Social, cultural and economic factors in the management of diabetes mellitus in Nigeria.

The problems of caring for diabetic patients in the developing world have been getting increasing attention recently. While the focus has often been on peculiar clinical characteristics such as pancreatic diabetes, malnutrition diabetes, J-type and other similar forms, there is a need to explore further the impact of the prevailing social, cultural and economic milieu on the patients and the management of their disease. The socio-economic status of 147 Nigerian diabetic patients was assessed by the use of an interview format and also their knowledge, attitudes, beliefs, expectations and concerns about diabetes was determined. The study confirmed that most of the patients are illiterate, poor and with very little understanding of the nature of their disease. Their greatest concern was the impact of diabetes on their ability to work and the extreme difficulty in getting their medications regularly and at affordable prices. A survey of twelve pharmacies revealed that many of the oral hypoglycemic agents, insulin, syringes, needles and materials for urine testing are not stocked by most of them. Some suggestions have been made as to possible solutions which will involve efforts on the parts of health care providers, patients, governments, pharmacies and private organizations in these countries and the international community as well, including the international drug companies. It is hoped that the problem will remain high on the agenda of all those concerned about diabetes and the care of diabetic patients throughout the world.