The start of Kenya’s growing diabetes problem may lie far beyond hospital wards and clinics. Increasingly, they can be traced to the country’s changing farms, shifting diets and the mounting pressures of climate change.
Across rural Kenya, traditional crops such as sorghum, millet, cassava, sweet potatoes and indigenous vegetables are gradually disappearing from many farms, replaced by maize and commercial cash crops.
Erratic rainfall, prolonged droughts and rising temperatures have made it harder for smallholder farmers to maintain diverse harvests, while rising living costs and school fees have pushed many families toward cheaper, processed foods high in sugar, salt and refined carbohydrates.
The trend mirrors a worrying global health pattern. According to the International Diabetes Federation’s Diabetes Atlas (2025), an estimated 589 million adults aged 20–79 are living with diabetes worldwide, with projections showing the number could rise to 853 million by 2050 if current trends continue. More than 90 percent of these cases are Type 2 diabetes, a disease closely linked to unhealthy diets, physical inactivity and obesity.
For farmer Andrew Omete, the transformation of farming over the past three decades reflects the difficult choices many rural households have had to make. He says climate change, declining yields, fluctuating market prices and the growing burden of school fees have gradually pushed families away from cultivating diverse food crops toward a handful of cash-generating or staple crops.
“Thirty years ago, we mostly ate what we grew. Our farms had millet, sorghum, sweet potatoes, beans and traditional vegetables,” he says noting that today, unpredictable weather, poor returns and the need to pay school fees have forced many farmers to concentrate on maize or crops that bring quick cash, making them buy much of their food from shops.
According to him, those changes have altered not only what families eat but also the health of entire communities. While he cannot attribute the rise in diabetes solely to diet, he says the increasing dependence on processed foods and sugary products has coincided with more cases of diabetes and other chronic illnesses.
“Diabetes was once rare here, but today many families know someone living with it. I cannot say food is the only cause, but we are eating fewer traditional foods and more processed foods than before.”
As food moves from the farm to the marketplace, another reality emerges. For many families, what ends up on the table is determined less by nutritional value than by what they can afford.
Regina Kemunto, a sales agronomist at Ndemo farms in Kisii, says staple foods such as maize flour, rice, beans, cooking oil and wheat flour continue to dominate household shopping baskets because they are considered essential. While sugary products such as soft drinks, biscuits and confectionery remain popular, especially among children and young adults, she notes that demand has become less predictable as prices rise and consumers become more health-conscious.
For her, inflation and supply chain disruptions have made fresh and nutritious foods more expensive in some seasons, forcing many households to prioritize foods that are cheaper, more filling and have a longer shelf life. As a result, processed foods often become the easier choice despite growing awareness of their health implications.
“We have seen customers become more careful about how they spend their money. When prices go up, many reduce quantities or focus only on basic necessities,” she says.
Even so, Kemunto adds, more shoppers, particularly those living with diabetes or caring for affected family members, are actively seeking products with less sugar, whole grains, healthier cooking oils and fresh fruits and vegetables.
“Customer choice is important, but making healthier foods easier to find and afford can influence better eating habits and improve public health,” she says.
As conversations with farmers and traders reveal how food systems have changed, doctors are witnessing the consequences in their consulting rooms. Dr. Bharath Marla, a consultant physician and cardio-diabetology specialist, says diabetes is no longer a condition affecting only older adults.
Increasingly, Marla notes, he is diagnosing younger patients, including people in their twenties, a trend he says was uncommon when he began practicing in Kenya eight years ago.
He also notes that many patients are arriving at hospital much later, when blood sugar levels are already dangerously high and complications have begun to develop.
“We are seeing younger patients with Type 2 diabetes, and many are diagnosed only after the disease has progressed significantly,” he says.
According to Marla, the greatest obstacle is no longer the availability of testing but the cost of long-term care. While blood sugar screening has become more accessible across much of the country, advanced monitoring technologies and newer medications remain out of reach for many patients, forcing some to delay treatment or settle for less effective options.
He adds that diabetes care should not stop with prescriptions. Effective management, he says, requires physicians, dietitians and physiotherapists to work together in developing personalized treatment plans rather than addressing each aspect of care in isolation.
“We have seen customers become more careful about how they spend their money. When prices go up, many reduce quantities or focus only on basic necessities”
— Regina Kemunto, sales agronomist