The Ghanaian children living with type II diabetes
Around this same time, confectionaries shops along the road to schools are opened busily cashing in as pupils stopped by to buy biscuits, flavored paper drinks, and toffees, for snack break which is usually after lunch in school
Others who have not had breakfast at home also stopped by the food joints to buy pasta and waakye (beans mixed with rice) served with stew and hot pepper (shito) to satisfy their morning hunger.
Not even a fruit seller is spotted along the road during this time and the children have become so used to drinks and business every day.
Maame Serwa, a brilliant class six pupil, is always seen eating sweetened cake with high sugar flavored drink every morning before class begins while she keeps sugary stuff also in her bag for snacks.
Although almost all of the kids have sweets for snack breaks, with only a few eating fruits as their snack, Mame Serwa’s habitual intake of sweets every morning and afternoon became a concern to her mates, they advised her several times to quit eating sugar, but she turned a deaf ear.
As time went by, Maame Serwa began to lose weight, she told her mates that she always felt hungry most of the time and could urinate a number of times before class was over.
Maame Serwa’s mother, a banker who was always busy with work paid less attention to her daughter’s complaints of tiredness and only offered her pain killers anytime she complained of tiredness, she realized that her daughter’s urge to eat was unusual but kept losing weight no matter how much she ate.
When Auntie Sarah noticed that her daughter’s frequent urination at night was getting worse, she took her to the hospital where Maame Serwa was diagnosed with Type II diabetes.
The doctor explained to Serwa’s mum that her daughter would have to be on medication to manage the condition and encouraged her to eat healthy foods, exercise regularly, and maintain a healthy weight.
This affected her studies as she became less active in class, her classmates were, however, supportive to help her through her condition.
Type II diabetes, according to the World Health Organisation (WHO), is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces.
Insulin is a hormone that regulates blood glucose.
Symptoms of type II diabetes may include, increased thirst, frequent urination, increased hunger, fatigue, blurry vision, darkened areas of skin, most often around the neck or in the armpits and groin, unintended weight loss, and frequent infections.
Type II diabetes among children may be due to being overweight, which is considered a strong risk factor, poor diet, and a sedentary lifestyle.
The condition among children could also be attributed to family history, race or ethnicity, age and sex, maternal gestational diabetes, low birth weight or preterm birth.
A healthy diet, weight loss, regular exercise, and good hygiene, Insulin replacement therapy, regular checking of blood sugar levels, and oral medication are the treatment for the condition.
Treatment includes encouraging children with the condition to eat healthy foods, get plenty of physical activity and maintain a healthy weight.
Maame Serwa said she gets tired very often and is not able to participate in class activities due to pains in her body.
Not happy with the condition and the pain she goes through, Maame Serwa has vowed to heed to any advice and maintain a healthy body weight so she could reverse the condition hopefully.
Dr Betty Bankah, a Family Physician at the Greater Accra Regional Hospital, expressed worry that a lot of children were being affected with type two diabetes due to lifestyle.
She noted that Ghanaians have moved away from the local foods and now eating a lot of processed foods, saturated fats, and meats without exercising.
She said: “We are having a lot of development of type two diabetes among children and teenagers due to lifestyle, a lot of children have become very obese because they are eating all the oily foods and carbohydrates and eventually putting on weight.”
“Unfortunately, in Ghana, when your child is big, then it shows a sign of wealth. Parents must be able to provide appropriate diet for the family and teach the children the right way to go and make sure the children are healthy”, she stressed.
She said: “We sit in front of the Television (TV), without moving around, we sit in our cars to work and come back home to the same routine. Kids are not allowed to go out and play outside but are given phones and tablets to play. All these are contributory factors to the disease”.
The Ghana Health Service (GHS) recorded over 96,000 NCD-related deaths in the year 2020.
Dr Afua Commeh, Acting Programme Manager, Non-Communicable Diseases (NCD), Ghana Health Service, also expressed concern about the increasing cases of NCDs in the country.
She stressed: “Previously, persons affected with stroke were in their 70s and beyond, however, people as young as 30s and 40s are being affected and stroke is a complication of hypertension and diabetes when not detected early.”
“So for children, the key thing is to be able to monitor what they take in physically. We reward our children with fast foods, a lot of the children in the international schools are currently becoming obese because for them, their parents can afford the fast foods and it is unhealthy and they come up with high blood sugars at very early stages”
She said the situation was very worrying because most parents hardly check their baby’s blood sugar when they are born unless complications set in.
“We keep stressing on awareness even with the health workers who keep seeing children suddenly losing weight, and not eating well. Among the tests, it is important to conduct diabetes test for the children and address it as soon as possible.”
Though there is an urgent need to increase public education and awareness to save lives, lack of funding remains a major challenge, hampering the efforts of the GHS, stakeholders, and partners.
Dr Afua Commeh said the revised NCD policy to serve as a guideline for awareness creation, advocacy and prevention would focus on areas that need urgent support.
Mrs Elizabeth Esi Denyo, Chairperson, of International Diabetes Federation, West Africa and President, of Ghana National Diabetes Association noted that being a diabetic in Africa is a problem on its own as diet, culture, and lifestyle, do not give a good bearing on the condition.
Mrs Denyo disclosed that 1,470 children under the age of 25 years were living with diabetes. Again, 800,000 adults are living with diabetes on insulin while 5 out of ten people walking on the streets have diabetes, they are not aware of.
It also disclosed that in 2019, kidney disease due to diabetes caused an estimated two million deaths.
WHO says with the increasing levels of overweight and obesity among children and adolescents in many countries including Ghana, the disease in this age group has the potential to become a global public health issue leading to serious health outcomes.
Mrs Denyo expressed concern over the high cost of treatment and management of diabetes in Ghana.
She said: “Inadequate health care service provision and limited access to essential diabetes medication makes children and adults develop serious complications and die young”.
“Undergoing laboratory tests every three months, the cost of medication, and being on the right diet has been a problem for many persons living with the condition, she added.
She attributed about 40 per cent of mortalities in Ghana to diabetes due to the cost of treatment.
According to the NCD revised policy, the increasing burden caused by the condition and associated risk factors could have implications for healthcare delivery in Ghana.
It said with the objectives of attaining Universal Health Coverage (UHC), in a way that truly leaves no one behind, access to quality healthcare that ensures financial risk protection for people with NCDs must be assured through the National Health Insurance Scheme (NHIS) and other funding mechanisms.
Mrs Denyoh noted that the NHIS was a major problem, as diabetic patients were not allowed to make choices in receiving medication.
She said, “we appreciate the NHIS, however, the Scheme does not make room for patients to choose medications.”
The Diabetes Association of Ghana was established with the objectives to give health education and advocacy to the public, mediate between individuals and government, making treatment accessible and available as well as make decision making in diabetes comfortable.
She, however, said not much has been achieved due to lack of funds to executive such activities and added that the Association had received stipends from the government for some time now.
It is expensive to do health education among the public. Either mass media or house-to-house is expensive, there are no vehicles to do distribution as little attention had been given regarding the condition.
According to her, mortality could increase due to lack of education and advocacy and advised individuals to take control of their lives whiles taking their health issues seriously.
“Don’t put anything in your mouth if you do not know what you’re going to gain from it, eat right, exercise a lot, do regular checkups, and follow instructions immediately after you are diagnosed with diabetes.”
Mrs Denyo advocated the need for government to pay more attention and assist with resources to scale up public education and advocacy to reduce mortality to the barest minimum.
By Muniratu Akweley Issah