cost of diabetes globally courtesy of American Diabetes Association

It was this time of the year I was preparing to do my end of year exams, three years ago. My best friend Ben called to inform me that he was in Moi Teaching and Referral hospital (MTRH) where he had brought his mother suffering from diabetes. He sounded distressed and disappointed with life. Despite my busy schedule I had to create time to go meet him in the medical ward. So I packed my laptop and trudged out of the learning resource center unwillingly.

This was not the first time he had brought his mother to the hospital. This was the umpteenth time. It has been five years since she had been diagnosed with diabetes type 2 but the struggle she had gone through had made it look like forever. She had been admitted with diabetic ketoacidosis many times and this time most of her organ systems had shut down. Was she going to pull through this one? No one knew. We just crossed our fingers hoping she beats all odds.

We sat down with Ben on a hard, cold wooden bench outside the medical ward. He slumped on the bench with shoulders drooping and the face wrinkled like a 70-year old man. His eyes looked very distant. I knew he was on the verge this time round. He narrated to me everything and I understood him so much but what could I do? I am just a third year medical student struggling to beat biochemistry, pathology, physiology, microbiology and other basic science courses. What did I know about diabetes? Nothing. I felt useless and I wished I were  a clinical year student. At least I would know a thing or two about diabetes.

Three years later, I am now a sixth year. The peak of medical school. I had promised my best friend I would change the lives of people living with diabetes one day and here we are. There is little at my disposal but I have enough knowledge and passion to educate people and let them know they are not alone. That someone is thinking about them and is working to improve their management in the future.

Today I want to tell you a story about diabetes and money. A story which will leave you sad. Diabetes as a disease in itself does not carry the worst prognosis. Provided with all resources, support and positive lifestyle modifications, people living with diabetes can have a near normal life. Unfortunately, the holistic care required for diabetes patients is too expensive and demanding. Most people find it non-sustainable and they end up dying from diabetic complications.

The cost of blood sugar machine (glucometers) is around 3000 Kenyan shillings which may be bought once. The cost of blood sugar strips (glucometer strips) is about 2500 Kenyan shillings containing 20 strips. The glucometer strips should be used after every meal and that means three strips per day. Within one week, all the strips will be used up and so another 2500 shillings is required for another week. The cost of seeing a physician is 1500 to as high as 3500 shillings per visit. Consider the cost of insulin ampule 500-700 shillings and needles 20 shillings requiring two per day. The diet modification requirements is expensive and more time is required for physical exercises. For majority of Kenyans earning less than 60,000 shillings per month find it almost impossible to sustain this lifestyle with family responsibilities still awaiting. In a month, an average of 20,000 shillings will be used up on medications and meals. There will be more working days missed from attending clinics and for hospitalization as compared to healthy working people. The chances that a company will view the patients as liabilities and lay them off is very high. The insurance companies may also find covering diabetes and other NCDs non-feasible and may require more expensive premium covers.


            Glucometer courtesy of GoK

Is it possible to handle two jobs per day? Most probably not because that will be part of the lifestyle modification. Spending such an amount for the number of years someone is set to live with the condition is almost impossible to most Kenyans. A policy needs to be implemented by the government to subsidize the cost of the medications and other supplies required in management of diabetes.

Before that happens, there is a less costly solution. That is prevention. Preventive measures need to be adopted and each county should launch NCD action teams to run the preventive strategies. We as individuals should also take upon ourselves to change our own lifestyles. Obesity and sedentary lifestyle is our greatest menace and we need to fight them. Gone are the times when all shapes are beautiful shapes; square and round should be eliminated. Let us fight for a healthy growing nation.


Checking blood sugar levels using glocumeter and strip