Diabetes prevention and control: National Action Plan for NCD Prevention, Control and Health Promotion in Pakistan.

More than 10% of the adult population in Pakistan suffers from diabetes. The National Action Plan for Non-communicable Disease Prevention, Control and Health Promotion in Pakistan (NAP-NCD) incorporates prevention and control of diabetes as part of a comprehensive and integrated national non-communicable disease (NCD) prevention effort. Building on existing data, the diabetes surveillance process has been integrated with a comprehensive population-based NCD surveillance system using waist circumference as a proxy indicator for the risk of diabetes in the short term; however, the surveillance strategy makes a case for future efforts to upgrade surveillance to allow a more comprehensive assessment incorporating biochemical assessments. The programme focuses on diabetes prevention by maximizing risk factor control as a common theme across the range of NCDs and lays emphasis on integrating prevention of'diabetes and intensified case finding in high-risk groups into health services as part of a comprehensive and sustainable, scientifically valid, culturally appropriate and resource-sensitive Continued Medical Education (CME) programme for all categories of healthcare providers. The programme also focuses on ensuring availability of anti-diabetics (insulin, sulphonylureas, metformin) at all levels of healthcare. Building capacity in the health system and coalitions in support of diabetes prevention has also been regarded as being critical.