We have to appreciate the fact that Diabetes Mellitus is a condition causing 25 times more blindness ; it is a condition causing
Nephropathy ending up in Kidney failure; Neuropathy causing numbness, wounds & amputations and Heart Attacks & Strokes which occur 4 – 5 times more frequently.
For obvious reasons then this metabolic disorder places a great burden on the Individual, on society and on Health Services. It, therefore, becomes important to know the Incidence and prevalence of such a devastating disease.
The incidence of Diabetes globally, as well as in our country is different for different types of Diabetes Mellitus namely:
1. Insulin Dependent Diabetes Mellitus ( IDDM ) or Type I
2. Non Insulin Dependent Diabetes Mellitus ( NIDDM ) or Type II
In addition, there is a clear third group of population with Impaired Glucose Tolerance ( IGT ). Number of patients suffering from Diabetes is increasing all over the globe. There are currently an estimated 143 Million people with Diabetes worldwide. The figure is projected to rise to 300 Million by the year 2025.
In Pakistan Insulin Dependent Diabetes Mellitus ( IDDM ) constitutes less than 2 % of total Diabetic population. The other 98 % suffer from Type II Diabetes.
A National Diabetic Prevalence Survey was initiated by the Diabetic Association of Pakistan, Karachi, in collaboration with WHO in 1994 and completed in 1998. According to this survey the prevalence of Type II Diabetes is about 12 % and Impaired Glucose Tolerance ( IGT ) Is around 10 % among the general population aged 25 years and above.
With reference to its distribution in various parts of the country:
In Rural Sindh: Prevalence is 13.9 % for Diabetes and 11.2 % for IGT.
In Urban Sindh: This is higher at 16.5 % for Type II Diabetes and 10.4 % for IGT.
In Balochistan Rural: Diabetes appears to be low at 7.5 % for Diabetes, as well as, IGT.
In Balochistan Urban: Again incidence as compared to rural is higher that is 10.8 % for Diabetes and 10.4 % for IGT.
In NWFP: Figures are available for Rural only, which is 12 % prevalence of Type II Diabetes and 9.4 % of IGT.
Similarly in Punjab while Rural prevalence is 6.23 % for Diabetes and 5.63 % for IGT. Figure is higher in Urban being 13.68 % for Diabetes and 10.32 % for IGT.
Comparing various age groups: Type II Diabetes occurs relatively early in our population as compared to Europeans. In Europeans it occurs usually above the age of 40 years, where as the onset of Diabetes in our population occurs in 15 – 18 % of people under 40.
Similarly if we compare the prevalence in Male and Female:
The prevalence rate of Type II and IGT increase with advancing age in both sexes, reaching a peak of 55 – 64 years in Men and 65 – 74 years in Women. This is probably because women live longer than men.
Type I or Insulin Dependent Diabetes Mellitus ( IDDM ) continues to be a rare disorder in Pakistan, a recent study in Karachi showed the incidence of Type I Diabetes of 100,000. people / year to be 1.01 for males and 1.04 for females.
Diabetes is also frequent in pregnancy. A study was carried out from 1986 to 1993 at antenatal clinic of Civil Hospital Karachi & this revealed that of the 12877 females attending an antenatal clinic showed 14.7 % , with risk factors, to have Diabetes Mellitus.
To sum up: In the global human population of 06 Billion, every 4th person is diabetic and by the year 2025, every 2nd person is expected to suffer from Diabetes. Pakistan today, has 8th highest number of Diabetes. Though not a cause for scare, It certainly is a food for thought.
PRESENTED BY: MUHAMMAD ILYAS SIDDIQUI
NEW FINAL YEAR M.B.B.S STUDENT (2001)
DEPARTMENT OF COMMUNITY MEDICINE
LIAQUAT MEDICAL COLLEGE, JAMSHORO