KARACHI, Nov 13: Pakistan, which is no more on the list of top 10 countries with the highest diabetic population, needs to enhance its prevention and control efforts to avert an increase in the level of diabetes and related complications in future, said senior physicians at a seminar held in connection with World Diabetes Day-2012 on Tuesday.
While Pakistan ranked seventh in the world with 7.1 million diabetic people in 2009 and the International Diabetes Federation (IDF) had predicted that the country would jump from seventh to fourth position by the year 2030, currently the country was not on the list of 10 countries, the health experts said.
But they feared that the country might fall again into this category if diabetes prevention and control efforts were not enhanced.
The National Institute of Diabetes and Endocrinology (NIDE), Dow University of Health Sciences (DUHS) as parts of its World Diabetes Day 2012 celebrations organised an awareness walk, public awareness seminar and a free diabetic camp at the Ojha campus of the university.
Focusing largely on the theme of the day celebrations, experts stressed the need for promotion and dissemination of education and preventive public messages inspiring and engaging the local communities as well as the government to recognise the importance of early awareness of the risk and danger of diabetes.
Prof M. Umer Farooq, pro-vice chancellor of the DUHS, said that World Diabetes Day was a call to all those who were responsible for diabetes care and could contribute to control it. There was need to encourage the government to implement and strengthen policies for the prevention and control of diabetes and its complications, he said, adding that it was also necessary to disseminate tools to support national and local initiatives for the prevention and management of diabetes and its complications.
NIDE Director Prof M. Zaman Shaikh observed that despite campaigns on diabetes, a number of patients suffered due to misconceptions about diabetes. Many patients and their families did not know how to administer an insulin injection, he remarked.
“Our campaigns should be aimed at raising awareness among the general public and those who are at the high risk of diabetes about the warning signals of the disease and promotion of actions encouraging early diagnosis of the disease.”
Prof Shaikh said it was estimated in 2009 that Pakistan ranked seventh in the world with respect to the diabetic population. At that time, the International Diabetes Federation (IDF) had also estimated that Pakistan would jump to fourth position by the year 2030, with an increased diabetic population of 13.8 million. However, he said, with the continuing efforts for creating public awareness about diabetes, its complications and precaution, at all levels of society, Pakistan at present didn’t fall in the category of top 10 counties with diabetic population. He said it was estimated that instead of the fourth position, Pakistan would fall on the 10th position in 2030 with an estimated diabetic population of 11.1 million.
At the same time, the NIDE director called for more integrated and vibrant efforts to ensure that the level attained over the past few years was maintained.
Pakistan was out of the list of the countries with highest diabetic population perhaps due to lapses of others or detection of more cases of diabetes in other countries, he observed.
According to him, the mean health expenditure on diabetes per year in Pakistan was only $24 per person in contrast to $55 in India, $33 in Afghanistan, $47 in Nigeria, $52 in Sudan and $571in Turkey.
Describing new modalities, Prof Shaikh discussed the concept of small insulin pumps with novel features. He said that marketing of such a tool could be programmed to deliver insulin based on individual’s lifestyle. He hoped that time was not far when the devices with the function of a pancreas would also be available to control blood sugar level in human bodies.
Highlighting new IDF guidelines, he said that oral hypoglycemic agents had been approved with some reservations for use in pregnancy as well.
Pakistan Diabetic Association General Secretary Prof Samad Shera said that insulin was a life-saving drug. Patients with Type 1 diabetes used insulin from day one of their diagnosis till the last day of their life, he said. Even in Type 2 of diabetes, he said, insulin was needed eventually because half of the patients required insulin after 10 year of oral drug use because of the progressive nature of the disease.
Regarding misconceptions about insulin therapy, Dr Shera said it was thought as the last stage of treatment, while practically it was the first stage of the management in diabetic patients. He also said that injecting in a proper way and at an appropriate place in the body was essential.
During an interactive discussion following the seminar, which was attended by a large number of people living with diabetes, postgraduate students and physicians, the common complications of diabetes like neuropathy, retinopathy (eye problems in diabetes) and cardiac (heart) complications were highlighted and the possible treatment options were discussed.