The WHO analysis of 14 African countries, which provided information on COVID-19 and comorbidities, showed that the risk of complications or death from COVID-19 among people with diabetes increases with age, with people aged 60 years and above facing greater risks.
Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation, but with early diagnosis and treatment, many of the harmful effects of the disease can be delayed or even avoided. The disease occurs either when the pancreas does not produce enough insulin [type 1 diabetes] or when the body cannot effectively use the insulin it produces [type 2 diabetes]. The more common is type 2 diabetes.
Over the past three decades, the occurrence of type 2 diabetes has risen dramatically in all countries around the world. The African Region has experienced a six-fold increase, from 4 million cases in 1980 to 25 million in 2014. With around 60% of people living with diabetes undiagnosed, the African region has the highest proportion of people unaware of their status. A study in Kenya found that 60% of people diagnosed with the chronic condition were not on medication.
“Far too many people are in the dark as to whether they have diabetes. People with this chronic condition suffer a double blow if they are also infected with COVID-19,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “We must turn this around by investing in early detection, prevention and treatment of diabetes.”
At the onset and the peak months of the COVID-19 pandemic, health services for diabetes were particularly disrupted. Only about a third of reporting countries in a WHO survey of 41 countries in sub-Saharan Africa indicated that services were fully functional.
“We must not lose sight of other health challenges as we combat COVID-19. World Diabetes Day is a key moment to call attention to this chronic illness, which is increasingly threatening the lives of Africans,” Dr Moeti said.
World Diabetes Day is marked on 14 November every year.
In many African countries, access to basic equipment for diagnosis and monitoring of diabetes is a challenge, especially in public and remote health facilities. There are also limited supplies of insulin and oral hypoglycaemic medicines for diabetes on the continent, while health workers are not sufficiently trained in diabetes diagnosis and care for patients.
The African region is also witnessing a rise in diabetes risk factors such as obesity. Increasingly sedentary lifestyle and consuming foods rich in sugar, fats and salt is heightening obesity, ranging from 2.5% of adults in Burundi to 26.9 % in Seychelles.
WHO is working with countries to train more nurses and other health workers and to expand access to diabetes prevention and care services through the WHO Package of Essential Noncommunicable Disease Interventions for Primary Health Care in Low-Resource Settings. Twenty-five countries have adopted the package and are working to decentralise and improve early diabetes detection and patient care.