Diabetes:Epidemiology, Prevention & Control

Seema Daud

International diabetes Federation (IDF): 2012

Diabetes in Pakistan – Estimated for 2014

Number of Diabetic Patients 7.1 million

Number of deaths in adults due to diabetes 88,000

Male to Female ratio of diabetic deaths 1:1.5

Cost per person with diabetes (USD) 52.7 US $

Number of cases of diabetes in adults that are undiagnosed (1000s) 3,471.9

Type II Diabetes in age ≥ 30 years 10%

Sources: International diabetes Federation (IDF): 2014 Diabetes Association of Pakistan (DAP): 2014)

Sources:1. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. Jan 2010;87(1):4-14.2. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. May 2004;27(5):1047-1053.

Iceberg of Disease (Diabetes): 1:2Tip of the

Iceberg

(Diagnosed)

Submerged

Portion

(Undiagnosed,

Subclinical cases,

Carriers)

Public Health Importance of Diabetes

Predisposing (Risk) Factors of Diabetes

Family History

Increasing Age Gender

South Asian, Chinese, African, Caribbean, Hispanics

Diet

• Between 1990 and 2010 : 60+ years > by 75.1%. • Projected life expectancy: 72 years by 2023. • WHO report (1998) projected: 5.6% of Pakistan’s > over 60 years of age, with a probability of doubling to 11% by the year 2025.

High Depression & Stress (Hussain &Tomenson, 2000)

• Pakistan’s urban population:

38%• Pakistan is

urbanizing at an annual rate of

3-4% • By 2025 urban

population:

50%

Levels of Prevention

• Primordial

Early childhood (preventing risk factors)

Health promotion & lifestyle modifications• Primary

Before the onset of disease

Health promotion & lifestyle modifications• Secondary

Early diagnosis

Screening & management

Tertiary

Prevent complications & rehabilitation

Digest Carbohydrates quickly

Release energy quickly

Feel hungry soon

Eat more

Digest Carbohydrates slowly

Release energy slowly

Feel full longer

Eat eat

High Glycemic Index of Food Low