Diabetes prevention in Bangladesh
Prof. Akhtar Hussain reports about a research initiative in Bangladesh, which is conducted by the Diabetic Association of Bangladesh and the University of Oslo. According to the IDF Diabetes Atlas, the diabetes cases in Bangladesh will have risen to 7.9 % by the year 2030, which is why it is necessary to act now.
Akhtar Hussain. Photo Øyvind Larsen
Diabetes Mellitus (DM) is now recognized as a global health challenge of the 21st century. On December 20, 2006 the United Nations General Assembly unanimously decided to designate November 14 as the “World Diabetes Day” (UN Resolution 61/225). The resolution urged all the member states to develop national policy for public awareness and prevention of diabetes.
Current projections estimate that prevalence of DM worldwide may double over the next two decades. Asia is emerging as the epicentre of diabetes epidemic. Like all other develop and developing countries prevalence and incidence of type 2 DM is also increasing in Bangladesh.
In 2010, the International Diabetes Federation (IDF) estimated that 5.7 million (6.1%) and 6.7 million (7.1%) of people living in Bangladesh is suffering from diabetes and impaired glucose tolerance (IGT) respectively. By 2030, that number of diabetic population is expected to rise to 11.1 million. This explosion in diabetes prevalence will place Bangladesh among the top seven countries in terms of the number of people living with diabetes in 2030.
Evidence suggest that type 2 DM can effectively be prevented. Recent research has shown that about 65% of type 2 DM can be prevented by adopting appropriate life style i.e. increasing physical activity and preventing obesity in Europe and America. Besides lifestyle intervention pharmacological interventions especially using metformin has also been shown to be effective in reducing the onset of diabetes in subjects with impaired glucose tolerance (IGT).
Primary Prevention of Diabetes Mellitus (PPDM) Projects of BADAS has already identified some cost-effective strategies for Bangladesh. Those include mass education trained General Practitioners, community leaders and school teachers; well motivated and oriented people with diabetes as ambassadors, religious leaders and folk singers. Even by producing cinema with appropriate massages(s). BADAS has submitted a draft of National Policy for Primary Prevention of Type 2 DM to the
Government of Bangladesh.
BADAS & University of Oslo, Norway is also running a diabetes prevention intervention study (DPIS) to assess the outcome of different intervention (lifestyle, metformin and glibenclamide) and by correcting micronutrient deficiencies in pregnant mothers to prevent diabetes among high risk group (both obese and under-nutrition) in Bangladesh. Beside intervention, project has already organized good number of mass awareness program in community level, developed leaflets, posters and a Prevention Guide Book in local language. Targeting all the high risk people in Bangladesh and Bengala speaking people living in different part of the world, project has recently develop a user friendly web-site to create a mass awareness in national and international level as well disseminate their developments. Using this site people can assess their risk status for diabetes as well as cardio-metabolic risk.
Furthermore, one can learn how to tackle their specific metabolic challenges following the Guide Book and other education toolkits which can be downloaded. Even a people with diabetes can check their current status in a few minutes.
Written for the Network “Who are active in diabetes prevention“ by Akhtar Hussain, Institute of Health and Society, UiO