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Uganda: A Community Approach to Diabetes Care

After studying the prevalence of diabetes in Uganda for five years, James Ntambi has come up with what he thinks may be the only realistic answer to a growing health problem: self-help.

Simple as it may sound, Ntambi, a CALS professor of biochemistry and nutritional sciences, believes that promoting the benefits of healthy lifestyles such as eating a balanced diet may be the best approach to combating the rising incidence of diabetes in African nations.

“You’re not going to ask people to start buying insulin and other expensive diabetes medications, or ask them to go to far away hospitals because they don’t have the funds,” Ntambi says. “You have to take care of yourself–that’s the message. Especially in the case of diabetes, where there is no cure, prevention is the key.”

To carry that message forward, Ntambi is launching a series of nutrition training sessions for health care professionals and policy leaders in Uganda. He says that educating leaders not only can help spread healthy practices into communities, but it can also help him explore the problem more deeply through survey research and targeted education.

“By the time we go there to the communities to evaluate, the people know about us, and they have heard about our intentions,” Ntambi says. “The impact we can make by training the local people is going to be big over time.”

In his previous research, Ntambi has uncovered an interesting trend in the incidence of Type II diabetes. Ugandan women who are diagnosed with the disease tend to be overweight or obese, while Ugandan men who are diagnosed tend to be thin. This gender split marks a significant difference from what health care workers and researchers have documented about diabetes in Western countries, where most people diagnosed with Type II diabetes tend to be overweight or obese. Ntambi’s co-investigator, Linda Baumann, of the UW-Madison School of Nursing, saw the same trend during an independent study in Thailand. While he isn’t sure what is causing this pattern, Ntambi says it may be a result of “environmental factors playing on genes” in developing countries.

To discover what those environmental factors may be, Ntambi, Baumann and their collaborators in Uganda are carrying out a project to survey people about their behaviors. The surveys are a way “to get into the community and get to know the people,” he says. “We want to learn how these people take care of themselves and how they monitor their blood sugar.” If the evaluations reveal connections, Ntambi’s team will follow up with tailored materials to educate people about preventing the disease.