35.3m adult population diabetic in country: survey

LAHORE
The Diabetes Prevalence Survey of Pakistan has revealed staggering 16.98 percent prevalence of diabetes as 35.3 million people among the adult population are found diabetic in Pakistan.
The latest data of 2017 belies the old figures of 6.56 percent of diabetes prevalence affecting just 7.6 million people in Pakistan, which is mentioned in the International Diabetes Federation 2017 Atlas, as diabetes prevalence also triplicates under the fresh survey conducted by Hayatabad Medical Complex, Peshawar, in collaboration with the Pakistan Endocrine Society and Institute of Public Health and Social Sciences, Khyber Medical College University, as well as the University of Manchester and University of Glasgow.
“One in every six persons is a diabetic in Pakistan as a whopping 9.04 percent of new diabetes mellitus (without knowing about their disease) were added to the fresh findings of the diabetes prevalence in Pakistan,” Prof AH Amir, consultant endocrinologist, Hayatabad Medical Complex, Peshawar, on Saturday unveiled the latest survey during his presentation on “Prevalence of Diabetes – Past, Present and Future; How are We Doing?” here at the PES-SAFES Summit 2017 titled “Together for Endocrinology”, organised by Pakistan Endocrinology Society – South Asian Federation of Endocrinology Societies (PES-SAFES), which is being held here at a local hotel.
Dr AH Amir informed that, based on census results of 2017 for adult population, approximately 21.9 million were suffering from diabetes mellitus (DM), which suggests ratio of 1:7 for diabetes prevalence among population aged 20 or above. Out of total prevalence in the latest survey, at least 17.85 percent female population is affected and 16.22 male populations is suffering from the disease.
He said that Diabetes Prevalence Survey of Pakistan (DPSP) was planned in February 2017 and started latest by April this year and completed in November 2017 despite one-month break during the holy month of Ramazan.
One lead epidemiologist headed three research teams having three members each to conduct the research. This scientific/medical survey was conducted upon a total of 18,856 eligible screened subjects out of initial sample size of 22,100 patients from among 378 clusters, 216 in the rural areas and 162 in the urban areas, across Pakistan. The male subjects included 10,100 (53 percent) and female subjects 8,756 (47 percent) from Sindh, Interior Sindh, Punjab, Southern Punjab, Balochistan, Khyber Pakhtunkhawa (central, southern and northern parts), Islamabad/Rawalpindi, Azad Jammu Kashmir-Gilgit Baltistan (AJK-GB) and Federally Administered Tribal Areas (FATA).
He explained the methods included multi-staged random cluster sampling as each cluster comprised 50 households with face-to-face interviews to collect basic demographic data. The Hb% test was conducted for eligibility after exclusion of all aneamic patients, which was followed by HbA1c performed, DCCT aligned, NGSP certified. Later, the nested sub-sample was tested with OGTT.
Breaking down the national figures of 16.98 percent diabetics, including 9.04 percent new diabetes mellitus (DM), AJK registered prevalence of 17.57pc of diabetics with 13.36 pc new DM; Interior Sindh recorded 14.01 pc diabetics with 8.46pc new DM; Islamabad registered 21.67pc diabetics with 10.94pc new DM; Karachi showed 16.16 pc diabetics with 10.56pc new DM,; FATA registered 23.53pc diabetics with 14.10pc new DM; Peshawar recorded 17.56pc diabetics with 6.59pc new DM; Lahore registered 15.30pc diabetics with 6.17pc new DM; Quetta showed 18.24pc diabetics with 12.94 pc new DM; South Punjab recorded 12.90pc diabetics with 7.41pc new DM; Northern KP registered 19.19pc diabetics with 9.90 pc new DM.
The samples were taken from the rural and urban areas of Karachi in Sindh (1052); districts of Sukkur, Larkana and Dadu in Interior Sindh (1249); Lahore district in Punjab (1052); districts of Multan, Bahawalpur and Rahimyar Khan in South Punjab (3938); Quetta district in Balochistan (850); districts of Karak and Haripur in Northern KP (5986); Peshawar in central KP (3081); Rawalpindi and Islamabad (946); Muzaffarabad in AJK-GB (498); districts of FR Peshawar and Khyber Agency in FATA (204).
Dr AH Amir revealed 10.91 percent prevalence of pre-diabetics with real-time figure of 22.6 million pre-diabetics in Pakistan, which suggested prevalence ratio of 1:7 for pre-diabetics in the country. However, based on census 2017, approximately 14.30 million people (10.94 percent female and 10.88 percent male) with a ratio of 1:9 were found to be pre-diabetics in the country.
While converting data from research to real-life situation, Dr AH Amir said that for every known three diabetics, there were another two undiagnosed diabetics as well as two pre-diabetics. With regard to data on obesity, Dr AH Amir said that, based on BMI and World Health Organisation (WHO) criteria of BMI 25, at least 31 percent of population is normal weight with BMI 25, 35 percent was overweight, 20 percent was obese class-1, 7 per cent was obese class-2 and 4 percent was obese class 3. Based on BMI WHO Asian criteria with BMI 23, at least 17 percent of population is normal weight with BMI 23, 29 percent is overweight, 31 percent is obese class-1, 13 percent is obese class-2 and 7 percent is obese class 3.
Dr AH Amir asserted that this was the largest research study on prevalence of diabetes ever conducted in Pakistan. He said that the country’s health budget and economics as well as personal health and economics had direct implications on these startling figures of diabetes prevalence in the country. He suggested the government and individuals allocate enough funding to look after its complications.