regarded as an epidemic. Obesity is a powerful risk factor in the progression of diabetes, especially type 2, which is more prevalent among the middle-aged and elderly, and is indeed the more common form of diabetes that we see in the endocrinology unit every day.
The general pattern and running of our society is another factor that puts us at risk. Most middle-aged to elderly women run different kinds of businesses from small shops to big stalls. In many of these cases, these women end up spending most of their time sitting almost throughout the day, from where they carry out most of their transactions and activities. Even those who are teachers or bankers still spend most of their days seated on their backs and less time actively moving and expending some calories. There is little that pushes many people to intentionally challenge their bodies. Subjects like exercise are reserved for those who have some extra time on their hands and are willing to indulge themselves a little bit. It is considered more a matter of recreation than an important factor in the maintenance of whole health.