Regina Kimanthi: Diagnosed with arthritis at 38, now battling diabetes at 48

At the age of 38, Regina Kimanthi was diagnosed with arthritis in 2015, following recurrent and unexplained joint pain and fatigue. “I have been on arthritis medication ever since,” she says.

But sometimes, she runs out of medicine and is forced to endure the pain. As a resident of Malawi village in Makueni County, money is scarce. After all, poverty is a constant challenge that she and her fellow villagers face.

We met Regina last month at a free medical camp in Wote, made possible through a partnership between the Makueni County government and the M-Pesa Foundation.

In total, 3,162 patients were seen between 8am and 6pm that day, highlighting the rising number of undiagnosed diabetes cases. Of these, 3.26 per cent were treated for diabetes—numbers closely mirroring the national prevalence of diabetes, which stands at 3.4 per cent. “I came so that the doctors could check on my arthritis and provide me with medication to last me for a while,” she explains.

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ALSO READ: Diabetes, a looming national disaster

Her blood pressure was normal, but the blood sugar test revealed that she had active diabetes. This left her confused, as she had no symptoms aside from the arthritis. “They told me that my blood sugar is not just high... it’s very high, and I need to start medication urgently,” she recounts.

She admits she doesn’t know when the diabetes developed. “I don’t know. But I suspect it runs in the family,” she says, tears welling up in her eyes.

She continues, “In 2018, my mother passed away. She had been diabetic. This disease made her life extremely difficult. At the time of her death, her blood sugar had dropped suddenly and drastically to below one.”

Dr Kirtida Acharya, a diabetes expert at MP Shah Hospital in Nairobi and the National Chair of Diabetes Kenya, says, “At least half of people with Type 2 diabetes don’t have symptoms.”

Generally, there are two main types of diabetes: Type 1 and Type 2 (diabetes mellitus). “Type 1 is the form that affects children and is treated with insulin injections. Type 2 is the more common form, and it has caused a global epidemic. Rising obesity and hypertension in the population are contributing factors to the increase in Type 2 diabetes,” Acharya explains.

What worries Acharya most, however, is the number of people who are pre-diabetic and heading towards full-blown obesity. “There are many people who are pre-diabetic and have no clue. Pre-diabetes is when blood sugar is higher than normal but not high enough to be diagnosed as diabetes,” she says.

“The importance of detecting pre-diabetes is that, by making lifestyle changes, one could prevent it from progressing into full-blown diabetes and bring blood sugar levels back to a healthy range. I encourage people to test their blood sugar regularly. Once you cross the threshold into Type 2 diabetes, the condition becomes much harder to manage than pre-diabetes,” she continues.

The World Health Organisation (WHO) recommends the fasting blood sugar test to diagnose diabetes. If the test shows a level higher than 7 millimoles per litre on two or more occasions, the result is positive for diabetes.

Some diabetologists also test for HbA1C (the average blood sugar level over the past two to three months). “If it’s less than 6.5 per cent, the test is confirmatory,” says Acharya.

While diabetes can often go undetected for some time, there are symptoms to watch for, according to Acharya. “Symptoms include constant fatigue, excessive thirst, recurrent fungal infections (on your feet or private parts), irregular periods in women, and a high frequency of miscarriage in women.”

Vision loss

She adds that high blood sugar is toxic. If left unchecked, it leads to serious health issues, such as vision loss and gangrene in the legs, potentially leading to amputations.

Death from diabetes usually occurs through cardiac arrest, congestive heart failure, kidney failure, or chronic kidney disease.

Regina still holds the memory of her mother’s death close to her heart. Through tears, she told The Standard, “I have accepted the diagnosis and will be diligent in taking my medication.”

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“I want to tell anyone in denial of a life-changing diagnosis to accept the reality and listen to what the doctors say. I cannot afford to skip my medicine. I will continue taking it. My only prayer is that I will be able to afford it going forward,” she says.

Although Kenya has enacted laws and developed policies on universal healthcare, diabetes patients, such as Regina—who need frequent check-ups and ongoing medication—remain at the mercy of philanthropy. “People stay at home because they have no money. What these free medical camps do is help us diagnose conditions early for treatment and management,” says Dr Harvey Mulei, the Chief Officer for Health Human Resource Management and Administration for Makueni.

He adds, “The county has a vision and mission to provide healthcare for everyone. But we know we can’t do it alone. That’s why our governor seeks strategic partnerships to reach all demographics.”

“When a condition is diagnosed early, the cost of treatment is much lower compared to when it is more advanced,” Mulei stresses.

Mulei believes that the medical camp attracted many who would not otherwise be able to afford medical care.

The risk factors for diabetes, according to Dr Acharya, include excess weight, poor diet, lack of physical activity, and family history. “Type 2 diabetes is largely preventable through lifestyle changes, such as weight control, healthy eating, and increased physical activity,” she says.

On following up with Regina recently, she told us that she would be out of medication in a week. “I don’t know what I’ll do next without money,” she said.