By Mike Mwaniki
Some 750,000 patients of type 2 diabetes may have a reason to smile after a new oral drug to manage the disease was registered by the Pharmacy and Poisons Board, the national medicines regulator. The medicine—Tranjenta (Linagliptin)— is manufactured by pharmaceutical company, Boehringer Ingelheim, and belongs to the group of diabetes medications called DPP-4 inhibitors.
Unveiled during a scientific symposium attended by medical experts drawn from Nairobi, Mombasa, Kisumu and other parts of the country, the drug is available in the country as prescription only medicine (POM) upon recommendation by registered medical professionals. Tranjenta assists in improving glycaemic control in adults with type 2 diabetes, along with diet and exercise. Experts sounded an alert over the rising cases of type 2 diabetes in the country and some of the prevailing complications associated with the condition such as chronic kidney diseases.
According to the Health Ministry’s STEPwise Survey for Non-Communicable Diseases (NCDs) Risk Factors report, the rise in diabetes is associated with demographic and social changes such as globalisation, urbanisation, aging population and adoption of unhealthy lifestyles, such as consumption of unhealthy diets and physical inactivity.
Prevalence of diabetes among adults in the country is estimated to be 4.56 per cent amounting to almost 750,000 persons and 20,000 annual deaths. The report warns that as the prevalence of diabetes mellitus is escalating—patients face an even greater threat from long-term complications such as foot, cardiovascular, eye, nerve and renal complications—that are the hallmark of diabetes and its impacts.
Experts observed that NCDs, and their related risk factors such as high blood pressure, high cholesterol, and excessive bodyweight, are a major burden to Kenya’s healthcare infrastructure. Prof Fredrick Otieno of the Department of Clinical Medicine at the University of Nairobi noted that approximately half of patients living with type 2 diabetes are at risk of declining renal function and treatment options for these patients can be limited.
“The new drug approved in Kenya has the unique feature of non-renal excretion and requires neither dosage monitoring nor adjustment when treating both hepatic and renal impaired type 2 diabetes patients.” An estimated 15.5 million adults were living with diabetes in Africa in 2017, representing a regional prevalence of 3.3 per cent.
Experts say with the rise of NCDs across the continent, diabetes remains a major problem in many countries. At same time, awareness drives are regarded as being poor, where the concentration of the disease varies considerably amongst different population groups. DPP-4 inhibitors, the medic added, provide effective and consistent glycemic control with a good tolerability profile and without severe hypoglycaemia or weight gain.
Prof Otieno said understanding diabetes is a necessary step towards prevention and control, which is recognised as an urgent priority in Kenya and across Africa. “Early conversation with patients helps them to maintain a healthy diet, increase physical activity and accept changes in treatments to help manage the disease,”. The Head of Advocacy Kenya Diabetes Study Group—who is also NCD Alliance Kenya and Kenya Diabetes Management and Information Centre founding member—Dr Eva Njenga said diabetes is a leading risk factor for impaired kidney function, an indicator of chronic kidney disease.
“Individuals with type 2 diabetes have 50 per cent significantly increased risk of impaired kidney function,”. Key risk factors for diabetes require interventions to change the unhealthy lifestyles. “These changes are most likely to occur with implementation of a coordinated range of interventions to encourage individuals to maintain a healthy weight, participate in daily physical activity, and consume a healthy diet.” Boehringer Ingelheim Head of Human Pharma (sub Saharan Africa) Ayman Eissa noted that lack of awareness and an increasing prevalence of type two diabetes are critical obstacles to overcoming the rise of diabetes in Kenya.
Implementation of preventive strategies, early diagnosis and treatment of type 2 diabetes in Kenya and the wider Sub Saharan African populations, the official noted, would facilitate a reduction in the clinical and public health burden of the disease and its comorbidities, including type 2 diabetes associated renal impairment.