This is a difficult story to share, but it has strong elements of perseverance and hope because the person who shared it with me is living with diabetes in situation that makes every day difficult. I connected with Olafimihan Nasiru a few months ago, thanks to the Nigerian Online Diabetes Community and he offered to share his diabetes story with me.

He deals with similar fears and issues faced by anyone with diabetes, but he – like others around the globe – faces additional challenges that many of us do not have to consider. He expanded on the effects that living with diabetes in Nigeria have had on him. Things are not easy for Nasiru, but he is looking at solutions and supports efforts to connect with others and raise awareness about the problems. He is kind and intelligent and was so willing to answer any questions I had about his diabetes and his life. Thank you, Nasiru, for connecting with me and speaking out. I hope we can all hear and share more stories like this.

Nasiru’s Story

I am a young man of 37 years of age, currently unemployed, living in Lagos, south western Nigeria. I have had diabetes for almost 10 years, so I think it is important to share part of my experience.

Growing up, I was relatively healthy in the early part my life, as attending the hospital or seeing a medical doctor was, on the whole, nonexistent. The common cold that I would occasionally have was treated with over-the-counter drugs, like paracetamol, although that fact may also reveal my poor economic background. This period of not going to the doctor actually ranged from my pre- school up to secondary school ages. It was not until I gained admission into university that I had the opportunity of meeting medical doctors at the school medical facilities for treatment of illnesses, like the common cold that is usually associated to academic and physical stress.

However, the end of my university education in August 2004 marked the beginning of a new turn in my personal health. About a month after leaving the school to prepare for the compulsory national service, strange changes started occurring in my body. The noticed changes, though I did not pay serious attention to them, included excessive craving for water and increased frequent urination. The other change was loss of weight. The curiosity of people about my sudden loss of weight prompted me to visit a drug store where I could not get a good explanation. I then visited a neighborhood clinic where I was wrongly diagnosed.

At this point, my condition was getting worse and I decided to visit a government primary health facility. At the hospital I was diagnosed with diabetes mellitus, as my fasting blood sugar test read over 300mg/dl. I was then referred to a secondary health institution where I met a diabetician and was fully diagnosed with type 1 diabetes at the age of 27. I was put on insulin injections at that time. The cause of my diabetes was not understood, though I was told that it could be hereditary, but there is no diabetes in my family history.

Living with diabetes has exposed me to some awful and embarrassing experiences of hypoglycemia, the major side effect of insulin, on several occasions. I have passed out at public places on different occasions before getting rescued at hospitals. And I have had several embarrassing situations in social and work gatherings due to disorientation or confusion. Moreover, depending on insulin has brought a financial burden on me, especially now that I am without work, since it has become necessary for me to secure all the medications and materials I need on my own. Being diabetic has also brought some negative psychological effects on me. For example, I believe my inability to secure a lucrative job is linked to the mental effects of diabetes on me. In addition, my social life is affected seriously, as dining in social gathering is sometime embarrassing, especially when I have to reject some certain foods.

The myths associated to diabetes in Africa, mostly due to ignorance, have not helped encourage me to typically disclose my diabetic status to people. For instance, I have gotten several words of advice ranging from direction to seek a spiritual cure, to a suggestion to abandon my insulin injections, with no logical alternative provided.

Based on my experience, I believe that much is still needed to be done in terms of diabetes education, access to insulin, care etc. to address the problem of diabetes globally, particularly in poor countries.

The cost of Nasiru’s diabetic basic management and supplies are broken down as follows:

• Insulin (Humulin 70/30): $19 per 10ml vial /$11 per 4ml vial (I usually take 9ml per month) or $40 per a set of 5 cartridges for pen
• Insulin pen: $94; disposable needles: $44 per a pack of 100
• Accu check active glucometer: $56.3
• Test Strips: $20 per pack of 50

I asked Nasiru what impact he has felt because of the exorbitant costs of managing his diabetes. He shared the following list.

• Being diabetic has been draining me financially, since I have to procure every item on my own with no assistance, especially now that I have no job and have almost exhausted my savings.
• I am usually psychologically and emotionally disturbed to the extent of sometimes feeling very depressed.
• I have suffered from embarrassment of falling unconscious in public as a result of hypoglycemia.
• I have had to limit my physical efforts and have been held back in achieving some goals because of my fear of hypoglycemia.

When discussing these difficult impacts, Nasiru shared what he thought the main challenges and possible solutions to these issues are.

Challenges

• Lack of education on diabetes and the need for diagnosis
• Myths and misconceptions around diabetes
• Lack of appropriate medical infrastructure
• Insufficient number of diabetologits and endocrinologists
• Financial inability to procure the basic diabetic management supplies
• Ignorance around diabetes management
• Absence of well-coordinated networks among diabetics in the country
• Absence of support from government

Possible Solutions

• Stepping up the efforts on creating awareness on symptoms, diagnoses and management by government , NGO’s and the media
• Establishment of more medical institutions for adequate provision of treatment
• Engagement and training of more specialists to cater for the increasing number of people living with diabetes
• Developing health insurance that covers diabetes and other non-communicable diseases
• Encouragement of interaction among people living with diabetes both locally and globally
• Encouragement of free or affordable access and management supplies, especially insulin, by government and NGO’s

Apart from the online community, I believe real time physical networking cannot be overemphasized.

You can follow Nasiru on Twitter at @olafimihannas.