At first sight, Beatrice Bitwire comes across as a healthy woman, albeit her slight limp caused by a sore on her foot. It's only until you get down to talk to her that you discover she is nursing a malignant ailment that keeps her wedded to a very strict drug regiment.

About twenty years ago, Bitwire, a 52-year old housewife, was diagnosed with diabetes when she was pregnant with her fourth child.

Initially, she did not see the disease as a big threat largely because of the lack of knowledge about the disease. Little did Beatrice know that her next years were going to be a constant battle for her life

"Every morning I am grateful to God for having given me another day. Every minute would be a constant prayer to at least see my baby girl go to primary." Bitwire reminisces.  

Over the past six years, Bitwire has gotten used to living positively with diabetes. On a daily basis, she wakes up to her usual routine that starts with a morning prayer which she performs with her daughter.

Five minutes before she gets breakfast, she must take her insulin injection and her first handful of tablets. She then proceeds to have breakfast along with her family. She makes sure she steers clear of salt and sugar as well fried stuff, all in the name of keeping her sugar levels stable.

Her chores include dish washing, gardening, cleaning her house, which serve as  her daily exercise. At one O' clock, she gets her light lunch which consists of mainly vegetables and no carbohydrates, which is followed by a siesta.

Late in the afternoon she wakes up to begin preparing the evening meal for her family. She concludes her day with her second lot of tablets and another shot of insulin.

Her healthy appearance comes at the cost of having to endure a daily insulin injection, which by her admission, has become something normal, considering that she administers them by herself twice a day in addition to taking an average of about 25 tablets.

"At the beginning, I was depressed, I couldn`t imagine my self every day with these drugs in my life, they created a new burden on my life, but after some time I got used to them," says Bitwire.    

When she does not take her drugs or when she delays, her blood pressure rises, causing her body to swell. In the worst case scenario she goes into comma and must be rushed to hospital at any cost.

But she rarely gets to that level as she observes very good discipline in the taking of her medication. It is something even her son Eugene Bitwire admires. He says: "I love her enthusiasm to life; of course it's not the same everyday. Some days she wakes up ill and doesn't leave bed. In such situations the entire house turns gloomy because we miss her humour and kindness."

But besides the high blood pressure and other associated ailments, the drugs Bitwire has been taking for years have started to bring her side effects.

"I usually have to take a glass of milk after swallowing my medicines because with time, I have developed ulcers in the stomach and the chest due to acidity of the drugs" she says .

What is diabetes
According to the online encyclopaedia Wikipedia, Diabetes is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced.

There are three main types of diabetes:
Type 1 diabetes: results from the body's failure to produce insulin, and presently requires the person to inject insulin. (Also referred to as insulin-dependent diabetes mellitus, IDDM for short, and juvenile diabetes.)

Type 2 diabetes: results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency. (Formerly referred to as non-insulin-dependent diabetes mellitus, NIDDM for short, and adult-onset diabetes.)

Gestational diabetes: is when pregnant women, who have never had diabetes before, have a high blood glucose level during pregnancy. It may precede development of type 2 Diabetes.

Symptoms
The symptoms of the disease may or may not show. Wikipedia adds that it has been proven that individuals that suffer from type 2diabetes may not have symptoms as the disease slowly manifests itself in the body.

On the other hand, people who experience type1diabetes may appear to be very sick at the time when they are diagnosed with the disease. The symptoms may include; blurry vision, excess thirst, fatigue, frequent urination, hunger and weight loss.

Extent of diabetes in Uganda
Over the years the disease has been rapidly spreading and claiming the lives of hundreds of Ugandans, according to Dr. Andrew Mugabe of Mutungo nursing home.

Mugabe adds: "In a week I receive about eight new patients and the number continues growing."

According to Mugabe, Diabetes, much like Hypertension or high blood pressure is on the rise in Uganda especially among well to do families.

He says: "Diabetes is common for people with white collar jobs as they don't get adequate exercise since they spend most of their time working behind desks and not working off their food intake."

In 1972 only 254 diabetic cases were registered in Mulago hospital. That number has multiplied by several hundred times to an alarming 300 cases weekly. According to the Uganda diabetes association, there are 10,000 diabetic cases reported annually.

Who is most at risk?
According to experts, the disease is commonly associated to people`s lifestyle. People who are not exposed to exercising of any sort are at risk of getting the disease. Age in this situation is not a factor to consider, as the disease attacks people of all ages, infants, teenagers, young adults, pregnant mothers and the elderly.  

However some diabetes is triggered by genetic factors such as insulin gene mutations or defects in insulin conversion.

The scaring statistics about the spread of the disease are a rude reminder though that if Ugandans do not dramatically change their lifestyles, diabetes is on a clear path to becoming a national epidemic.

By Yvonne Bitwire