The Invisible Epidemic: Why Nigeria’s Diabetes Crisis Demands Urgent Indigenous Clinical Research

As the world marks World Diabetes Day, attention is increasingly turning to countries facing rapidly rising burdens of non-communicable diseases. Among these, Nigeria stands out as a country confronting a silent but intensifying diabetes epidemic. According to the International Diabetes Federation (IDF), Nigeria’s diabetes prevalence among adults aged 20–79 years is estimated at 3%, representing approximately 3 million adults living with the condition in 2024 (IDF, 2024). While this figure alone is significant, mounting evidence indicates that it may underestimate the true scale of the problem.

Recent local research reveals a more troubling situation. A comprehensive systematic review and meta-analysis drawing on data from studies conducted between 1990 and 2023 reported a pooled prevalence of type 2 diabetes of around 7%, more than double the official IDF estimate (Olamoyegun et al., 2024). This discrepancy is indicative of the likelihood that international modelling may not fully capture the epidemiological transition underway in Nigeria, where urbanisation, dietary shifts, reduced physical activity, and ageing all contribute to rising non-communicable disease rates.

One of the most pressing challenges is the high level of undiagnosed diabetes. A community-based study using HbA1c testing found that 84.2% of individuals with diabetes were previously unaware of their condition (Ajayi et al., 2023). Undiagnosed diabetes often presents only when complications such as neuropathy, kidney disease, cardiovascular disease, or diabetic foot problems have already developed, increasing both the clinical and financial burden on patients and the Nigerian health system.

Despite the magnitude of the problem, Nigeria’s scientific and clinical research output related to diabetes remains comparatively low. Analyses consistently show that Nigeria lacks sufficiently robust, context-specific evidence to inform national guidelines, treatment pathways, and prevention strategies (Ogbera, 2014). Many clinical recommendations in Nigeria are therefore adapted from non-African or high-income country studies whose findings may not fully represent Nigeria’s genetic background, environmental exposures, cultural practices, or socioeconomic realities. This misalignment can reduce the effectiveness of care and impede the adoption of locally appropriate management models.

The economic dimension of diabetes care presents an additional layer of complexity. In the absence of widespread health insurance coverage, out-of-pocket payments remain the dominant financing mechanism for chronic disease management in Nigeria. Research shows that the mean monthly direct cost of diabetes care can reach ₦56,245 (over 80% of the current national minimum wage), a figure that is unmanageable for many households (Okoronkwo et al., 2015). Patients frequently resort to coping strategies such as borrowing, selling assets, or relying on family support to pay for treatment. These economic pressures often result in missed appointments, poor medication adherence, and the postponement of essential monitoring or laboratory tests.

The consequences of inadequate financing and limited access to care are stark. Diabetes complications are responsible for a substantial proportion of hospital admissions in tertiary facilities. Conditions such as diabetic foot ulcers can lead to prolonged hospital stays, amputation, and significant mortality. Studies from northern Nigeria have shown that more than 90% of costs related to diabetic foot care are paid out-of-pocket, placing families at high risk of catastrophic expenditure (Muhammad et al., 2018). Although multiple authors have documented the financial and clinical impact of diabetes, updated national-level cost estimates remain scarce, further highlighting the need for sustained indigenous research efforts.

Nigeria’s public health response must therefore evolve beyond reliance on external data and guidelines. There is an urgent need for locally led, contextually relevant clinical research that investigates treatment efficacy, population-specific risk factors, cultural determinants of health behaviours, and cost-effective models of care. Clinical trials conducted in Nigerian populations can generate actionable insights into medication responsiveness, lifestyle intervention feasibility, and long-term disease trajectories. Such studies are crucial for designing interventions that are both scientifically robust and culturally appropriate.

A strengthened research ecosystem would support improved surveillance and policy development. Enhanced investments in research infrastructure, training for clinician-scientists, and collaboration among academic institutions, local health authorities, and private research organisations such as Bispharm Clinical would significantly advance Nigeria’s capacity to respond to its growing non-communicable disease burden. Private-sector and academic partnerships can help bridge existing gaps by supporting investigator-initiated studies, registries, and longitudinal cohort projects capable of generating high-quality data.

At Bispharm Clinical, we believe the evidence compels a clear conclusion: meaningful progress requires sustained commitment to building the scientific foundations of diabetes care within Nigeria. By prioritising locally validated evidence, Nigeria can transition from reactive, complication-driven care to proactive, preventive, and patient-centred management. Only then can we hope to curb this invisible epidemic and build a future in which effective diabetes care is accessible and grounded in the realities of Nigerian communities.

References

Ajayi, I.O. et al. (2023) ‘Prevalence of haemoglobin A1c-based dysglycaemia among Nigerian adults: high undiagnosed rate of diabetes’, Frontiers in Endocrinology, 14.

IDF (2024) Nigeria: Diabetes country report 2024. International Diabetes Federation. Available at: https://idf.org/our-network/regions-and-members/africa/members/nigeria(Accessed: [12 November 2025]).

Muhammad, F. Y., Pedro, L. M., Suleiman, H. H., Uloko, A. E., Gezawa, I. D., Adenike, E., Ramalan, M., & Iliyasu, G. (2018). Cost of Illness of Diabetic Foot Ulcer in a Resource Limited Setting: A Study from Northwestern Nigeria. Journal of diabetes and metabolic disorders, 17(2), 93–99. https://doi.org/10.1007/s40200-018-0344-8

Ogbera, A.O. (2014) ‘Diabetes mellitus in Nigeria: The past, present and future’, World Journal of Diabetes, 5(6), pp. 868–878.

Okoronkwo, I.L. et al. (2015) ‘Socioeconomic inequities and payment-coping strategies among patients with hypertension and diabetes mellitus in Nigeria’, Nigerian Journal of Clinical Practice, 19(1), pp. 74–82.

Olamoyegun, M.A. et al. (2024) ‘A systematic review and meta-analysis of the prevalence of type 2 diabetes in Nigeria’, Clinical Diabetes and Endocrinology.