Serial miscarriage horror as diabetes haunts women

Wrong diagnosis led to medication and blood transfusions that, instead of making her life better, worsened situations.

“I was a very sickly child. In high school, instead of trying to find out what the problem was, they kept testing for pregnancy,” Waithaka says.

“At some point in high school, my parents stopped paying my school fees because they saw no hope in me due to my medical condition. I had to hustle for fees to see myself through school,” she says.

This abandonment would follow her later in life after her husband walked out on her over the loss of four children.

“I knew the loss of four children devastated him because it depressed me, too,” Waithaka says.

“He just woke up one day and walked out of the marriage, never to come back. My own mother castigated me and told me I had brought shame to the family.”

Even the hospital in Nyeri where Waithaka lost the four children did not have answers to her condition.

“They actually sent me away and told me to never set foot in that hospital when I tried to know what the problem was,” she says.

It was during a church outreach programme that Waithaka was diagnosed with Type 1 diabetes.

While Type 2 diabetes is known to be caused by lifestyle choices, such as diets and other medical conditions, Type 1’s cause is not yet fully understood.

Some research, however, claims it is an autoimmune disease, where the body’s immune system mistakenly attacks and destroys the insulin-producing cells (beta cells) in the pancreas.

“I was put on medication and taught the types of food I should eat and how to eat them. And thank God after a while, I got a baby, who also has diabetes Type 1, but we are managing,” Waithaka says.

Part of Waithaka’s meal plan involves keeping off processed and street foods.

“If I have to go to a meeting away from home, I prefer carrying homemade foods,” the mother of one says.

“I eat a lot of greens and avoid introducing new foods into the diet due to a lack of knowledge of their contents.”

DIET WOES

Jane Muthoni is meticulous about what she eats. Her Type 1 diabetes diagnosis many years ago not only affected her lifestyle but also infiltrated her bones and transformed the very way she lives.

For years, Muthoni, who was diagnosed with the non-communicable disease at childhood, has known food stands between her life and death.

Her bag, on the other hand, has insulin injections, whose sole purpose is to keep her alive.

“Having Type 1 diabetes means my body is not producing enough insulin, so I have to inject myself every morning and evening. I also avoid foods that are high in sugars, salt and fats,” the mother of three says.

Before the diagnosis, Muthoni’s childhood was fraught with challenges. She was in and out of hospitals with different ailments.

“This went on until high school. If it was not tonsils, it was fever and general body tiredness. At some point, I lost my eyesight,” she says.

Immediately after the diagnosis, she was kept off all starchy food. And so, for years, Muthoni survived on a diet of beans and vegetables.

“This meal was traumatising. I asked myself so many questions. Why me? Why not my friends or my other family members?”

In high school, to satisfy her craving for a different meal, she would secretly eat githeri, which gave her side effects, such as dizziness.

But with constant research and visits to a number of specialists, including general physicians and nutritionists, Muthoni was introduced to some safe starches, such brown bread, brown ugali and safe non-hydrogenated oils.

This later changed to her only taking small portions of carbohydrates, proteins and vitamins per plate.

The biggest price she paid for living with diabetes is sitting for her KCSE exam on a hospital bed.

“The frequent hospital visits did not end with the diagnosis. I still had episodes that put me in bed, considering there are days I cheated on my diet,” she says.

Muthoni would go on to pass her exams, go to college and have children. However, in 2022, her 10-year-old daughter was diagnosed with the same disease.

“Having lived with the disease for many years, I coped very quickly with the diagnosis. The biggest challenge is, however, managing the diet of two diabetic people in one household,” Muthoni says.

“This has in many instances resulted in high expenses on food budgets and to some extent, stigma from extended family members, who do not yet understand what it means to live or handle someone with diabetes.”

MILLIONS AFFECTED?

The Ministry of Health estimates that 800,000 Kenyans are living with diabetes, but only 20 per cent are enrolled in comprehensive care programmes.

“This leaves more than 600,000 individuals underserved, receiving substandard care,” Medical Services PS Dr Ouma Oluga said.

“We are working on a national access programme to lower medication costs and ensure treatment continuity.”

He, however, warned of a potentially much larger undiagnosed diabetic population, estimating that up to two million Kenyans could be living with undetected diabetes or a pre-diabetic state.

Waithaka and Muthoni, who work at the Kenya Defeat Diabetes Association, say the association is working on a programme that is helping persons living with diabetes to form support groups.

Like alcohol anonymous groups, these support groups help them share their challenges and new knowledge and studies on how to manage the disease.

“The challenges are uniform across the country — many are struggling with diets and access to treatment,” Muthoni says.

“Apart from building support, these support groups are also sharing knowledge and forming teams on how they can easily access products such as insulin.”

The meetings also sensitise members to push the government to formulate policies that will help make their lives easier.

WARNING LABELS

One of the policies is the front-of-pack warning labels (FOPWL) on products to inform consumers about potential health risks associated with ultra-processed foods and beverages.

The labels are designed to make it easier for individuals to make informed choices at the point of purchase, especially regarding items high in saturated fat, sugar or sodium.

They are intended to prevent non-communicable diseases, such as diabetes, heart disease and obesity.

Some countries have already implemented these labels on food products. They include Argentina, Chile, Israel, Mexico, Peru and Uruguay.

Kenya, led by the International Institute for Legislative Affairs (IILA) in partnership with the Ministry of Health, made a breakthrough this year and came up with the country’s Nutrient Profile Model (NPM).

An NPM is a technical document that sets the threshold for nutrients of concern.

It is this threshold that is used to decide if a product should have a FOPWL label or not.

“If a product does not exceed the threshold set on the NPM, then it will not have a front of pack warning label,” IILA programme officer Gideon Ogutu said.

The NPM design adopted by the Kenya team is the octagonal shape, with black and white colours.

“It took a lot of effort for us to come up with an NPM because the first document had a lot of gaps that needed to be addressed,” Ogutu said.

“And I want to thank the Ministry of Health for steering us to this success. It is after MoH took over the process that we made headway and finally came up with the NPM.”

Kenya’s NPM model borrows from other countries with success stories as well as WHO guidelines.

“We settled on the octagonal shape because it is related to stop or a warning sign, which is basically what the warning labels are trying to communicate,” Ogutu said.

“The black and white colours are used because they are fairly neutral and relatable.”

Anne Swakei of the Non-Communicable Disease Alliance of Kenya says the FOPWLs are not only important for persons living with diabetes but also other NCDs, such as cancer and cardiovascular diseases.

She says implementation of the labels will only be important if proper awareness and sensitisation are conducted.

“Not everyone who lives with NCDs can read and write, and so it will be important that once adopted, sensitisation campaigns be conducted by the Ministry of Health and other partners,” Swakei says.

“We also cannot assume that those who can read and write will automatically understand what the front-of-pack warning labels are. So, the campaign messages should consider this and also inform the consumers on what parts of the products they will be placed.”