Abiodun Sivowaku
Millions of Nigerians living with diabetes are struggling to afford the lifelong treatment required to manage the condition, exposing them to potentially fatal complications as the cost of medicines, insulin and essential monitoring supplies continues to rise.
With an estimated 11.4 million Nigerians affected, health advocates warn that many are being pushed out of treatment by the high cost of care, while millions more may be living with the disease without knowing their status.
As Nigeria joins the rest of the world to mark the 2026 World Diabetes Day, experts are calling for urgent government intervention to improve early diagnosis, make treatment affordable and address lifestyle-related risk factors, including unhealthy diets, obesity and physical inactivity.
The International Diabetes Federation (IDF) describes diabetes as a chronic condition that develops when the pancreas cannot produce enough insulin or when the body cannot effectively use the insulin it produces.
Insulin enables glucose from food to enter the body’s cells for energy. When insulin production or utilisation is impaired, glucose accumulates in the bloodstream, potentially damaging vital organs and causing kidney failure, blindness and cardiovascular diseases.
Type 1 diabetes occurs when the body produces little or no insulin, making daily insulin treatment essential for survival. Type 2, which accounts for about 90 per cent of cases, occurs when the body cannot effectively use insulin or produce enough to regulate blood sugar.
World Diabetes Day is commemorated annually on November 14. This year’s theme, “Early Action on Diabetes”, highlights the importance of early diagnosis and timely treatment in preventing complications.
According to the World Health Organisation (WHO), nearly three out of every four adults living with diabetes in Africa remain undiagnosed.
WHO Regional Director for Africa, Dr Mohamed Janabi, said an estimated 24.6 million adults aged 20 to 79 were living with diabetes in the region in 2024, a figure projected to reach 59.5 million by 2050.
Describing Africa’s high rate of undiagnosed cases as alarming, Janabi said early diagnosis and treatment could prevent complications and save lives. He urged governments, healthcare workers and development partners to intensify awareness and improve access to affordable care.
He advised Nigerians to watch out for excessive thirst, frequent urination, unexplained weight loss, persistent tiredness and blurred vision, urging those experiencing such symptoms to seek medical attention and people at increased risk to undergo regular screening.
Patient Spends 60% Of Income On Treatment, Sacrifices Children’s School Fees
The financial burden of managing diabetes is forcing some patients to sell or mortgage property, borrow money and choose between healthcare and their children’s education.
A diabetes patient and national coordinator of the Network of Persons Living with Diabetes in Nigeria, Comrade Bernard Enyia, said he spends more than 60 per cent of his income on treatment and sometimes sacrifices his children’s school fees to afford medication.
The expenses almost double when he is hospitalised, he said, adding that strikes by health workers often force patients to seek more expensive treatment in private facilities.
“Sometimes I sacrifice my children’s school fees for my treatment. At times, I mortgage my property to raise money for my treatment, especially when admitted. Sometimes I borrow or access loans to meet up with the very high costs,” he said.
Enyia, who is also the second vice president of the Diabetes Association of Nigeria, said he was diagnosed at 40 after experiencing persistent weakness, excessive thirst and hunger, and blurred vision.
He said the unavailability of insulin and other essential supplies had compounded the difficulties of managing the condition. When insulin is unavailable, he sometimes skips doses or rations his medication, while sourcing supplies from other states can take two to three days.
He also lamented discrimination against people living with diabetes, disclosing that he was once dismissed from employment in a private enterprise because of frequent hospitalisation.
According to him, misconceptions that diabetes is caused by witchcraft, poisoning or the activities of perceived enemies continue to fuel stigma.
“Many friends desert you. Some friends are willing to buy you a crate of beer or more, no matter the cost, but will not buy you a bottle of insulin or a tablet,” he said.
Enyia said financial constraints sometimes prevented him from maintaining the recommended diet, despite having abandoned many of his favourite foods and becoming cautious about sweetened beverages.
He called on the Federal Government to expand health insurance coverage to include diabetes medications and subsidise insulin and other essential drugs.
He also urged the government to revive the proposed sugary drinks tax, arguing that the revenue could support diabetes prevention and treatment programmes.
Other recommendations included appointing diabetes desk officers in state ministries of health, making specific budgetary provisions for diabetes programmes and establishing economic empowerment initiatives for people living with the condition.
He further urged the government to address recurrent industrial action in the health sector, which disrupts access to essential services and increases patients’ expenses.
Meanwhile, worried that millions of Nigerians cannot afford diabetes treatment, the Diabetes Association of Nigeria (DAN) has written an open letter to the Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, demanding urgent government intervention.
In the letter, DAN’s national president, Prof. Ejiofor Ugwu, said the estimated 11.4 million Nigerians living with diabetes could represent only a fraction of the actual burden, which he put at about three times higher because of widespread undiagnosed cases.
Ugwu said only about a third of diagnosed patients were receiving appropriate treatment, while just a third of those receiving treatment achieved good blood sugar control.
He lamented that Nigeria lacked a National Diabetes Registry and relied largely on hospital records and IDF surveys for information on the disease.
According to the association, 94 per cent of people living with diabetes have suffered at least one complication, while 80 per cent were diagnosed only after complications had developed.
About 40 per cent of patients reportedly experience eye complications, with diabetes ranking among the country’s top three causes of blindness.
DAN also said at least one in three stroke patients and one in two heart attack patients in teaching hospitals have diabetes.
Ugwu identified diabetes as one of the top three causes of kidney failure, accounting for about six in 10 patients on dialysis, and said it was responsible for approximately 60 per cent of limb amputations nationwide.
Foot ulcers affect 16.7 per cent of people living with diabetes, with one in three patients who develop them eventually undergoing amputation. He added that many teaching hospitals record at least one diabetes-related leg amputation weekly, while the disease kills an estimated 30,000 Nigerians annually.
Ugwu described the statistics as evidence of widespread human suffering, citing mothers who ration insulin, fathers who skip blood sugar tests because they cannot afford test strips and parents forced to choose between buying insulin and paying school fees for children living with Type 1 diabetes.
DAN said the prices of diabetes medicines and consumables had increased by more than 500 per cent in five years, putting the average monthly cost of care at between N200,000 and N300,000.
It warned that some patients had resorted to prayers and alternative medicines, while rural communities faced additional difficulties because of shortages of trained personnel, equipment and medicines.
To address the crisis, DAN urged the Federal Government to declare diabetes a national health priority and fast-track a National Diabetes Policy and Strategic Plan under a funded programme for non-communicable diseases.
It demanded immediate subsidies on insulin, oral medications, glucometers and test strips, alongside a total tax waiver on imported essential diabetes medicines and consumables.
The association also called for wider and more affordable National Health Insurance coverage, particularly in rural areas, with blood glucose test strips included in the benefits package.
It further demanded the revival and increase of the Sugar-Sweetened Beverages (SSB) tax, which was stopped in June 2024. DAN proposed raising the tax from N10 per litre to at least N200, with legislation guaranteeing that the proceeds would fund diabetes and other non-communicable disease prevention programmes.
Other demands included a national non-communicable diseases survey, a National Diabetes Registry and stronger primary healthcare services equipped to manage uncomplicated diabetes cases.
Ugwu urged the health minister to move beyond annual speeches and take decisive action to make diabetes treatment affordable and accessible, insisting that no Nigerian should die simply because of poverty.
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Experts Seek Higher Sugar Tax, Better Health Insurance
Supporting DAN’s demands, the executive director of Corporate Accountability and Public Participation Africa (CAPPA), Akinbode Oluwafemi, called on the Federal Government to increase taxes on sugar-sweetened beverages and invest the proceeds in strengthening the health sector.
He warned that unhealthy diets, sugary drinks and aggressive marketing of highly processed foods were increasing the risk of non-communicable diseases.
“Without decisive policy intervention, we risk raising generations dependent on high-sugar products, leading to obesity, type 2 diabetes, cardiovascular diseases and early death,” he said.
Oluwafemi recommended higher taxes on sugary drinks, sodium reduction targets, front-of-pack nutrition labelling and restrictions on marketing ultra-processed foods to children.
He said revenue from taxes on tobacco, alcohol and other harmful products should be channelled towards preventing and managing non-communicable diseases.
Also, the president of the Healthcare Federation of Nigeria (HFN), Dr Njide Ndili, described diabetes as one of the heaviest financial burdens Nigerian households face because it requires lifelong management.
Ndili said a vial of insulin that previously cost about N5,000 now sells for approximately N25,000, meaning patients who require two vials monthly spend about N50,000 on insulin alone.
“Doctors report that a vial of insulin that cost about N5,000 now sells for around N25,000. Many patients need two vials a month, roughly N50,000 for insulin alone, before glucose monitoring. And most Nigerians still pay out of pocket, so that cost lands directly on households,” she said.
She added that glucometers, test strips, laboratory investigations and transportation further increased treatment expenses, forcing some patients to skip essential monitoring.
Ndili also identified fragmented healthcare delivery as a challenge, explaining that patients often visit different providers without shared medical records, resulting in late detection of complications.
“Patients see different providers with no shared records, so complications are caught late,” she said.
She warned that rising fuel, transport, food and medicine prices had worsened the situation.
“When transport, food and drug prices rise together, chronic care is often the first thing families cut,” she said.
Citing DAN’s estimate that diabetes medicine prices had risen by between 300 and 500 per cent in recent years, she said patients increasingly rationed doses, delayed hospital visits and returned only when complications developed.
On affordability for low-income earners, Ndili said insulin alone was beyond the reach of many Nigerians earning the N70,000 minimum wage.
“The minimum wage is N70,000 a month. Insulin alone at about N50,000 a month would take more than two-thirds of that, before monitoring, consultations, transport, food and rent. For an insulin-dependent patient on minimum wage,
managing diabetes alone is effectively out of reach,” she said.
She urged the government to include diabetes care in health insurance packages, particularly the Basic Health Care Provision Fund, covering medicines, test strips and routine check-ups.
She also recommended pooled procurement of quality-assured insulin and other essential medicines to reduce prices and ensure reliable supplies.
“Turning a lifelong out-of-pocket cost into a covered, predictable one is the biggest single change we can make,” she said.
Ndili further advocated stronger local production of insulin and diabetes consumables to reduce dependence on imports.
FG Moves To Boost Local Insulin Production
Meanwhile, the Federal Government has outlined interventions to improve diabetes prevention, diagnosis and treatment, including efforts to reduce dependence on imported insulin.
Through the Ministry of Innovation, Science and Technology and its agency, the National Biotechnology Research and Development Agency (NABRDA), the government signed a Memorandum of Agreement with Shanghai Haiqi Industrial Company Limited of China for sustainable insulin production in Nigeria.
The ministry said the partnership would build local production capacity, reduce treatment costs, improve availability and create jobs while strengthening the country’s medical biotechnology industry.
Similarly, the Federal Government disclosed at the 78th World Health Assembly in 2025 that more than 60,000 frontline health workers had been trained to provide integrated healthcare services, including diabetes management.
It also announced plans for pooled procurement of essential diabetes and hypertension medicines to reduce costs and improve access at selected primary healthcare facilities.
Despite these interventions, concerns persist over the affordability and availability of medicines, insulin and essential monitoring devices.
Nigerians Urged To Screen Regularly For Diabetes
The director of Family Health and Community Health Services at the FCT Primary Healthcare Board, Dr Aderonke Akande, has urged Nigerians to undergo regular diabetes screening, warning that many people remain unaware of their condition until complications develop.
She said regular blood sugar checks were essential for early diagnosis, noting that poorly managed diabetes could damage the heart, kidneys, liver, brain and other organs.
According to her, genetic factors, obesity, unhealthy diets and physical inactivity can increase the risk of developing the condition.
Akande cautioned against the misconception that consuming sugar directly causes diabetes, explaining that excessive sugar and carbohydrate consumption, particularly alongside physical inactivity, could contribute to obesity and insulin resistance.
Obesity makes body tissues less responsive to insulin, making it difficult to maintain normal blood glucose levels, she explained.
She identified excessive thirst, frequent urination, unexplained weight loss, persistent hunger and wounds that heal slowly as warning signs, urging people experiencing these symptoms, particularly those with a family history of diabetes, to seek medical attention.
On prevention, Akande recommended at least 30 minutes of brisk walking daily, saying people unable to engage in strenuous exercise could adopt simple physical activities at home.
She also advised Nigerians to eat more fruits, vegetables and protein while controlling carbohydrate portions. People living with diabetes, she said, did not need to eliminate entire food groups but should follow dietary advice from qualified nutritionists.
She warned against excessive consumption of refined sugar and alcohol, as well as smoking, and urged diagnosed patients to adhere to prescribed medication and lifestyle recommendations.
The FCT health official called on Nigerians to prioritise annual medical examinations, including blood sugar and blood pressure checks, rather than waiting until symptoms develop.
She encouraged residents to visit primary healthcare centres and general hospitals for screening and urged families to pay attention to warning signs among their members.
Akande stressed that diabetes was manageable and that people living with the condition could lead healthy lives through early diagnosis, appropriate medication, dietary control and regular physical activity.
