Nutrition and diabetes management

In Mali, diabetes constitutes the second cause of hospitalisation after HIV-related diseases and it represents more than 95% of the consultations in internal medicine. Prevalence of diabetes is around 2% of the adult population, equalling about 106,000 people. Due to poor control and management, a very high prevalence of complications is found among people with diabetes. A small survey conducted in 2000 indicated a presence of high blood pressure in 16.7% and serious retinopathy in 55.3% of the cases surveyed. Only about 30% of people with diabetes can afford oral medication or where necessary, insulin. In recognition of this problem, Santé Diabète Mali, in collaboration with three hospitals in Bamako, has initiated work to analyse the nutritional values of local foods and to introduce nutrition education for people with diabetes, their families and at risk groups. Objective The project seeks to address diabetes management from a nutritional point of view and aims to sensitise the Malian population on diabetes in general and the link between food and diabetes. Approach The project has two main components: Component 1 is directed specifically towards people with diabetes, aiming to improve their nutritional intake and thereby enabling them to better control their diabetes. Nurses will be trained on nutritional aspects to enable them perform nutritional education for people with diabetes attending the community health centres and hospitals. This component also seeks to provide health care professionals with the tools necessary for setting up individualised diets taking into account the local foods as well as the socio economic and cultural characteristics of the target groups. Scientific analysis of the nutritional values of foods consumed in Mali, particularly by people with diabetes, will form a central element in this work. Component 2 seeks to address more widely the entire population of communes 1 and 2 of Bamako city. The aim is to inform and sensitise the population on diabetes and its link to nutrition in order to cause a change of behaviour among the target group. Various activities form part of this component, including organisation of "The Week of Diabetes"; conducting screening camps; using mass media to disseminate important messages; addressing community and family leaders; and training of nursing staff of the community health centres. In the present project, these activities form a pilot intervention focusing exclusively on communes 1 and 2 of Bamako which have a total population of 364,000 people. The NGO Santé Diabète Mali is the coordinating body in the implementation of the project. The specific activities are implemented in collaboration with key local institutions in diabetes care in Mali: the Gabriel Touré Hospital, the Centre for the fight against diabetes, the Point G Hospital and for Component 2, the Amadou Hampaté Ba Centre. Internationally the project collaborates with the National Institute for Health and Medical Research (INSERM), the Research Institute for Development (IRD) and the "Hotel Dieu" hospital in France. These institutions provide expertise in key areas and support the local institutional strengthening. Expected impact Up to 100,000 people with diabetes covered through nutritional advice and counselling Awareness of diabetes and its risk factors raised among the populations of communes 1 and 2 of Bamako, totalling 364,000 people 50 health care professionals (doctors and nurses) trained 50 diabetes/nutrition educators trained  Results achieved at project completion Studies have been conducted analysing the food consumption among people in Bamako in general and in people with diabetes as well as analysing the glycaemic index and biochemical composition of Malian food. Results have been disseminated and used in nutrition education (study on nutrition in French/English) 27 peer educators have been trained in diabetes awareness and prevention. The educators are local to the areas where they deliver health education and the sessions are typically held in home settings Peer educators have reached a total of 406,786 people; 20% of the population in commune 2 of Bamako (133, 579 people) and 8% of the population in commune 1 (273,207 people) Information about diabetes has been disseminated through participating in a radio show, a television debate, broadcasting of 100 radio messages and through traditional chiefs. A  7-minute film has been produced to create awareness about diabetes Existing educational tools have been adapted to the Malian context 1,053 people have been screened for diabetes and 80 of them were diagnosed with diabetes The project has had the following impact: All research data obtained has made it possible to establish new guidelines for nutritional management of Malian diabetes patients. These guidelines are disseminated by specialists and health care staff through the training organised by Santé Diabète Mali. The results of the nutritional research will make it possible to set up individualised diets for people with diabetes, taking the local food items into account as well as the socioeconomic and cultural characteristics of the Malian patients.

Project data

Area Partner Project responsible Duration Project budget WDF contribution Project number

Mali  Santé Diabète Mali Mr. S. Besancon August 2004 - July 2007  EUR 259,700 EUR 56,000  WDF04-074

This page was last updated 10-9-2007 by sfh.wdf