The ongoing struggle: How Type 1 Diabetes is a financial burden for Tanzanian families

TANZANIA: FOR over 27 years, George Kwayu has faced the challenges of type 1 diabetes, a condition that has shaped his life with resilience.

He exemplifies perseverance, managing the daily demands of this chronic illness while refusing to let it define him.

Type 1 diabetes, formerly known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition where the pancreas produces little to no insulin.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) in the United States, type 1 diabetes occurs when the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas.

Scientists believe this condition may be triggered by a combination of genetic and environmental factors, such as viruses.

As beta cells decrease in number, the pancreas’s ability to produce insulin declines. Eventually, significant loss of these cells results in type 1 diabetes, leading the body to completely fail to produce the insulin necessary to regulate blood sugar levels.

Mr Kwayu, Chairperson of the Tanzania Diabetes Youth Alliance (TDYA), was diagnosed with Type 1 Diabetes Mellitus (T1DM) in 1999 and has been on insulin therapy since age four. He notes that treating type 1 diabetes poses a considerable financial burden for many Tanzanian families, despite their best efforts to manage their children’s care.

“The cost of diabetes treatment is substantial,” Mr Kwayu said.

“We have requested the Medical Stores Department (MSD) to reduce taxes on diabetes medications to alleviate the suffering of many children.” Mr Kwayu added, “Tanzania has around 10,000 children and young people living with diabetes.

Many rely on medication without insurance and the high costs lead to preventable deaths.”

According to the World Health Organisation (WHO), approximately 422 million people globally have diabetes, with the majority in low- and middle-income countries. Diabetes directly causes about 1.5 million deaths annually.

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Both the number of cases and the prevalence of diabetes have steadily increased over recent decades. Symptoms of type 1 diabetes can develop suddenly and may include increased thirst, frequent urination, constant hunger, unexplained weight loss, changes in vision and fatigue.

While type 1 diabetes typically manifests in childhood or adolescence, it can also develop in adults. Despite extensive research, there is currently no cure for type 1 diabetes.

Treatment focuses on managing blood sugar levels through insulin, diet and lifestyle changes to prevent complications.

Mr Kwayu has called on authorities, particularly the Ministry of Health and MSD, to reduce or eliminate taxes on diabetes medications, which significantly contribute to the high costs of treatment.

He emphasised, “Diabetes treatment requires significant financial resources and reducing medication costs could help many suffering children.” Many parents, upon learning that their child has T1DM, often withdraw them from school.

This is usually due to a lack of understanding of the disease and concerns about their child’s ability to cope academically.

While type 1 diabetes cannot be prevented, effective strategies exist to prevent type 2 diabetes and mitigate the complications and premature death that can arise from all types of diabetes.

Early diagnosis is crucial; the longer a person lives with undiagnosed and untreated diabetes, the poorer their health outcomes may be.

Access to basic diagnostics, such as blood glucose testing, should be available in primary health care settings. Patients will also need periodic specialist assessments or treatments for complications.

Symptoms of Type 1 Diabetes: Increased thirst, frequent urination, bedwetting in children who previously stayed dry at night, constant hunger, unexplained weight loss, mood changes or irritability, fatigue and weakness as well as blurry vision.

The Role of Insulin: Once a significant number of islet cells are destroyed, the body produces little to no insulin.

Insulin is a hormone secreted by the pancreas, which regulates blood sugar levels by allowing sugar to enter the cells.

As blood sugar levels drop, the pancreas produces less insulin.