Diabetes Epidemic
Pakistan Tops MENA in Diabetes Prevalence: Urgent Action Required to Tackle Alarming Rates and Foster Healthier Communities.
Type 2 diabetes (T2D) is a chronic metabolic disorder characterized by high blood sugar levels resulting from the body’s ineffective use of insulin or insufficient insulin production. It is the most common form of diabetes, accounting for the majority of diabetes cases worldwide.
Diabetes global epidemic
Diabetes becoming the biggest epidemic in Ismaic Republic of Pakistan.She is currently grappling with a concerning rise in the prevalence of diabetes, particularly Type II Diabetes. Despite having a smaller population compared to China and India, Pakistan has recorded the highest diabetes rate globally.
This epidemic poses a significant health challenge, with an estimated 33 million Pakistanis, or 30.8% of the population, living with diabetes. Moreover, a substantial portion remains undiagnosed, increasing the likelihood of complications and life-threatening emergencies. To effectively address this crisis, it is crucial to understand the key factors contributing to the prevalence and explore potential solutions.
Findings of Discovery of Diabetes (DD)
According to healthcare experts associated with the Discovering Diabetes (DD) project in Pakistan, a screening of over 21,729 individuals conducted over the past year revealed that around 53% of the population were diagnosed with diabetes. Out of the screened individuals, 11,500 were found to be suffering from type-2 diabetes. The DD project, launched in collaboration with the Pakistan Endocrine Society (PES) and local pharmaceutical firm Pharmevo, aims to address the challenges faced by over 10 million undiagnosed diabetics in the country who are at risk of severe complications.
The project has successfully connected 8,255 patients with healthcare professionals at 200 Discovering Diabetes Clinics nationwide for treatment. Since its launch in 2021, the project has reached out to approximately 5 million people through medical camps, awareness campaigns, print and electronic media, social media, and a toll-free helpline (0800-66766). It also collaborates with universities to track missing diabetics and raise awareness about the disease, emphasizing the importance of adopting a healthy lifestyle to delay or prevent the onset of diabetes.
Renowned diabetologist Dr. Abbas Raza praised the efforts of the Discovering Diabetes team in collecting valuable data and connecting patients with healthcare facilities. He urged other players in the pharmaceutical industry to support or initiate similar projects to obtain accurate data and identify the millions of undiagnosed diabetics in Pakistan. Dr. Ibrar Ahmed, President of the Pakistan Endocrine Society (PES), highlighted the need for partnerships between health associations and the pharmaceutical industry to tackle the diabetes epidemic in the country. The PES has launched a pilot project in Mardan, with plans to establish screening centers in Sindh, Punjab, Balochistan, and Azad Kashmir to identify individuals at risk of diabetes.
The risk factors associated with the diabetes epidemic can be categorized into two main types: modifiable and non-modifiable factors. Understanding these risk factors is crucial for preventing and managing diabetes. Here are some key risk factors:
Report of the Daily Mail
A recent report by the Daily Mail highlighted the alarming prevalence of diabetes in the Middle East and North Africa (MENA) region. According to data from Our World In Data, Kuwait and Egypt ranked among the top 10 countries globally with the highest rates of diabetes in 2021.
Kuwait claimed the third spot, with 24.9 percent of its population affected, while Egypt secured the tenth position at 20.9 percent. Surprisingly, Mauritania stood out as the only Arab state in the bottom 10, with a low rate of just 2.1 percent.
Several factors contribute to the high prevalence of diabetes in the MENA region. Research suggests that a combination of malnutrition, physically demanding agrarian lifestyles, and genetic predispositions to insulin resistance among ethnic groups play a role. Pakistan emerged as the country with the highest rate, with 30.8 percent of its population suffering from diabetes, and alarming growth rates have been observed in recent years.
Interestingly, Western countries like the United States and the United Kingdom ranked lower than expected on the list, with the US at 59th place and the UK at 136th. However, it is worth noting that obesity, high sugar and salt intake, sedentary lifestyles, and the consumption of ultra-processed foods contribute to the global surge in diabetes cases.
The chronic condition of diabetes arises from insufficient insulin production in the body, leading to dangerous levels of blood sugar. Type 2 diabetes, which typically develops in adulthood, accounts for about 90 percent of diabetes cases worldwide. The increased consumption of ultra processed foods has been linked to the prevalence of the condition, often accompanied by obesity.
Studies have shown that certain national diets, like Japan’s traditional diet emphasizing raw or lightly processed foods and smaller portions, have positive health benefits, including a lower risk of type 2 diabetes and other conditions such as heart disease. In contrast, research conducted in the US revealed that approximately 73 percent of the country’s food intake consists of ultraprocessed foods with high levels of salt and sugar.
With diabetes contributing to over 400,000 deaths globally in 2021, addressing the underlying factors, promoting healthier diets, and encouraging active lifestyles are crucial steps in combating this growing health concern.
Diabetes epidemic risk factors
- Modifiable Risk Factors: a. Unhealthy Diet: Consumption of a diet high in processed foods, sugar, unhealthy fats, and low in fruits, vegetables, and whole grains increases the risk of developing diabetes. b. Sedentary Lifestyle: Lack of regular physical activity or leading a sedentary lifestyle contributes to a higher risk of developing diabetes. c. Obesity: Excess body weight, particularly abdominal obesity, significantly increases the risk of developing type 2 diabetes. d. High Blood Pressure: Hypertension or high blood pressure is a modifiable risk factor that increases the likelihood of developing diabetes. e. Unhealthy Lifestyle Habits: Smoking, excessive alcohol consumption, and poor sleep patterns have been linked to an increased risk of diabetes.
- Non-Modifiable Risk Factors: a. Family History: Having a close family member with diabetes, especially parents or siblings, increases the risk of developing the disease. b. Age: The risk of developing diabetes generally increases with age, especially after the age of 45. However, due to the rising prevalence of obesity, type 2 diabetes is now increasingly affecting younger age groups as well. c. Ethnicity: Certain ethnic groups, such as South Asians, Hispanics, African Americans, and Native Americans, have a higher predisposition to develop diabetes. d. Gestational Diabetes: Women who have had gestational diabetes during pregnancy are at a higher risk of developing type 2 diabetes later in life. e. Polycystic Ovary Syndrome (PCOS): Women with PCOS, a hormonal disorder, have an increased risk of developing diabetes.
DIABETES MANAGEMENT
How to combat the diabetes epidemic
Combatting a diabetes epidemic requires a comprehensive approach that addresses various aspects of the disease. Here are some strategies to combat the diabetes epidemic:
- Awareness and Education: Raise public awareness about diabetes, its risk factors, and prevention measures through educational campaigns. Promote healthy lifestyle choices, such as regular physical activity, balanced diet, and weight management.
- Early Detection and Screening: Implement widespread screening programs to identify individuals at risk of diabetes or in the early stages of the disease. Encourage regular check-ups and screenings for early detection and intervention.
- Access to Healthcare: Improve access to quality healthcare services, especially in underserved areas. This includes ensuring availability of healthcare facilities, trained healthcare professionals, and affordable diabetes medications and supplies.
- Prevention Programs: Implement targeted prevention programs that focus on reducing modifiable risk factors. These programs can include promoting healthy eating, physical activity, and weight management, as well as addressing other risk factors like smoking and excessive alcohol consumption.
- Support for Healthy Lifestyles: Create supportive environments that facilitate healthy lifestyles. This can involve promoting physical activity in communities, providing access to nutritious food options, and creating policies that encourage workplace wellness programs.
- Diabetes Management and Treatment: Enhance diabetes management and treatment services, including access to diabetes education, self-management training, and regular follow-up care. Promote the use of evidence-based treatment guidelines and multidisciplinary care approaches.
- Research and Innovation: Support research initiatives to better understand the causes, prevention, and treatment of diabetes. Encourage innovation in diabetes management, such as the development of new technologies, medications, and interventions.
- Policy and Advocacy: Advocate for policy changes that prioritize diabetes prevention, early detection, and management. This includes promoting healthier food environments, implementing sugar taxes, and creating supportive policies for physical activity.
- Collaboration and Partnerships: Foster collaboration among government agencies, healthcare providers, community organizations, and international stakeholders. Collaborative efforts can pool resources, expertise, and best practices to effectively combat the diabetes epidemic.
Socioeconomically factors
Poverty:
Pakistan faces high levels of poverty, with a significant portion of the population living below the poverty line. Poverty exacerbates health disparities, limits access to education and healthcare, and contributes to the prevalence of chronic diseases such as diabetes.
Income Inequality
Pakistan exhibits significant income disparities, with a concentration of wealth in certain segments of society. Income inequality affects access to quality education, healthcare, and opportunities for social and economic mobility, creating barriers to socio-economic development.
Education: Access to quality education remains a challenge in many parts of Pakistan, particularly in rural areas. Low literacy rates and limited educational opportunities hinder human capital development, job prospects, and economic growth.
Unemployment: High unemployment rates, particularly among the youth, pose a significant socioeconomic challenge. Lack of job opportunities, particularly for skilled workers, leads to underemployment and limited income-generating potential.
Gender Inequality:
Gender disparities persist in Pakistan, affecting women’s access to education, employment, healthcare, and decision-making power. Gender inequality contributes to social and economic marginalization, limiting overall development potential.
Healthcare Infrastructure:
Pakistan’s healthcare system faces challenges, including inadequate infrastructure, limited access to healthcare services, and a shortage of qualified medical professionals. These challenges hinder effective disease management and contribute to health inequalities.
Rural-Urban Divide:
There is a noticeable disparity between rural and urban areas in terms of access to basic amenities, healthcare facilities, education, and employment opportunities. Rural areas often face infrastructural deficiencies and limited access to services, perpetuating socio-economic gaps.
Food Security:
Ensuring food security remains a challenge in Pakistan, with a significant portion of the population facing malnutrition and limited access to nutritious food. Inadequate food security can exacerbate health issues, including diabetes.
Diabetes is known to disproportionately affect individuals who are in poor health, lead sedentary lifestyles, or live in conditions that expose them to a higher risk of chronic illnesses. In Pakistan, these factors align with the prevalence of diabetes, as many citizens living in poverty or unsanitary environments face an elevated risk. Limited access to clean water and nutritious food, coupled with low vaccination rates, further exacerbates the situation.
The socioeconomic challenges faced by vulnerable populations contribute significantly to the worsening diabetes epidemic.
Role of Education and Awareness
Education is a critical pillar of socio-economic development, empowering individuals and fostering progress. However, Pakistan faces significant challenges in its education system, particularly in terms of access, quality, and equity. Here is an overview of the education system in Pakistan, highlighting some of the key issues:
Limited Access: Despite efforts to increase enrollment rates, access to education remains limited, particularly in rural areas and among marginalized communities. Many children, especially girls, are unable to attend school due to factors such as poverty, cultural norms, and lack of infrastructure.
Insufficient Infrastructure: Inadequate infrastructure, particularly in rural areas, hinders the provision of quality education. Many schools lack basic facilities, such as proper classrooms, libraries, laboratories, and sanitation facilities, making the learning environment challenging for students.
Teacher Shortages
Pakistan faces a severe shortage of qualified teachers, especially in rural and remote areas. The shortage of teachers impacts the quality of education and the student-teacher ratio. In some cases, primary schools in the countryside have only one teacher who is responsible for teaching all subjects from nursery to class 5th.
Lack of Specialized Teachers
The education system often lacks specialized subject teachers, particularly in primary schools. This means that a single teacher is expected to cover multiple subjects, resulting in a compromised quality of instruction. The teacher’s limited expertise and training may affect students’ understanding and learning outcomes.
Quality of Education:
The overall quality of education in Pakistan needs improvement. The focus is often on rote learning and memorization rather than critical thinking, creativity, and problem-solving skills. This approach hampers students’ ability to apply knowledge in practical situations.
Gender Disparities
Gender disparities persist in education, particularly in rural areas. Girls’ enrollment rates are lower than boys, and cultural barriers often limit their access to education. This gender gap perpetuates social inequalities and hampers overall development.
Lack of Teacher Training
Teachers often lack adequate training and professional development opportunities, particularly in remote areas. Insufficient training can hinder effective teaching methodologies, classroom management, and student engagement.
Addressing these challenges requires significant efforts and reforms in the education system. It is essential to invest in infrastructure development, recruit and train qualified teachers, improve curriculum and teaching methodologies, and promote gender equality in education.
Additionally, there is a need for greater investment in research and innovation to drive educational reforms and ensure that students receive a quality education that equips them with the skills needed for the future.
One critical aspect of combating the diabetes epidemic in Pakistan is the promotion of education and awareness. Currently, there is a severe lack of informational resources and educational materials regarding diabetes and its management.
Many individuals living with diabetes lack the knowledge required for effective self-care and disease management. This knowledge gap leaves them more susceptible to complications and further health deterioration. Therefore, efforts should be made to develop comprehensive educational programs that provide accessible information and empower individuals to take control of their health.
Healthcare Infrastructure Challenges
Pakistan’s healthcare system faces various challenges that impede effective diabetes management. Insufficient and unreliable infrastructure, overcrowded hospitals, and a shortage of qualified medical professionals significantly hinder the provision of quality care.
Additionally, the shortage of essential medications, including insulin, adds another layer of complexity to the problem. Access to affordable medication is limited, leaving individuals struggling to afford life-saving treatments. Addressing these healthcare infrastructure challenges is crucial to improving diabetes care and reducing the burden of the epidemic.
Conclusion:
The worsening diabetes epidemic in Pakistan necessitates a multifaceted approach to mitigate its impact. By addressing socioeconomic factors such as poverty and unsanitary living conditions, improving education and awareness about diabetes, and strengthening healthcare infrastructure, progress can be made in combating the epidemic.
Efforts should focus on providing access to clean water and nutritious food, promoting health education campaigns, ensuring the availability of essential medications, and enhancing healthcare facilities across the nation. Only through collective efforts and targeted interventions can Pakistan confront and overcome its worsening diabetes epidemic, ultimately improving the well-being of its citizens.
source
Kuwait, Egypt among top 10 countries for rates of the condition worldwide in 2021.” Arab News, 30 May 2023, https://arab.news/57mqm.
