Diabetes cases in Kenya are rising at an alarming rate primarily due to change in lifestyle leading to increased consumption of unhealthy diets, physical inactivity, and subsequently obesity. Diabetes is one of the leading causes of renal failure, lower limb amputation, and blindness. These complications if undetected and untreated are often serious and cause huge human suffering and disability. In addition, they result in significant socioeconomic costs resulting from premature morbidity and mortality (Death). Diabetes also triggers cardiovascular disease which is the leading cause of death in diabetic patients.

The World Health Organization (WHO) estimates that the prevalence of diabetes in Kenya has more than doubled in the last three decades, accounting for 20 percent of deaths in the country. A report published by the WHO on World Health Day shows that the widespread presence of Diabetes in Kenya is likely to rise by 1.2% by 2025. The current prevalence rate is 3.3 % which has risen by more than 150 percent from 2.4 percent in 1980. According to a survey done in 2015 by the Ministry of Health, 2% of Kenyan’s aged 18 – 69 years (1 in 50) have raised blood glucose or are on treatment for diabetes. This prevalence was highest at 5% among those aged 45 – 59 years (1 in 20).

According to the World Health Organization (WHO), the projected rise in diabetics can be attributed to the fact that two-thirds of diabetics are undiagnosed and this has posed a challenge to Kenya’s health sector. Many Kenyans that live without knowing their diabetes status have made it difficult for the country to make progress on the management of diabetes.

Not knowing one’s status also has an impact on the possibility of eradicating diabetes, hence slowing down the country’s efforts toward fighting this disease.

This gives us a view and shows us why fighting diabetes has become a difficult process for the government.

As a country, Kenya has been ranked the 31st country by the International Diabetes Federation (IDF) with a prevalence of 460 diabetic cases for every 10,000 people.

According to recent research on Diabetes in Kenya, the disease is prevalent in rural and semi-rural communities. Gender-wise, many women are affected by diabetes in comparison to men. Of the 1548 cases based on a review of diabetes cases in various hospitals, 59% were female. The mean age among the women was 58.

Based on the research that was conducted by the International Diabetes Federation there is a correlation between gender, age, and presence of the rate of increased diabetes cases across different Kenyan counties. In counties such as Isiolo, Othaya, Mukurweini, Thika, and Meru the diabetic ratio is higher in Isiolo that in Meru. It is at 310 – 400 per 10,000 respectively.

The 8th edition of IDF’s diabetes atlas reveals that an estimated 15.5 million adults in Africa between 20-79 years were living with diabetes and adults aged 55 to 64 had the highest prevalence in Africa.

Management of diabetes in Kenya

According to the Kenya Vision 2030, the Kenyan government is keen on improving the health sector through the provision of equitable, affordable, and quality health care to all its citizens.

In the Kenya, diabetes is managed on three primary units of care, at the district level through district hospitals, county hospitals and referral hospitals.

As in all treatment of diabetes, the goal is to maintain healthy blood glucose levels through managing the levels of cholesterol, high blood pressure to prevent the progression of other diabetes-related complications, such as heart disease, stroke, and kidney problems.

Treatment in a majority of Kenyan hospitals includes the administration of insulin, dietary recommendations, and physical exercise. As diabetes is a chronic disease whose management relies on patient self-care, there has been an emphasis on patient education in recent years.

This education often touches on, how to monitor blood glucose levels, how to properly self-administer insulin shots (and injection sites), dietary information, lifestyle improvement, physical exercise, and home management of the disease.

Most of this education is carried out at the point of care with the individuals’ healthcare provider.

Despite evidence that the majority of diabetes cases can be prevented and reversed through the 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. The result is large increases in expenditure on drugs for diabetes and at the individual level, catastrophic out of the pocket expenditure.  Further, while these drugs may lead to some improvement in blood glucose control, these improvements are not always sustained, and further medication is often required.

Challenges in diabetes management in Kenya

While access to quality healthcare remains a challenge to most individuals, some challenges facing diabetes management include:

• Access: to consumables for diabetes care, such as syringes, lancets, glucometers, etc. is often an added expense that most patients are unable to meet.
• Education: most county programs that train and educate on diabetes are often underfunded, understaffed, and with limited resources. As a result of this, the level of the information made to individual patients suffers in quality.
•  Insulin supply: where county hospitals provide insulin at subsidized prices, the supply of the drug is often out of stock, causing patients to source the drug from private institutions, often at an added cost.
• Delayed screening: While an estimated 44% of diabetes cases remain undiagnosed, the most common types of diabetes in Kenya include type 1, type 2, and gestational diabetes.