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Review
. 2018 Dec 27:12:85-96.
doi: 10.2147/DMSO.S141356. eCollection 2019.

Current management strategies to target the increasing incidence of diabetes within Pakistan

Abdul Basit  1 , Asher Fawwad  2 , Shaista Ali Siddiqui  3   4 , Kulsoom Baqa  4
Affiliations
Review

Current management strategies to target the increasing incidence of diabetes within Pakistan

Abdul Basit et al. Diabetes Metab Syndr Obes. .

Erratum in

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: guidelines; health care service model; non-communicable diseases; primary prevention.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
PROMPT guidelines for the management of T2DM. Abbreviations: DPP, Diabetes Prevention Program; PROMPT, Pakistan’s Recommendations for Optimal Management of Diabetes from Primary to Tertiary care level; T2DM, type 2 diabetes mellitus; TZDs, thiazolidinediones; FBS, fasting blood sugar.
Figure 2
Figure 2
BRIGHT recommendations of SMBG for different groups. Note: Adapted from Basit A, Khan A, Khan RA. BRIGHT Guidelines on Self-Monitoring of Blood Glucose. Pak J Med Sci. 2014;30(5):1150–1155. Abbreviations: BRIGHT, Better Recommendations, Implementation and Guideline development for Health care providers and their Training; SMBG, self-monitoring of blood glucose.
Figure 3
Figure 3
Service model for diabetes care.
Figure 4
Figure 4
Risk Assessment of Pakistani Individual for Diabetes.
Figure 5
Figure 5
Proposed service model to target rising incidence of diabetes in Pakistan. Abbreviations: MSPH, Master of Science in Public Health; NCDs, non-communicable diseases.
See this image and copyright information in PMC

References

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