Islamabad : A worrying 27.4 million Pakistanis or 1 in every 4 persons aged 20 years and above are suffering from diabetes. The figure represents a massive three-fold increase in the number of diabetics—from 8.7% in 1994-98 to 26.3% in 2016-17, reveals the second National Diabetes Survey of Pakistan (NDSP) 2016-17.
Titled ‘Diabetes – A Growing National Crisis,’ the survey was launched Wednesday at a ceremony that had Minister for National Health Services Muhammad Yusuf Shaikh as the chief guest. The survey is a joint initiative of the Pakistan Health Research Council, together with the Diabetic Association of Pakistan, and Baqai Institute of Diabetology and Endocrinology, and has been conducted under the aegis of the Ministry of Health.
A population-based survey of adults aged 20 years and above, NDSP 2016-17 has been carried out to determine the prevalence of diabetes, hypertension, obesity, and dyslipidemia in the urban and rural populations of four provinces in Pakistan. A total of 10,834 adults participated in the survey; one-third (30.2%) had positive family history of diabetes, 14.5% were tobacco users, 43.9% were males and 56.1% were females. The data was weighted to give a representative figure for the country, and the burden was calculated using recent census findings 2017.
According to the findings, 14.4 million people (14.2%) in Pakistan are overweight, 44.6 million (43.9%) are obese, and 47 million (46.2%) are hypertensive. Most obese persons are aged between 40-49 years. Around half the population (46.2%) has hypertension; its prevalence increases with age and is highest (65.7%) in the 60 years or above age bracket. There is also an increasing trend of younger people developing diabetes as according to the survey, 30% youngsters aged between 20-39 years have diabetes.
The survey indicates a slightly high prevalence of diabetes in urban (28.3%) compared to rural areas (25.3%). Similarly, overall glycemic dysregulation (diabetes, pre-diabetes) is also prevalent more in urban (43.8%) than rural areas (39.2%). Overall prevalence of normal glucose tolerance is 60% and of newly-diagnosed diabetes is 7.1%, with slightly more preponderance in men than women aged 50 years and above. Diabetes prevalence is highest in Sindh (32.3), followed by Punjab (30.2%), Balochistan (29.55), and KPK (13.2%). However, prevalence of pre-diabetes and newly-diagnosed diabetes is higher in Balochistan as compared to the other three provinces.
Urban women have significantly higher prevalence of diabetes than rural women above the age of 40 years. On the other hand, urban men in the 30-39 age group have shown significantly lower prevalence of diabetes than rural men. Age, family history of diabetes, hypertension, obesity and dyslipidemia are the most significant risk factors for diabetes.
Overall, 60.7% of the population has normal while 39.3% has raised cholesterol levels. High triglycerides have been seen in 51.5% of the respondents. Majority of the population has low values of high density lipoprotein (83.5% men, 90% women).
In suggesting measures for prevention and control of diabetes, the survey calls for a massive public awareness campaign involving the print and electronic media, as well as community elders and religious leaders; promotion of physical activity in schools and colleges with the involvement of education departments; inclusion of information on the risk factors and prevention of diabase in the curriculum; effective population level interventions that encourage intake of fruits and vegetables and avoidance of junk food; training of health care providers on diagnosis and treatment of diabetes; and the preparation of a National Action Plan for control of the deadly disease.
Speaking at the survey’s launching, Muhammad Yusuf Shaikh termed the findings of the survey “very worrying;” yet, he was convinced that despite the grim figures, “we have the knowledge and expertise today to create conditions which can considerably reduce the onset of diabetes for the next generation. This can be achieved by increasing awareness on the importance of a healthy diet and regular physical activity for everyone.”
Secretary Health Zahid Saeed lamented that a majority of the population of Pakistan consumes unhealthy diet, and due to urbanization and availability of easy transport, people are becoming more and more inactive. He said, taking a life course perspective is essential for preventing diabetes.
Earlier, the Executive Director of PHRC Muhammad Ali Shahzada dwelt at length on the importance of the survey and presented highlights of the diabetes situation, globally and in Pakistan. Globally, about 2.9 million people have diabetes, and the burden is expected to rise to 628.6 million by 2045.