Experts warn of hidden diabetes crisis as obesity and chronic disease rise

Kenya could be facing a hidden diabetes crisis, with up to six in every 10 people living with the disease unaware of their condition, health experts have warned.

The warning comes amid rising obesity and an increasing burden of hypertension, heart disease and chronic kidney disease, putting further pressure on a health system already grappling with the high cost of treating non-communicable diseases.

 Dr Rosslyn Ngugi, a physician, ophthalmologist and president of the Kenya Diabetes Study Group, said official diabetes estimates could be far below the actual number of people affected.

 “In Kenya we can see the prevalence of diabetes is grossly underestimated,” Dr Ngugi said, putting current estimates at between 3.3 and 4.5 per cent.

 She said the high rate of undiagnosed cases was particularly worrying because many patients only seek medical attention after complications have developed.

 “Majority of the patients are walking around not realizing that they actually have diabetes,” she said.

The concerns come as Novo Nordisk moves to introduce Ozempic for diabetes care and Wegovy for weight management in Kenya, placing renewed focus on the country's growing burden of type 2 diabetes and obesity.

 Ngugi said obesity was increasingly being seen alongside chronic conditions, creating a complex health burden for patients and healthcare providers.

“Majority of our patients with diabetes are obese, they have hypertension, they are progressing to chronic kidney disease and the main driver is obesity,” she said.

She urged the country to rethink its approach to non-communicable diseases by investing more in prevention, screening and early treatment.

“We need to take a step back and see how we can go back into preventive medicine rather than reactive medicine,” she said.

Hypertension, which Dr Ngugi estimates affects between 12 and 14 per cent of the population, is also closely associated with obesity.

The problem, she said, is no longer confined to adults, with obesity increasingly affecting children, pregnant women and older people.

“We are saying obesity is not a lifestyle disease. It's actually a metabolic condition that is grossly, grossly causing cardio metabolic disease, and we need to focus on that,” she said.

 The growing demand for treatment has also raised concerns over affordability. While newer medicines offer additional options for people living with diabetes and obesity, their cost could limit access for many patients requiring long-term care.

Dr Ngugi said efforts to lower the cost of medicines were important but called for insurers and policymakers to play a greater role in ensuring patients can access appropriate treatment.

“If I can manage to keep my patient away from the hospital by reducing the overall cardiovascular burden, haven't I changed the care of the patient?” she asked.

She also called for healthcare workers to be adequately trained to identify suitable patients and prescribe the medicines appropriately.

Danish Ambassador to Kenya Stephan Schønemann said early diagnosis, strong health systems and evidence-based treatment were critical in tackling the growing burden of chronic diseases.

“The importance of a strong health sector, that you make the diagnosis early, that you have a healthcare system that does take care of the patient, that you follow up, and that your treatment is strong and based on evidence,” he said.

He pointed to the difference in life expectancy between Denmark, at about 82 years, and Kenya, at about 64 years, saying stronger health systems could contribute to longer and healthier lives.

Novo Nordisk Head of Business Area Africa Malika De Maillard said Ozempic and Wegovy were being introduced in response to the growing medical need among people living with type 2 diabetes and obesity.

She said more than 58 million patients globally had been exposed to the two medicines, while stressing the importance of evidence, quality and safety.

But experts say new medicines alone will not solve Kenya's diabetes challenge.

With a large proportion of patients still undiagnosed and obesity driving multiple chronic conditions, they argue that screening, early intervention and sustained access to treatment must form the center of the country's response.

 As Dr Ngugi puts it, the first battle may simply be finding those who do not yet know they are sick.