Diabetes - “sugar”, in everyday Accra speech - is common and growing in Ghana, mostly type 2, which comes on in adults and is tied to weight, inactivity and family history. Like high blood pressure, it can go unnoticed for years while it damages the eyes, kidneys, nerves and blood vessels.

The signs

Many people have none. When there are signs, they include:

  • Being very thirsty, and passing urine often, including at night.
  • Losing weight without trying.
  • Tiredness.
  • Cuts and sores that heal slowly, and repeated infections.
  • Blurred vision.
  • Tingling or numbness in the feet.

If any of these sound familiar, get tested - do not wait for the annual check.

Getting tested

  • Free once a year in the NHIA’s annual health check, which includes blood sugar, for adults, with or without an NHIS card.
  • At a pharmacy or laboratory, a finger-prick test is quick and cheap.
  • A doctor confirms it with a fasting blood sugar test or an HbA1c, which shows your average sugar over about three months.

— The free annual health check

NHIS, and medicines

Diabetes care is used heavily under NHIS, and common diabetes medicines are on its medicines list. As with blood pressure:

  • Not every brand or insulin type is covered; ask what equivalent is.
  • Test strips and glucometers are usually bought yourself, at pharmacies and medical shops. Make sure strips match your meter.
  • Keep the card active, and keep a few days of medicine in hand against stock-outs.

Insulin must be kept cool. In Accra’s heat, a fridge - or a clay pot or a cooling pouch when the power is off - matters. Do not freeze it.

— NHIS — Pharmacies and medicines

Eating with diabetes, Ghanaian style

Nobody is asking you to give up Ghanaian food. The changes that matter are mostly about how much and with what:

  • Smaller portions of the starch - banku, fufu, kenkey, rice, yam, plantain - and more of the soup’s vegetables, beans and fish.
  • Beans and red red, kontomire and garden egg stews are good friends.
  • Sugary drinks are the biggest single source of sugar: minerals, malt, sweetened sobolo and fruit juice. Water is the change that works fastest.
  • Fruit is fine in reasonable amounts, whole rather than juiced. A whole pineapple at once is not reasonable.
  • Move every day - a brisk walk counts. Early morning, before the heat.

A dietitian at a teaching hospital or a large private hospital can build a plan around what you actually eat.

— Ghanaian food — Running in Accra

The checks that prevent the worst

  • Your feet, every day. Diabetes dulls feeling in the feet, so a cut or a blister from a sandal goes unnoticed and infects - the road to amputation. Look at them, keep them clean and dry, and do not walk barefoot.
  • Your eyes, once a year, for diabetic eye disease, which can be treated before it costs you your sight.
  • Your kidneys and blood pressure, at every review.

— Dentists and eye care

Low sugar is an emergency

People on insulin or some tablets can have their sugar drop too low: sweating, shaking, confusion, sometimes collapse. Something sugary at once - a sweet drink, glucose - and then food. If they cannot swallow or do not recover quickly, get them to a hospital.

— Emergency numbers — High blood pressure