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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.
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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
Diabetes.
2.
Non Insulin
Dependent Diabetes
Mellitus ( NIDDM )
or Type
II
Diabetes.
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
DEPARTMENT OF COMMUNITY MEDICINE
LIAQUAT MEDICAL COLLEGE,
JAMSHORO
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