Diabetes, Metabolic Syndrome and Obesity (Dec 2018)
Current management strategies to target the increasing incidence of diabetes within Pakistan
Abstract
Abdul Basit,1 Asher Fawwad,2 Shaista Ali Siddiqui,3,4 Kulsoom Baqa4 1Department of Medicine, Baqai Medical University, Baqai Institute of Diabetology and Endocrinology Karachi, Karachi, Pakistan; 2Department of Biochemistry, Baqai Medical University, Research Departments, Baqai Institute of Diabetology and Endocrinology Karachi, Karachi, Pakistan; 3Kaizen Management Consultancy, Sharjah, United Arab Emirates; 4Research Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University Karachi, Karachi, Pakistan Abstract: According to the recently published National Diabetes Survey of Pakistan (NDSP 2016–2017), the prevalence of diabetes is 26.3%. Hence, Pakistan has around 27.4 million people >20 years of age suffering with diabetes. Compared to previous estimation of having around 7 million diabetic patients based on a survey done in 1994–1998, the figures are disturbingly alarming. The four main strategies to tackle the rising incidence of diabetes in Pakistan are as follows: 1) creating multidisciplinary teams through capacity building of the health care professionals (HCPs), including doctors, dieticians, diabetes educators, diabetes foot assistants, and program managers in standardized evidence-based protocols, enhancing their knowledge and skills in managing diabetes and their related comorbidities; 2) promoting primary prevention and awareness all over Pakistan using screening methods such as Risk Assessment of Pakistani Individuals for Diabetes (RAPID); 3) defining strategies for the management and prevention of diabetes and its complication through forums such as the Pakistan Diabetes Leadership Forum (PDLF); and 4) implementing a nationwide diabetes care program including registration, treatment, and referral protocols. The epidemic of diabetes in an under-resourced and overburdened health care system of Pakistan poses a serious challenge not only for the doctors but also for the multiple stakeholders involved in the community systems. There is a need for promoting and screening the population using RAPID and registering people with diabetes through Diabetes Registry of Pakistan (DROP). Future priority areas and interventional strategies shall include the following: implementing a diabetes health care service model in both rural and urban population using evidence-based clinical guidelines along with lifestyle modifications (LSMs) and prevention policies. Current management strategies and proposed future directions may successfully target the increasing incidence of diabetes. Keywords: non-communicable diseases, primary prevention, health care service model, guidelines
