Basit Abdul, Fawwad Asher, Siddiqui Shaista Ali, Baqa Kulsoom
Department of Medicine, Baqai Medical University, Baqai Institute of Diabetology and Endocrinology Karachi, Karachi, Pakistan,
Department of Biochemistry, Baqai Medical University, Research Departments, Baqai Institute of Diabetology and Endocrinology Karachi, Karachi, Pakistan.
Diabetes Metab Syndr Obes. 2018 Dec 27;12:85-96. doi: 10.2147/DMSO.S141356. eCollection 2019.
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.
根据最近公布的《巴基斯坦全国糖尿病调查(2016 - 2017年)》,糖尿病患病率为26.3%。因此,巴基斯坦有大约2740万20岁以上的人患有糖尿病。与1994 - 1998年调查得出的此前估计约700万糖尿病患者相比,这些数字令人不安地惊人。应对巴基斯坦糖尿病发病率上升的四大主要策略如下:1)通过对医疗保健专业人员(HCPs)进行能力建设来组建多学科团队,这些人员包括医生、营养师、糖尿病教育工作者、糖尿病足护理助手以及按照标准化循证方案配备的项目经理,提高他们管理糖尿病及其相关合并症的知识和技能;2)在巴基斯坦全国利用诸如《巴基斯坦人糖尿病风险评估(RAPID)》等筛查方法促进一级预防和提高认识;3)通过诸如巴基斯坦糖尿病领导力论坛(PDLF)等论坛确定糖尿病及其并发症的管理和预防策略;4)实施一项全国性糖尿病护理计划,包括登记、治疗和转诊方案。在巴基斯坦资源不足且负担过重的医疗保健系统中,糖尿病流行不仅给医生带来严峻挑战,也给社区系统中的多个利益相关者带来挑战。有必要利用RAPID对人群进行推广和筛查,并通过巴基斯坦糖尿病登记处(DROP)对糖尿病患者进行登记。未来的优先领域和干预策略应包括以下方面:利用循证临床指南以及生活方式改变(LSMs)和预防政策,在农村和城市人口中实施糖尿病医疗服务模式。当前的管理策略和提议的未来方向可能成功应对糖尿病发病率不断上升的问题。