*Disease affecting affluent Kenyans*

By Adam Mynott
BBC News, Naivasha

In Kenya the official rate for people suffering from diabetes is 3.5%,
but even the experts at the Ministry of Health in Nairobi know this is a
ludicrous underestimate.

The real rate of diabetes in Kenya is more like 10%, and some say it
could be higher.

Of all the serious non-communicable diseases, diabetes has the
distinction of being the least diagnosed.

The World Diabetes Foundation, which is issuing grave warnings that
diabetes is turning into a pandemic, estimates that in the developing
world a quarter of people who have diabetes don't realise it.

The symptoms of thirst, aching joints, failing eyesight and loss of
balance are put down to old age or a persistent cold or a virus.

Just visitors

It is also a disease that preys on people who are relatively affluent,
so in the developing world, where the increase is most dramatic, it is
catching many by surprise.

Dr Osborn Tembu
Most people don't visit the hospital until the symptoms get quite
severe. For months people can be walking around with elevated sugar
levels-Dr Osborn Tembu Naivasha

Naivasha town sits alongside the eponymous lake in the Rift Valley about
an hour's drive from Kenya's capital, Nairobi.

It is a scruffy conurbation that doesn't, at first sight, betray
relative affluence.

A third of the cut flowers sold in Europe are grown in greenhouses
clustered around the southern margin of Lake Naivasha and, while it
hasn't made the town wealthy, the flower business has provided thousands
of jobs and injected money into Naivasha.

It is this money that is indirectly pushing up the rate of diabetes locally.

The town's District Hospital held an open day recently and the 700 or so
people who dropped in were tested for diabetes.

These weren't people who were ill. They were just visitors, but doctors
found that more than 5% of them had diabetes.

Recently retired

Dr Osborn Tembu, who runs a clinic for diabetes sufferers every
Thursday, was not surprised.

He said "Most people don't visit the hospital until the symptoms get
quite severe. For months people can be walking around with elevated
sugar levels, which can be very harmful."

He said the other problem in diagnosing diabetes is that, "the vast
majority of people in the villages don't know about diabetes. They are
aware of the infectious diseases but diabetes, no."

Recently retired Naivasha businessman Amos Kit Kiranje knew about
diabetes, but it was a while before he realised that something was wrong.

"I had thirst," he said, "excessive thirst, a lot or urination, blurred
vision. I was actually seeing double. I suffered from, palpitations. I
could not talk properly and in the mornings, I got up and immediately
felt dizzy."

Cut down

Mr Kiranje and at least 85% of people suffering from diabetes have Type
II which is linked directly to a poor diet and a lack of exercise.

MRI Scan showing internal fat deposits
Type II diabetes is linked directly to a poor diet and a lack of exercise

By his own admission, Amos is carrying a bit too much weight and now
he's retired, he's not as active as he used to be, like many others in
Naivasha.

At the clinic at Naivasha District Hospital every Thursday he is told to
cut down on starchy foods, to avoid sugary drinks and to take more exercise.

"I know now how to control my diabetes," he said, "but it's not easy."

Type II diabetes is hitting the developing world.

It is being contracted in places which are more used to hunger,
malnutrition and poverty.

Changing lifestyles

Type II diabetes is a disease of affluence and in communities in Kenya
and the whole of the developing world its effects are increasingly
severe because there is no natural resistance to it.

It's a big problem for me... It's a lot of money
Amos Kiranje
Retired businessman, Naivasha

In the West, where diabetes is also a bad problem, there is a level of
tolerance to it, which mitigates its prevalence.

In Africa, India, parts of the Far East and South America there is not.

Dr William Maina, the head of the non-communicable diseases unit at
Kenya's Ministry of Health, is worried about changing lifestyles.

"Today we are seeing more people consuming unhealthy foods; foods that
are high in carbohydrates, high in sugars, high in salts, high in fats.
At the same time we are seeing people lead more sedentary lifestyles.
This is exposing them to risks," he said,

"Diabetes is very serious. It's a killer."

Diabetes is already responsible for as many deaths as HIV/Aids, around
300m worldwide every year, but it gets nothing like the attention and
publicity.

Expensive

Kenya is launching a public health drive to inform and warn about diabetes.

While exercise and the right food can avert diabetes, restoring the
correct sugar concentration in the blood in some patients, can only be
achieved with prescribed insulin.

This is the other critical issue in the developing world.

Insulin is an expensive drug and in Kenya where the per capita income is
put at $1,200 a year it is beyond the reach of many.

Amos Kiranje says it's a struggle for him to meet the costs, and
compared to many he is not poor.

"I have to buy drugs for blood pressure as well and other things so I
spend around 2,000 or 2,500 shillings ($38) every month.

"It's a lot of money."