By Beatrice Nakibuuka
As the world prepares to mark World Diabetes Day on 14 November 2025, Uganda joins the global call to “Know Your Risk, Know Your Response.” Across the country, hospitals, communities, and health advocates are raising awareness about a disease that has quietly crept into millions of homes, claiming lives, draining families financially, and threatening national productivity.
Once considered a condition of the rich or elderly, diabetes now affects Ugandans of all ages, from children in rural schools to professionals in city offices. Doctors warn that the numbers are rising faster than ever, fuelled by unhealthy diets, sedentary lifestyles, and limited awareness. Tragically, many people living with diabetes do not realise it until serious complications, such as blindness, kidney failure, heart disease, or amputations set in.
This year’s theme is a timely reminder that the disease is both preventable and manageable if detected early. For that to happen, every Ugandan must take responsibility.
Growing problem
Diabetes has quietly become one of Uganda’s most pressing health challenges. The Uganda Diabetes Association estimates that over five million Ugandans are living with the disease, many unknowingly. Once rare, diabetes has evolved from a medical curiosity in the 1970s into a major public health concern.
Professor Andrew Marcel Otim, a diabetologist and endocrinologist at Nakasero Hospital, traces this rise to shifts in diet and lifestyle.
“In the 1970s, Mulago Hospital had about 256 registered diabetes patients,” he recalls, adding: “By 1984, the number had grown to 1,800, and by 2010 it was over 11,000. Today, we are in the millions.”
He explains that, in the past, being overweight was seen as a sign of success. “Fat people were respected and called mafuta mingi. But ignorance about eating habits contributed to the rise of diabetes,” he says.
Modern urban living has worsened the problem. Fast foods, processed snacks, sugary drinks, and long sedentary hours have replaced the physically active lifestyles of the past.
What happens in the body
Diabetes occurs when the body cannot properly regulate sugar (glucose) in the blood. Normally, insulin, a hormone produced by the pancreas, helps transport glucose into body cells for energy. When the body becomes resistant to insulin or produces too little, sugar builds up in the blood, a condition known as hyperglycaemia.
“Diabetes mellitus is characterised by an increase in blood sugar above normal levels. A fasting blood sugar above 7 mmol/L, or 126 mg/dl, indicates diabetes,” Prof Otim explains.
There are three main types of diabetes:
- Type 1 diabetes – usually develops in children or young adults when the pancreas stops producing insulin. It requires daily insulin injections.
- Type 2 diabetes – the most common form, occurring when the body becomes resistant to insulin or fails to produce enough. It is often linked to obesity, poor diet, and inactivity.
- Gestational diabetes – occurs during pregnancy due to hormonal changes. Although it usually disappears after childbirth, affected women are at higher risk of developing type 2 diabetes later.
Warning signs, complications
Dr William Lumu, a diabetologist at Mengo Hospital, notes that many people overlook the early symptoms until complications develop.
“Frequent urination, especially at night, constant thirst, fatigue, blurred vision, wounds that heal slowly, and frequent infections are warning signs,” he says.
Sometimes these symptoms are mild or absent, delaying diagnosis. “Even if you’re unsure, see a doctor. Early testing can prevent life-threatening complications,” he advises.
Uncontrolled diabetes damages nerves and blood vessels, leading to kidney failure, stroke, heart disease, impotence, and amputations. It is also the leading cause of adult blindness globally.
Prof Otim adds that the disease often shows up in unexpected ways. Gum disease, recurrent infections, and skin conditions such as acanthosis nigricans, a dark, velvety patch on the neck or elbows, may all signal diabetes.
In severe cases, high blood sugar causes blurred vision or blindness, while unexplained weight loss occurs when the body burns fat for energy due to lack of insulin.
Cost of living with diabetes
Managing diabetes is lifelong and expensive. While treatment is often free in public hospitals, private care can cost between Shs100,000 and Shs300,000 or more per visit, depending on the severity and complications.
“The high cost usually comes from treating related conditions like high cholesterol, kidney disease, and nerve damage,” Dr Lumu says. He adds that governments in East Africa spend less than 50 dollars per diabetic annually, compared to thousands in developed nations.
Managing diabetes
Although diabetes has no cure, it can be effectively managed through diet, exercise, medication, education, and regular monitoring.
Patients are encouraged to:
- Check their blood sugar regularly.
- Control blood pressure and cholesterol.
- Have medical reviews every three to six months.
- Undergo kidney, eye, dental, and foot check-ups.
Prof Otim emphasises that type 2 diabetes is largely preventable, and even reversible, through lifestyle change.
“Most people with type 2 diabetes don’t need insulin,” he says. “Proper nutrition, regular exercise, and awareness can prevent or control the condition.”
Food as medicine
There is no single “diabetic diet,” but eating right makes all the difference. Diabetics should eat three balanced meals daily and avoid skipping or overeating.
Dr Lumu recommends high-fibre, low-fat meals such as brown rice, whole grain bread, beans, peas, and vegetables. He warns against sugary drinks, fried foods, and fatty meats.
“Use skimmed milk, trim visible fat, and never eat chicken skin,” he advises.
Healthy eating stabilises blood sugar, reduces cholesterol, and helps maintain a healthy weight, all key to controlling diabetes.
Foot care: Small steps that save limbs
Foot care is critical for diabetics because nerve damage and poor blood flow can lead to ulcers or amputations.
Doctors recommend daily washing with lukewarm water and mild soap, drying thoroughly (especially between toes), moisturising, and wearing properly fitting shoes. Diabetics should never walk barefoot and should check their feet daily for cuts, blisters, or swelling.
“Even a small wound can become serious if ignored,” warns Dr Lumu adding: “See your doctor immediately if you notice sores or infections.”
Protecting the next generation
Gestational diabetes and poor nutrition during pregnancy increase the risk of diabetes in children. Babies born to diabetic mothers are often overweight and more likely to develop type 2 diabetes later.
The Centers for Disease Control and Prevention (CDC) advises expectant women to maintain a healthy lifestyle and get tested. “Before pregnancy, losing excess weight, eating well, and exercising regularly can prevent gestational diabetes,” the CDC notes.
National concern
Diabetes is more than a medical issue, it is a national crisis. Rising cases strain Uganda’s healthcare system and threaten the economy through lost productivity and premature deaths.
But the solution lies within reach: awareness, prevention, and early detection. Ugandans are urged to embrace physical activity, eat more natural foods, and go for regular health check-ups. Communities, too, must support diabetic patients with understanding rather than stigma.
“If handled properly, type 2 diabetes can be prevented and even reversed,” says Prof Otim. “The power is in our hands—through discipline, awareness, and lifestyle change.”
New drugs
The World Health Organization (WHO) recently updated its list of essential medicines to include powerful new treatments for type 2 diabetes.
Scientific evidence shows that glucagon-like peptide-1 (GLP-1) receptor agonists, including semaglutide, dulaglutide, and liraglutide, and the dual receptor agonist tirzepatide can help people with diabetes, especially those with heart or kidney disease. These drugs improve blood sugar control, reduce heart and kidney risks, support weight loss, and lower the risk of early death.
However, high prices limit access. The WHO urges countries to prioritise those who benefit most, encourage generic competition to reduce prices, and expand access through primary care, especially in underserved communities.
The organisation continues to support fair pricing and equitable access, aiming to ensure that all people living with diabetes can benefit from these life-changing therapies.
Ultimately, Uganda’s fight against diabetes begins with each individual. Knowing your risk, testing regularly, and adopting healthy habits are the first steps towards a healthier, diabetes-free future.
