Diabetes In Pakistan


Diabetes Mellitus (DM) is a group of metabolic disorders characterized by hyperglycemia resulting from defects in insulin secretion (Type1 DM), insulin action (Type2 DM), or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels. In Type1 DM 15-20% patients develop proteinuria and 70-80% out of microalbuminuric patients develop overt nephropathy later on. In Type2 DM 2-20% develops proteinuria and 20% of microalbuminuric patients develop overt nephropathy. Diabetic nephropathy is considered the most common cause of End Stage Kidney Disease worldwide. It is estimated that in 2015, 415 million people had diabetes worldwide with type 2 DM making up about 90% of the cases. This represents 8.3% of the adult population, with equal rates in both women and men. As of 2014, trends suggested the rate would continue to rise. Moreover Diabetes at least doubles a person's risk of early death. From 2012 to 2015, approximately 1.5 to 5.0 million deaths each year resulted from diabetes. The rising Prevalence of Diabetes and Diabetic nephropathy is serious burden on the health care facilities worldwide. The global economic cost of diabetes in 2014 was estimated to be US$612 billion. The prevalence of diabetes Mellitus (DM) and impaired glucose tolerance (IGT) and the contributing risk factors have been a focus for the whole medical community in Pakistan. The prevalence of diabetes in the urban versus the rural areas is 6.0% in men and 3.5% in women against 6.9% in men and 2.5% in women, respectively in previous studies. Overall glucose intolerance (DM + IGT) is 22.04% in urban and 17.15% in rural areas. The major risk factors identified are age, positive family history and obesity especially central obesity. However these numbers are bound to increase tremendously in coming years; the prevalence is estimated to increase up to 13% in 2035 and Pakistan will be in the top ten countries having largest population with DM. These alarming statistics are concerning for us as a nation. Diabetic nephropathy is the top most cause of End Stage Kidney Disease worldwide and in Pakistan as well. Nation-wide screening and awareness regarding diabetes and its risk factors should be done.