It has been 20 years since, Sabina Nyaboke, 52, was diagnosed with diabetes. A resident of Nyamira County, the wife and mother says she was fit and healthy all her life until one morning when everything changed.
"I had just woken from my bed. I started feeling weak and tired but I thought that maybe it was because I had slept longer than usual. I went on with my day but the next morning, I had the same symptoms," Sabina narrates.
Sabina says she didn't seek medical attention for the next few weeks because she hoped the feeling would go away. Finally, she decided to visit a health facility in Kisii County where medics examined her. According to Sabina, the report read: 'Sabina's body was dehydrated'.
"The medics explained that dehydration was the main reason I was feeling weak and tired. I was put on intravenous therapy (IV therapy), which I was told, was the quickest way to hydrate my body," Sabina explains.
"I was attended to and went back home but the following day, I was still feeling weak and tired so I went to hospital and was again put on IV therapy," Sabina says adding that she went through IV therapy several times over a year, remaining optimistic that she would be okay and she would eventually go back to living a normal life.
At the end of the year 2003, Sabina's health deteriorated and this caught the attention of her children. They took her to a referral hospital in Nairobi and, after several tests, she was told she had Type 2 diabetes.
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"I had never imagined that I would have such a condition. I had been hearing about diabetes on the radio but it had never occurred to me that I could be a victim," Sabina says.
Type 2 diabetes, the most common type of diabetes, is a condition that happens because of a problem in the way the body regulates and uses sugar as a fuel. Your body can't use energy from food properly because your pancreas doesn't make enough insulin or any at all, or when your body isn't properly responding to the effects of insulin. As a result, your blood sugar rises to abnormal levels.
According to World Health Organization (WHO), more than 420 million people live with diabetes globally and 4 in 5 of them live in low and middle-income countries.
In 2013, WHO predicted that this condition would rise to 45 per cent from 3.3 per cent in Kenya by 2025. Global numbers are likely to rise by 2045 when the survey estimates that nearly 800 million people will be diagnosed with the disease.
The Ministry of Health says diabetes remains one of the leading non-communicable diseases that account for 40 per cent of the deaths in Kenya annually.
While there is no cure for diabetes, it can be managed through treatment and some people may be able to reach a stage of diabetes remission. Managing the lifetime condition means accepting the diagnosis and continuously seeking medical attention to manage the symptoms.
Unfortunately, managing a lifetime condition is emotionally and physically taxing and poses a serious financial burden to individuals, families and economies.
The estimated global direct health expenditure on diabetes in 2019 is USD760 billion and is expected to grow to a projected USD 825 billion by 2030 and USD 845 billion by 2045, according to the US National Institutes on Health.
It is estimated that the proper management of diabetes in Kenya would cost about Sh12,000 per month, that is Sh144,000 a year, amounts that are out of reach for the average Kenyan.
For Sabina, this became apparent to her as soon as she was diagnosed.
"After diagnosis, I was admitted to the facility so that my health could be watched. The medics promised me I was to be out of hospital as soon as blood sugar level had reduced to normal levels," Sabina narrates. "I was taking a lot of medication and receiving injections every morning and evening," she says.
The days turned into months and 3- 4 months later, she was told she would finally be allowed to go home. The hospital bill, she says, was a shocking huge amount.
When she asked some of her fellow patients why the bill was so high, they told her that it wasn't unusual.
"They told me that diabetic drugs are always charged expensively and that's why many patients die prematurely, not only because of late diagnosis but also because of poverty as most cannot afford the treatment and diet cost," Sabina recalls. This revelation, she says, never left her mind.
After one week back at home, Sabina's blood sugar started rising back to abnormal levels. The weakness returned and she was unable to perform any household chores or walk for long distances. She also lost a lot of weight.
"I was a lady of adventure but now 'I don't have any legs' to facilitate this. After walking even a short distance, I get tired, I weighed 98 kgs before I became sick. Look at me now, I weigh 54 kgs. Just see that difference, " Sabina recalls.
According to Isaac Ogutu, the Founder of Afya Fitness20 Healthcare Initiative, diabetes limits one's productivity in various ways, especially if it is not well-managed.
"Managing diabetes often requires taking medication, monitoring blood sugar levels, and making dietary adjustments. This can be time-consuming and disruptive to work routines," says Ogutu whose qualification is a medical laboratory Officer.
"Poorly controlled diabetes can affect cognitive function, including memory and concentration, which can hinder productivity at work or in daily tasks. High or fluctuating blood sugar levels can lead to fatigue, making it difficult to stay focused and energetic throughout the day," Ogutu says.
Sabina says that the most taxing thing over the 20 years of managing her condition has been buying the medication.
"The drugs are not free so you have to dig deep in your pocket and buy them," she says adding that the change of diet also added to the cost.
"I was advised that I eat healthy plant foods that would provide vitamins, minerals and carbohydrates in my diet. I avoid eating sugary foods and I only take a little salt in my food," Sabina says. "If you are diagnosed with this condition, you just need to learn how to live with it," Sabina says adding that she was advised to ensure she had three wholesome meals and three snacks a day.
"I call upon the government and concerned stakeholders to intervene and support families caring for diabetic people. They should also come up with ways of spreading awareness and educating the public on facts surrounding this condition. Few people know the causes," Sabina says.
"To all diabetic people, accept that you have this lifelong condition. Follow the doctor's advice, take your daily medications as prescribed and maintain a balanced diet. If you do that, believe me, you will live more than the 20 years I have lived with it," Sabina advises.