Diabetes prevention and management in South Asia: A call for action, Pramod R. Regmi, Om Kurmi, Nirmal Aryal, Puspa R. Paut, Amrit Banstola, Folashade Alloh and Edwin Van Teijlingen
Pramod R. Regmi
Research Fellow, Faculty of Health and Social Sciences, Bournemouth University, UK;
Visiting Research Fellow, Chitwan Medical College, Tribhuvan University, Nepal
Nuffield Department of Population Health, University of Oxford, UK
Department of Medicine, University of Otago, New Zealand
Puspa Raj Pant
Centre for Child and Adolescent Health, the University of the West of England, UK
Faculty of Health and Applied Sciences, the University of the West of England, UK;
Department of Research and Training, Public Health Perspective Nepal, Nepal
Faculty of Health and Social Sciences, Bournemouth University, UK
Edwin Van Teijlingen
Centre for Midwifery, Maternal and Perinatal Health, Bournemouth University, UK;
Manmohan Memorial Institute of Health Sciences, Tribhuvan University, Nepal;
Nobel College, Pokhara University, Nepal
Background: Globally, the number of people living with Diabetes Mellitus (DM) has increased four-fold since 1980. South Asia houses one-fifth of the world’s population living with diabetes, and it was the 8th leading cause of deaths in 2013 for South Asians.
Aim: To review and discuss the context of diabetes in South Asia, with a particular focus on, a) contributing factors and impact; b) national health policies around non-communicable diseases in the region, and c) to offer recommendations for prevention and management of diabetes.
Method: We assessed relevant publications using PubMed, Scopus and OvidSP. Similarly, the World health Organization (WHO) and relevant ministries of each South Asian country were searched for reports and policy documents.
Results: Emerging evidence supports that the prevalence of diabetes (ranging from 3.3% in Nepal up to 8.7% in India) in South Asia follows the global trend over the past decades. Urban populations in the region demonstrate a higher prevalence of diabetes, although is also a public health concern for rural areas. Changes in the pattern and types of diet, together with increasingly sedentary, lifestyles are major causes of diabetes. The overall agenda of health promotion to prevent diabetes has not yet been established in the region, and the majority of the countries in the region are inadequately prepared for the therapeutic services for diabetes.
Conclusions: The early onset of the diabetes, longevity of morbidity and early mortality may have a significant impact on people’s health expenditure and health systems, as well as on the region’s demographic composition. There is an urgent need to reduce the prevalence of diabetes in the region through evidence-based interventions ranging from prevention and early detection to appropriate treatment and care. We suggest that a multi-sectorial collaboration across all stakeholders is necessary to raise awareness about diabetes, its prevention, treatment and care in the region.
Keywords: Diabetes Mellitus; South Asia; Low and Middle Income Countries; Non-Communicable Diseases