Mohiuddin Abdul Kader
Dr. M. Nasirullah Memorial Trust, Tejgaon, Dhaka, Bangladesh.
Cent Asian J Glob Health. 2020 May 26;9(1):e416. doi: 10.5195/cajgh.2020.416.
With the increasing burden of non-communicable diseases in low-income and middle-income countries (LMICs), biological risk factors, such as hyperglycemia, are a major public health concern in Bangladesh. Optimization of diabetes management by positive lifestyle changes is urgently required for prevention of comorbidities and complications, which in turn will reduce the cost. Diabetes had 2 times more days of inpatient treatment, 1.3 times more outpatient visits, and nearly 10 times more medications than non-diabetes patients, as reported by British Medical Journal. And surprisingly, 80% of people with this so called "Rich Man's Disease" live in low- and middle-income countries. According to a recent study of American Medical Association, China and India collectively are home of nearly 110 million diabetic patients. The prevalence of diabetes in this region is projected to increase by 71% by 2035. Bangladesh was ranked as the 8th highest diabetic populous country in the time period of 2010-2011. In Bangladesh, the estimated prevalence of diabetes among adults was 9.7% in 2011 and the number is projected to be 13.7 million by 2045. The cost of diabetes care is considerably high in Bangladesh, and it is primarily driven by the medicine and hospitalization costs. According to Bangladesh Bureau of Statistics, in 2017 the annual average cost per T2DM was $864.7, which is 52% of per capita GDP of Bangladesh and 9.8 times higher than the general health care cost. Medicine is the highest source of direct cost (around 85%) for patients without hospitalization. The private and public financing of diabetes treatment will be severely constrained in near future, representing a health threat for the Bangladeshi population.
随着低收入和中等收入国家（LMICs）非传染性疾病负担的日益加重，高血糖等生物风险因素成为孟加拉国主要的公共卫生问题。通过积极改变生活方式来优化糖尿病管理对于预防合并症和并发症至关重要，这反过来又会降低成本。据《英国医学杂志》报道，糖尿病患者的住院治疗天数是非糖尿病患者的2倍，门诊就诊次数是非糖尿病患者的1.3倍，用药量是非糖尿病患者的近10倍。令人惊讶的是，80%的这种所谓“富贵病”患者生活在低收入和中等收入国家。根据美国医学协会最近的一项研究，中国和印度合计有近1.1亿糖尿病患者。预计到2035年，该地区的糖尿病患病率将上升71%。在2010 - 2011年期间，孟加拉国被列为糖尿病人口第八多的国家。2011年，孟加拉国成年人中糖尿病的估计患病率为9.7%，预计到2045年这一数字将达到1370万。孟加拉国的糖尿病护理成本相当高，主要由药品和住院费用推动。根据孟加拉国统计局的数据，2017年每位2型糖尿病患者的年均成本为864.7美元，这是孟加拉国人均国内生产总值的52%，比一般医疗保健成本高出9.8倍。对于不住院的患者来说，药品是直接成本的最高来源（约85%）。糖尿病治疗的私人和公共资金在不久的将来将受到严重限制，这对孟加拉国人口构成了健康威胁。
