Diabetes has become one of the most pressing public health challenges of our time, affecting millions of people across Nigeria and the world. Despite its rising prevalence, many still lack a clear understanding of what diabetes really is, how it develops, and the steps individuals and families can take to manage it effectively.

In this edition of the AfriReporters Health Series, we sit down with Dr. Emmanuel Obaseki, PharmD, a clinical pharmacist and diabetes educator, to break down the condition in simple terms. From symptoms and risk factors to lifestyle choices, myths, and the latest advances in treatment, Dr. Obaseki sheds light on how communities can respond better to this growing health concern.

Can you explain in simple terms what diabetes is and the different types that exist?

Diabetes is a condition that affects how the body handles sugar from the food we eat. Normally, our body uses a hormone called insulin, which works like a key, to help sugar move from the blood into our cells where it can be used for energy. In diabetes, that process is disrupted. Either the body does not produce enough insulin, or the insulin does not work effectively. As a result, sugar builds up in the blood—a condition called hyperglycemia (high blood sugar). Over time, this can damage important organs like the eyes, kidneys, heart, and nerves.

There are three main types. Type 1 diabetes usually starts early in life and happens when the body stops making insulin completely. Type 2 diabetes, the most common in Nigeria and globally, develops when the body does not use insulin well, a problem called insulin resistance. Gestational diabetes occurs during pregnancy and can affect both mother and child if not well managed.

What are some of the most common symptoms people should look out for?

Diabetes often presents with a classic triad of symptoms known as the “three Ps”: polyuria (frequent urination), polydipsia (excessive thirst), and polyphagia (increased hunger). Other warning signs include unexplained weight loss, constant tiredness, blurry vision, recurrent infections, slow-healing wounds, and tingling or numbness in the hands or feet. These latter symptoms can indicate neuropathy (nerve damage) or poor circulation. Many people in Nigeria ignore these symptoms, thinking they are just “body weakness” or stress. Recognizing them early can make a huge difference in preventing serious complications.

From your experience as a pharmacist, how early can diabetes be detected, and how important is early diagnosis?

Diabetes can be detected very early, even before major symptoms appear, through simple blood sugar tests. Two common tests are:
Fasting Blood Sugar (FBS): This measures your blood sugar after you have not eaten for at least 8 hours, usually overnight. It gives a baseline of how your body handles sugar without recent food intake.

Random Blood Sugar (RBS): This measures your blood sugar at any time of the day, regardless of meals. It’s useful for spotting spikes in blood sugar that might be missed by fasting tests.
Doing these tests correctly is important because inaccurate readings can lead to misdiagnosis. For people at risk, routine screening is key. Early diagnosis is crucial because it allows proper management and helps prevent complications such as retinopathy (eye damage), nephropathy (kidney damage), non-healing wounds, or even amputations. Unfortunately, many patients in Nigeria only discover they have diabetes when complications have already developed. I know a man who had to undergo leg amputation and another whose sore never healed because their condition was picked up too late.

What are the main risk factors for developing diabetes, especially in our local communities?

The main risk factors include family history, being overweight, physical inactivity, and unhealthy diets. In many Nigerian communities, the growing preference for fast food, sugary drinks, and processed snacks is a concern. Traditionally, our diets included vegetables, legumes, and whole grains, but these are often replaced by processed options. Hypertension and advancing age are also important risk factors. In some rural areas, lack of access to healthcare means people live with undiagnosed diabetes for years. Lifestyle, environment, and cultural habits all play a significant role.

How critical is the role of diet and lifestyle in managing diabetes?

Diet and lifestyle are central to managing diabetes. Medicines help, but they cannot replace healthy habits. For Nigerians, this means paying attention to how we eat common foods like amala, eba, pounded yam, rice, yam, and beans. None of these foods are “forbidden,” but portion size, preparation, and balance matter.

For example, a large bowl of pounded yam with egusi soup full of palm oil and fatty meat can raise blood sugar and cholesterol. But smaller portions of amala with ewedu or gbegiri soup, with more fish or lean meat, are healthier. Igbo families who enjoy fufu with oha, ofe nsala, or bitterleaf soup can still eat these meals if swallow size is reduced and vegetables and protein are increased. In the North, tuwo masara or tuwo shinkafa can be paired with miyan kuka, okra, or groundnut soup in moderation. Even jollof rice can be healthier with more vegetables and grilled protein instead of fried chicken.

Regular exercise, even simple activities like brisk walking to the market, dancing at home, or farming work, helps the body use insulin better. Weight control, stress management, and avoiding smoking are also important. Some people with early Type 2 diabetes can reach healthy sugar levels just by making consistent lifestyle changes.

What role do pharmacists play in helping patients manage diabetes beyond dispensing medications?

Pharmacists are often the most accessible health professionals in our communities. Beyond giving out medications, we educate patients on proper use, monitor for side effects, and provide lifestyle counseling. We also check for dangerous drug interactions, encourage routine blood sugar testing, and in many pharmacies across Nigeria, help patients track their blood pressure and weight. For those who cannot always see a doctor, pharmacists become key partners in daily diabetes management.

Many patients struggle with adherence to medication. What strategies do you recommend to improve compliance?

Adherence is a major challenge in Nigeria, often due to cost. Medicines, insulin, and testing supplies can be expensive. Health insurance through NHIS or HMOs is limited, incomplete, or does not cover all diabetes medicines. Taking insulin regularly can also be a burden—it requires daily injections, careful storage, and planning around meals and travel.
Community outreaches are very important. I regularly participate in events where free medicines are provided alongside education on diabetes care. This support makes a real difference because patients feel encouraged and informed.
Lack of education is another barrier. More educated patients tend to follow treatment plans and manage their lifestyle better, while others turn to herbs or unverified remedies, which can worsen the condition.

For daily reminders, I advise patients to tie medicines to routines like morning or evening prayers, mealtimes, or other daily activities. Family members can also play a big role in encouragement and support.

Can you shed light on some of the misconceptions or myths about diabetes that you often encounter?

One common myth is that diabetes is caused solely by eating sugar. While sugar intake matters, the condition also involves genetics, weight, and lifestyle. Another misconception is that once you start diabetes medicine, the body becomes “addicted” to it. In reality, long-term treatment is necessary to manage the condition safely.

Some people believe herbal remedies can cure diabetes. While some may help lower blood sugar, abandoning prescribed medicines can be dangerous. I have seen patients who delayed proper treatment only to return with foot ulcers that never healed or complications that led to amputation.

What are some of the latest developments in diabetes care or treatment that patients should know about?

Globally, new medicines not only lower blood sugar but also protect the heart and kidneys. Devices like continuous glucose monitors allow real-time tracking of sugar levels without repeated finger pricks. In Africa, access to these technologies is still limited but gradually improving. On the policy level, organizations are working to make insulin more affordable and accessible. These advances help patients manage diabetes more effectively and reduce complications.

Finally, what advice would you give to individuals living with diabetes and their families on maintaining good quality of life?

With proper care and attention, diabetes can be well managed. Do not ignore medicines, do not skip checkups, and take lifestyle seriously. Eat wisely, stay active, monitor your blood sugar, and remain consistent. Family support is critical. Encourage your loved ones, remind them about medicines, and join them in making healthier choices. Many complications in Nigeria, such as non-healing wounds and amputations, can be avoided with early diagnosis, consistent treatment, and good lifestyle habits. Education and awareness are key to improving outcome.

 Bio

Dr. Emmanuel Obaseki is a pharmacist who has been actively involved in patient care and health education since 2013, when he began participating in community health outreaches as an undergraduate at the University of Benin. Since earning his Doctor of Pharmacy degree in 2019, he has worked across hospital practice, retail pharmacy, and medical sales representation, giving him a broad perspective on the healthcare challenges people face. He remains deeply committed to community engagement, offering free medical outreaches and practical health education. His passion is to make quality healthcare accessible, practical, and culturally relevant, helping individuals and families live healthier, fuller lives.