Putting women in the frontline against diabetes

Every year, women’s lives continue to be lost to various non-communicable diseases (NCDs), especially diabetes. However, if well empowered they can turn tables against the chronic disease burden and hold the keys in the national response as Our contributor Dingaan Mithi writes.

During the commemoration of the 2017 World Diabetes Day under the theme Women and Diabetes: Our Right to a Healthy Future, women had a great opportunity to amplify their voices in tackling diabetes as a growing chronic burden.

In Malawi, in every 100 people, six have diabetes and the most affected are women, according to statistics. The state of affairs is prevalent across the globe.

“Over 300 million people worldwide have diabetes, and approximately half of these are women. As a result of increasing lifespans, the number of women at high risk of diabetes is rising,” reads in part a paper, Women and NCDs, published by the Swiss-based International NCD Alliance.

“The toll that diabetes takes on women is significant, particularly in terms of diabetes-related complications such as heart disease.”

Calls for a stronger response against diabetes are now growing and civil society organisations (CSOs), diabetic patients and the media are asking policymakers and authorities to prioritise diabetes in decision-making and policy reviews.

United Nations (UN) in recognition of the pioneering discovery of insulin in 1922 by Frederick Banting and Charles Best set November 14 to remember diabetes.

Machinga District Council chairperson Margaret Uladi says most women live with diabetes for a long time without knowing because they do not go for early diabetes test.

“It is a huge challenge because most people, including women, are diagnosed with diabetes at a very late stage

when complications have progressed,” she says.

She, however, observes that the implications of diabetes hit hard when it affects women since they are unable to take care of their families.

“Women take care of the home and when they are down their families are seriously affected. Apart from the household level, inactivity of women due to diabetes slows down national economic growth, “says Ali.

She calls for a national response against diabetes that involves both men and women.

“Government and its development partners need also to upgrade and strengthen primary healthcare structures so that they are able to respond to diabetes well and timely,” says Ali.

Former parliamentarian and Cabinet minister John Bande, who is also Diabetes Association of Malawi (DAM) patron, laments the slow response against diabetes and bringing women to the spotlight.

“CSOs need to do more in confronting diabetes because they are seriously lagging behind in the national diabetes response,” he says.

However, Bande highlights that for a stronger diabetes response that puts women in the frontline, Malawi needs an intensive public awareness and the strengthening of maternal health services in public facilities. He says there is also need to ensure that pregnant women have access to information on gestational diabetes which occurs during pregnancy.

Gestational diabetes is a form of diabetes that develops in one in 25 pregnancies worldwide. It is associated with perinatal (foetal death) complications.

Women with gestation diabetes and their offspring are at an increased risk of developing Type 2 diabetes later in life.

“We must work hard and strengthen diabetes prevention in maternal health care. Not only that, let’s go to all primary and secondary schools to raise awareness,” says Bande.

According to the International NCD Alliance, diabetes is a critical maternal health issue. Preconception planning is crucial for women with Type 1 and Type 2 diabetes. Uncontrolled or undiagnosed diabetes during pregnancy leads to delivery of foetal macrosomia or large-for gestational-age (LGA) infants.

Apart from threatening the pregnant mother’s life, the condition creates costly complications to treat obstructed labour and complications that threaten the life and health of the newborn child.

Mwalone Jangiya was diagnosed with diabetes in 2011.

“Since 2011, I have been taking diabetes medications and I am here today to give testimony. However, let me advise all patients not to stop taking diabetes drugs,” she appeals.

Another patient and diabetes educator, Mariam Ladi, says women who are diabetic should always observe and stick to their diet.

“It is important for all women to make sure they eat the right food and take their diabetes medications timely,” she says.

In the new 2017-2022 Health Sector Strategic Plan, government has singled out NCDs as a top priority and seeks to ensure that the chronic disease burden is reduced. However, many policy and decision-makers in government lament that NCDs are underfunded.

One key message is that women, as mothers, have a huge influence over the long-term health status of their children. Women who are informed of the importance of their own health when pregnant and understand the risk factors associated with NCDs are better equipped to avoid NCDs both for themselves and future generations.