By Tendai Chisiri
The rapid adoption of Western lifestyles in Africa including Zimbabwe has brought about unprecedented economic growth and cultural exchange however this shift has also introduced a daunting health concern that is the rising prevalence of diabetes and hypertension says Dr. Misheck Ruwende medical practitioner with Centre for Diabetes Management (CDM) in Harare.
As Africans increasingly emulate Western habits, they unwittingly inherit accompanying health risks. ” We have adopted the Western people’s lifestlye but we didn’t adopt their sophisticated healthy system whereby they diagnosed the conditions early and they treat the person”, said Dr. Ruwende in an interview with this publication.
Diabetes is a chronic metabolic disorder characterized by high blood sugar levels. There are two primary types of diabetes which are type 1 Diabetes (T1D) where one has autoimmune disease, body attacks insulin-producing beta cells, pancreas produces little/no insulin and is typically diagnosed in childhood/adolescents. It requires insulin therapy.
Type 2 Diabetes (T2D) causes metabolic bolic disorder, body becomes insulin resistant, pancreas initially produces excess insulin, then decreases, often linked to obesity, physical inactivity, and diet. Typically it is diagnosed in adulthood and may be managed through lifestyle changes and/or medication.
Gestational diabetes develops during pregnancy whilst Latent Autoimmune Diabetes in Adults (LADA) combines T1D and T2D characteristics. Maturity-Onset Diabetes of the Young(MODY) is a rare, genetic form. Secondary Diabetes results from another medical condition or treatment.
Symptoms of diabetes are increased thirst, frequent urination, fatigue and blurred vision. The causes of diabetes are genetics, obesity, physical inactivity and diet. Complications are heart disease, kidney damage, nerve damage and blindness.
Hypertension is the chronic medical condition characterized by elevated blood pressure. Types of hypertension are primary (essential), secondary and issolated systolic hypertension. Symptoms of hypertension are headaches, dizziness, nosebleeds, and fatigue with the causes being genetics, obesity, lack of exercise or sodium intake. Its complications are heart disease, stroke, kidney damage and vision loss.
According to World Health Organisation (WHO), the number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014 in Africa. Over the last few decades, the burden of hypertension has been rapidly increasing in low-and middle-income countries (LMIC) including African countries due to population growth and ageing . In Africa, the cumulative estimated prevalence of hypertension is ~30.8%. With rising urbanization, unhealthy lifestyles such as malnutrition and low physical activity, high blood pressure will likely continue to increase.
” Our biggest problem in Zimbabwe and Africa why we are having a sharp rise of these health conditions like diabetes and hypertension is because we have adopted the lifestlye of the Western people. By adopting their the lifestyle of Western people, we have also adopted their diseases”, laments Dr. Ruwende.
He outlined that the lifestlye being adopted is whereby the intake of processed food like macaroni, spaghetti, tinned fish, and tinned beans is on the rise instead of the traditional food like sugar beans that is grown in our fields.
Dr. Ruwende elaborated the change of lifestlye for example people longtime ago used to walk long distances like 5 kilometres thereby exercising regularly. ” We are now exercising less, people are now frequently relying on cars for transportation abandoning the long walks were once part of daily life so you see some growing fat and there is a problem that a big stomach is a sign of success whilst its a disease and that disease puts us at the risk of diabetes, hypertension and cancer”, he said.
“Again on westernisation, it is now fashionable to be drinking alcohol and smoking. Drinking and smoking puts us at the risk of diabetes and hypertension”, he added.
“People are encouraged to eat food from their gardens or go traditional. So what I mean by going traditional is if it is sadza, we go for mealie meal from small grains like sorghum and millet. Brown sadza is encouraged instead of white sadza which is foreign. Lets also eat what we cook at home instead of junk food”, Dr Ruwende said.
“Vegetables are very important. Lets fill our stomachs with vegetables. If one can be able to plant vegetables lets do that. Commercial ones that are bought in the supermarkets sometimes have chemicals or fertiliser. But when you do your own vegetables behind the house or backyard garden, you are likely to put some manure there which is going to be more organic. So we encourage more of that. Let’s not much rely on instant foods”, he added.
He emphasised the need of early detection in order for one to live long life. “It is very important for the early detection of diabetes and hypertension. These conditions are termed silent killers as they will be destroying inside. By the time you would be diagnosed, they would have destroyed inside, they would be now causing complications. For example diabetes affects the whole body, eyes, heart, liver, for men erect dysfunctional, for women vaginal itchness, low sex drive or unhealing wounds in the feet, normally one gets amputated like what happened to the late muscian Cephas Mashakada”, Dr Ruwende said.
“But if we detect these diseases early, even hypertension is the common culprit of stroke, we prevent the onset of these complications mentioned. The person lives a normal healthy life. Its what most of the Western people are doing. Like I said, we have adopted their lifestlye but we didn’t adopt their sophisticated heslthy system whereby they diagnose the conditions early and they treat the person. A person diagnosed lives long life. Patients come late to the hospital and they die early. But if those people are detected early the better that is why we encourage health check-ups once a year”, he added.
“By 2045, the amount of people with diabetes would have doubled in Africa because of the lifestlye we are leaving. Center for Diabetes Management as a hospital test for diabetes and hypertension every patient that comes. We do this because these are silent killers so one can have these conditions without being aware, so each person who comes to the hospital, we test so that we can detect early. If there is a condition, we try to manage them before they develop complications. It doesn’t matter whether the one has come with diarrhoea, flue, HIV or headache, we check these silent killers, diabetes and hypertension. That what should be done in all hospitals but because of lack of resources, some hospitals don’t do that”, Dr Ruwende revealed.
“We also teach on diet. There are nurses who draw some nice graphs for the patient such that besides the treatment, we are also preventing. These diets about traditional foods are preventive diets so if people take these lifestyle measures, it assists them on diabetes and hypertension. For person without diabetes, the healthy lifestyle or healthy plate protects them from diabetes and hypertension. For some already with diabetes and hypertension, it helps them to control these conditions”, he said.
Diabetes and hypertension are interconnected such that diabetes increases hypertension risk, hypertension exacerbates diabetes complications and the conditions have shared risk factors which are obesity and physical inactivity.
For one to manage these health conditions there is need for lifestyle modifications through diet, exercise and stress reduction, medications as oral hypoglycemics, insulin and ntihypertensives as well as monitoring blood glucose and blood pressure.
Ways to prevent diabetes and hypertension are healthy diet, regular physical activity, weight management, stess reduction (meditation, yoga) and regular health check-ups.
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