The Silent Sugar Crisis: Millions May Have Diabetes Without Knowing It
Oluwatobi Adu 
ABUJA, Nigeria – Millions of Nigerians may be living with diabetes without knowing it, as limited access to screening, misconceptions about the disease and the absence of obvious symptoms leave many people unaware of their blood sugar levels. In this report, Oluwatobi Adu examines the experiences of Nigerians who have never been tested or rarely check their blood sugar, and the gaps in awareness and primary healthcare that could allow a manageable condition to progress to life-threatening complications.
‘I Never Had a Reason’: Why Nigerians Skip Blood Sugar Tests
For Ayobami Arizs, a 30-year-old digital entrepreneur in Mowe-Ibafo, Ogun State, checking his blood sugar had never seemed necessary.
He had never undergone a blood sugar test because he felt no need to do so. Although he tried to moderate his sugar intake, he acknowledged that his diet did not eliminate the need for screening. “I never have a reason to do that, and I don’t pray for it,” he said, explaining why he had never checked his blood sugar.
The interview prompted Arizs to reconsider his approach. He agreed that people who feel healthy should consider screening and said he would make testing part of his healthcare routine. He also considered the cost affordable.
However, he suggested that people who consume a lot of sugar should test monthly, while those who consume less should test every three months. Health professionals caution that screening frequency should not depend on sugar consumption alone. Age, family history, previous results and other risk factors also influence when testing is appropriate.
Arizs’s experience highlights a central challenge: when people feel well, they may see little reason to test for a condition that can develop without obvious symptoms.
For Oreoluwa, 27, a resident of Ibadan, Oyo State, blood sugar testing had happened only once, during a medical outreach.
She said she had not made screening a regular habit because she felt healthy and often lacked time. Yet she rejected the belief that slim people or those without symptoms could not develop diabetes. “Even if someone feels healthy, it’s still good to check blood sugar because diabetes can start without symptoms,” she said.
Oreoluwa said testing was available at pharmacies, private laboratories and hospitals in Ibadan. She estimated that tests cost between ₦1,000 and ₦3,000 at many facilities, describing the expense as somewhat affordable.
Her experience reveals another gap: knowing that a test is available does not necessarily mean making it part of routine healthcare.
The Cost of Waiting for Symptoms
In Lugbe, Abuja, Janet Musa, a 31-year-old secretary, said she last checked her blood sugar in early January.
Musa rejected the misconception that diabetes affects only people who are overweight or visibly unwell. She said people should consider screening even when they feel healthy. “Diabetes can affect anyone, regardless of their body size,” she said.
She added that testing can help identify high blood sugar early and create an opportunity to prevent complications through appropriate care. Musa said tests were available at hospitals, health centres and medical laboratories in Abuja. She estimated that costs ranged from ₦3,000 to ₦5,000, depending on whether a facility was government-owned or privately operated.
For some Nigerians, however, the decision to seek screening competes with other demands on their time and money.
Ibrahim Sani, a 35-year-old commercial driver in Kubwa, Abuja, said feeling healthy and working long hours had kept blood sugar testing off his priority list. “I have never really thought about it because I feel healthy and have not experienced any symptoms that would make me worry about my blood sugar,” he said.
Like Musa and Oreoluwa, Sani rejected the assumption that slim people could not develop diabetes. “I believe slim people can also have diabetes. Being slim does not automatically mean someone is healthy,” he said.
Although he knew that testing was available at hospitals, health centres and some medical laboratories in Abuja, he said he would need to confirm the cost before deciding where to go.
The interview changed his perspective. “This interview has also made me realise that I should not wait until I feel sick before checking my blood sugar,” he said.
From Ogun and Oyo states to the Federal Capital Territory, these accounts reveal a gap between awareness and action. Some people have never been tested, while others have screened only once or during free medical outreaches.
These interviews do not establish how widespread the experiences are across Nigeria. They do, however, illustrate how the absence of symptoms, limited time and concerns about cost can discourage preventive healthcare.
The Numbers Behind Nigeria’s Diabetes Burden
The available figures point to a wider public health challenge. The Endocrine and Metabolism Society of Nigeria (EMSON) has been cited as estimating that approximately 15 million Nigerians are living with diabetes. The report attributes a prevalence of six to seven per cent to the organisation, although the population covered and date of the estimate require confirmation.
The 2023–2024 Nigeria Demographic and Health Survey offers another indication of limited screening among Nigerians aged 15–49. An analysis of the survey found that only 18.6 per cent of women and 17.6 per cent of men in this age group had ever had their blood sugar measured.
Reported diabetes diagnoses were considerably lower: 0.9 per cent among women and 1.3 per cent among men. These figures do not establish how many Nigerians have undiagnosed diabetes. The proportion reporting a previous diagnosis measures known cases, not everyone living with the condition. However, the low proportion who had ever been tested raises questions about opportunities for early detection.
The survey analysis also found differences in screening by residence, geopolitical zone, household wealth and educational attainment. Testing was more common in urban areas, southern zones, wealthier households and among people with more education.
These disparities suggest that access to preventive healthcare is uneven. People with fewer opportunities to obtain testing may be less likely to discover elevated blood glucose before symptoms or complications emerge.
The International Diabetes Federation has also identified a substantial undiagnosed diabetes burden across Africa, including Nigeria. Establishing the precise number affected requires figures from the relevant edition of its diabetes atlas.
The consequences of delayed diagnosis can be serious. Persistently high blood glucose can damage the eyes, kidneys, nerves, heart and blood vessels. Poorly healing foot wounds can also develop serious complications, sometimes leading to amputation.
Early diagnosis cannot guarantee that complications will be prevented. It does, however, create an opportunity for appropriate treatment, monitoring and support.
Why Do People Delay Screening?
For Mrs Adesope Kaosarat, a public health expert and registered nurse at Foko Primary Healthcare Centre in Ibadan, the reasons people postpone testing extend beyond a lack of information.
She identified limited awareness, financial constraints, fear of a diagnosis and the belief that healthy people do not need medical checks as major barriers. The cost of screening can also extend beyond the test itself. Transport, consultations, additional laboratory investigations, medication and follow-up appointments can place further pressure on household budgets.
Misconceptions compound these challenges. Some people believe diabetes affects only older adults, those who eat large amounts of sugar or people who are overweight. Others assume that having no symptoms means their blood sugar is normal.
Kaosarat called for stronger public education, affordable testing and improved access to community-level healthcare. “Do not wait until you feel sick before checking your blood sugar. Knowing your status early gives you a better opportunity to take action,” she said.
Her advice highlights why awareness campaigns alone may not be enough. People also need accessible services and clear guidance on what to do when a test reveals a possible problem.
Diabetes Is Not Simply a Disease of Sugar or Body Size
One misconception continues to complicate prevention: the belief that eating too much sugar is the sole cause of diabetes. Kaosarat explained that diabetes includes different conditions with distinct causes and risk factors.
Type 1 diabetes develops when the immune system attacks insulin-producing cells in the pancreas. It can affect children, teenagers and adults and is not caused by eating too much sugar. Type 2 diabetes occurs when the body cannot use insulin effectively or produce enough to maintain normal blood glucose levels. Genetic factors, age, physical activity, dietary patterns and body weight can influence the risk.
Having a parent or sibling with diabetes can increase a person’s risk of developing type 2 diabetes, but it does not make the condition inevitable.
Kaosarat warned against judging a person’s health by appearance. “Diabetes does not have a particular body shape. You cannot determine whether someone has diabetes simply by looking at them. A blood test is needed to establish the diagnosis,” she said.
Although excess body weight, particularly around the waist, is a risk factor for type 2 diabetes, slim people can also develop the condition. Unexplained weight loss may itself be a warning sign. “Diabetes does not discriminate by age. While type 2 is more common in adults, type 1 diabetes can develop in children and teenagers under 20. Anyone can be affected, so regular screening is important at every age.”
These distinctions matter. Messages that focus only on sugar consumption or body weight can give some people false reassurance while overlooking other risk factors.
Warning Signs People Should Not Ignore
Diabetes can develop gradually, and some people experience no obvious symptoms in its early stages. Others may overlook the warning signs or attribute them to other causes.
Kaosarat identified excessive thirst, frequent urination, increased hunger, unexplained weight loss, persistent tiredness, blurred vision, slow-healing wounds and recurrent infections as possible symptoms.
Anyone experiencing these signs should seek medical assessment rather than assume their blood sugar is normal.
However, symptoms alone cannot confirm diabetes, and their absence does not rule it out. Blood tests and appropriate clinical assessment are needed to establish a diagnosis. Kaosarat said prolonged high blood glucose could damage several organs and systems, causing kidney disease, eye damage, nerve problems and cardiovascular complications, including heart attack and stroke. “When diabetes remains undiagnosed or poorly controlled for a long time, high blood sugar can damage different organs and systems in the body,” she said.
In some cases, diabetes can also cause acute medical emergencies that require urgent treatment. These risks explain why waiting until a person feels visibly ill can delay an important opportunity for diagnosis and care.
Can Nigerians Get Tested Close to Home?
For many people, the nearest primary healthcare centre could provide the first opportunity to access diabetes screening. Yet the availability of testing depends on whether facilities have the necessary equipment, supplies and trained personnel.
Kaosarat said many primary healthcare facilities could offer basic blood sugar testing, although services varied. Some patients might require referral to larger facilities for further investigations or treatment.
She called for better-equipped primary healthcare centres, trained health workers and reliable supplies for testing.
The challenge is not simply whether a facility exists. A centre without the necessary equipment or consumables may be unable to test patients, even when they are willing to be screened.
Transport costs, waiting times and access to follow-up care can create further obstacles.
For commercial drivers and other informal-sector workers who spend long hours working, convenient service hours and community outreach could make screening easier.
However, outreach programmes must also provide clear referral pathways. Identifying a possible problem is only the first step; patients need access to confirmatory tests, clinical assessment and appropriate treatment.
What Can a Blood Sugar Test Tell You?
Matron Oladipupo O.A., officer-in-charge of Elewura Primary Health Centre in Ibadan, Oyo State, explained how blood sugar testing helps assess diabetes.
The pancreas produces insulin, a hormone that helps regulate blood glucose. When the body cannot produce enough insulin or use it effectively, blood glucose levels can rise.
Oladipupo identified fasting blood glucose testing as one method used to assess blood sugar. The test is commonly performed after an overnight fast, with specific instructions provided by a healthcare professional or laboratory.
Other tests include glycated haemoglobin, known as HbA1c, which measures average blood glucose over approximately two to three months. Random blood glucose testing may also help assess people who have symptoms and need prompt evaluation.
The appropriate test depends on the person’s circumstances. An abnormal result may require confirmation or further clinical assessment before a diagnosis is established.
Home glucose meters can help people monitor their blood sugar, particularly those already managing diabetes. However, a single reading from a home device does not necessarily establish a diagnosis.
Oladipupo stressed the importance of following prescribed treatment and medical advice. “Diabetes is not curable, but it can be managed if the person takes his or her drugs regularly,” she said.
Although diabetes is generally a chronic condition, appropriate treatment, monitoring and support can help people manage blood glucose and reduce the risk of complications. Treatment varies according to the type of diabetes and each patient’s needs. Medication should be taken as prescribed, with any adjustments guided by a qualified health professional.
Prevention Without Blame
Kaosarat recommended balanced meals, regular physical activity and other measures that can reduce the risk of type 2 diabetes or support overall health.
She advised people to eat a variety of nutritious foods, including vegetables, beans, whole grains and fruits in appropriate portions. She also encouraged them to limit sugary drinks and excessive consumption of highly refined foods and foods high in unhealthy fats.
Such advice does not require Nigerians to abandon traditional meals. Balanced portions, nutritious ingredients and healthier preparation methods can support healthier eating habits.
Regular physical activity, including walking, dancing and cycling, can also improve overall health. Adults are generally advised to aim for at least 150 minutes of moderate-intensity activity each week, where their health permits.
Other measures include avoiding smoking, maintaining a healthy weight where possible and managing conditions such as high blood pressure.
However, prevention messages must not blame people who develop diabetes. Genetic susceptibility, age, environmental conditions, food availability and access to healthcare can all influence risk.
Type 1 diabetes cannot be prevented through dietary changes or exercise. Lifestyle changes alone are also not a substitute for prescribed treatment.
For people already living with diabetes, continued medical care, appropriate monitoring and medication where indicated remain essential.
From Awareness to Action
The experiences of Arizs, Oreoluwa, Musa and Sani reveal different points along the same continuum: never having been tested, screening only once, delaying follow-up or reconsidering preventive healthcare after learning more about the risks.
Their accounts are not a national survey. They nevertheless illustrate why information alone may not be enough to close Nigeria’s diabetes screening gap.
People need affordable tests, accessible facilities, clear guidance and a reliable pathway to treatment when screening identifies a possible problem.
Kaosarat’s message is straightforward: people should understand their risk factors and discuss appropriate screening with a healthcare professional rather than wait for symptoms. Primary healthcare centres can help make this possible, provided they have the equipment, personnel and supplies required to deliver reliable services.
For policymakers and health authorities, the challenge is to turn awareness into practical access. Public education must address misconceptions about age, body weight and sugar consumption, while screening programmes should connect patients to confirmatory testing, treatment and continuing care.
For individuals, feeling healthy should not be treated as proof that blood sugar is normal. But the responsibility cannot rest on individuals alone. The health system must make screening accessible and ensure that people can act on their results.
A blood sugar test can reveal a problem that symptoms have yet to expose. Early detection, however, is only the beginning. People also need the treatment and support required to manage their health.
Nigeria’s diabetes challenge is not only about how many people are living with the condition. It is also about how many have the opportunity to find out in time—and what happens after they do.
About the Author
Hope Ajayi