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Type 2 Diabetes In Developing Countries

Diabetes Mellitus In Developing Countries And Case Series

Diabetes Mellitus In Developing Countries And Case Series

1. Introduction Diabetes mellitus is a growing public health affecting people worldwide both in developing and developed countries, and poses a major socio-economic challenge [1], [2]. A chronic metabolic disorder of multiple aetiologies is assuming epidemic proportions worldwide [3]. It is also a complex disorder with profound consequences both acute and chronic. Genetic and environmental factors play a role in the development of the disease [4]. The cells of the body cannot metabolise sugar properly due to a total or relative lack of insulin. The body then breaks down its own fat, protein, and glycogen to produce sugar resulting in high sugar levels in the blood with excess by products called ketones being produced by the liver [5]. Diabetes causes disease in many organ systems, the severity of which may be related to how long the disease has been present and how well it has been controlled. The term diabetes mellitus describes a metabolic disorder of multiple aetiology characterised by chronic hyperglycaemia with disturbances of carbohydrate, fat, and protein metabolism resulting from defects in insulin secretion, insulin action or both [6],[7],[8],[9]. Diabetes mellitus may present with characteristic symptoms such as thirst, polyuria, blurring of vision and weight loss [6]. The abnormalities of carbohydrate, fat, and protein metabolism are due to deficient action of insulin on target tissues resulting from insensitivity or lack of insulin [6]. The effects of diabetes mellitus include long-term damage, dysfunction, and failure of various organs[6]. Type 1 diabetes mellitus encompasses the majority of diabetes, which are primarily due to pancreatic islet beta cell destruction and are prone to ketoacidosis [9]. If diabetes is not taken care of, complications such as h Continue reading >>

Prevalence Of The Complications Of Diabetes In Developing Countries

Prevalence Of The Complications Of Diabetes In Developing Countries

Sarpong C, Nsiah K, Mensah F. O, Agyeman-Duah E*, Ahmed F. D Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi-Ghana. *Corresponding Author: Agyeman-Duah E, Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi-Ghana, E-mail: [email protected] Abstract: Diabetes mellitus is a medical condition which arises when there is an uncontrollably high level of glucose in the blood. It is a carbohydrate metabolism disorder which also affects protein and fatty acid metabolisms. Several complications result from diabetes as a result of poor glycemic control. This project aimed at determining the various complications developed by diabetics who visited the Diabetics Clinic of the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana, from January to December, 2013. It involved 475 diabetes with an age range of 11 to 100 years with modal age range being greater than 60 years (56.8%) and a mean age of 63.8 ± 3.2 years. It comprised of 45.7% males and 54.3% females. The predominant diabetes type was type 2 (affecting 269 patients) followed by unclassified diabetes type (affecting 188 patients) and then type 1 diabetes (also affecting 18 patients). Complications were found in 365 (76.8%) patients with most of these complications occurring in females who were above 40 years. The most prevalent complication was hypoglycemia, which affected 180 patients (37.9%). Peripheral circulatory complication affected 18 patients (3.8%), renal complication affected 123 patients (25.9%) and ketoacidosis also affected 42 patients (8.8%) whilst two patients (0.4%) suffered multiple complications. These complications caused 57 deaths (12%) and these deaths wer Continue reading >>

Prevention Of Type 2 Diabetes And Its Complications In Developing Countries: A Review

Prevention Of Type 2 Diabetes And Its Complications In Developing Countries: A Review

Abstract Type 2 diabetes mellitus (T2DM) is a significant global public health problem affecting more than 285 million people worldwide. Over 70% of those with T2DM live in developing countries, and this proportion is increasing annually. Evidence suggests that lifestyle and other nonpharmacological interventions can delay and even prevent the development of T2DM and its complications; however, to date, programs that have been specifically adapted to the needs and circumstances of developing countries have not been well developed or evaluated. The purpose of this article is to review published studies that evaluate lifestyle and other non-pharmacological interventions aimed at preventing T2DM and its complications in developing countries. We undertook an electronic search of MEDLINE, PubMed, and EMBASE with the English language restriction and published until 30 September 2009. Nine relevant publications from seven studies were identified. The reported interventions predominantly used counseling and educational methods to improve diet and physical activity levels. Each intervention was found to be effective in reducing the risk of developing T2DM in people with impaired glucose tolerance, and improving glycemic control in people with T2DM. The current evidence concerning the prevention of T2DM and its complications in developing countries has shown reasonably consistent and positive results; however, the small number of studies creates some significant limitations. More research is needed to evaluate the benefits of low-cost screening tools, as well as the efficacy, cost-effectiveness, and sustainability of culturally appropriate interventions in such countries. Notes The authors wish to thank those International Public Health Unit staff located at the School of Public Continue reading >>

Primary Prevention Of Type 2 Diabetes: An Imperative For Developing Countries

Primary Prevention Of Type 2 Diabetes: An Imperative For Developing Countries

The global prevalence of diabetes currently exceeds 400 million and is projected to increase to more than 600 million affected persons by the year 2035. Developing countries will account for the greater proportion of the projected increase in diabetes prevalence. Indeed, if current trends remain unabated, people with diabetes in developing countries will comprise >70 % of the global diabetes burden by the year 2035. Diabetes is now the leading cause of blindness, end-stage renal failure, nontraumatic limb amputations, heart disease, and stroke. These expensive complications inflict a major drain on the economies of even upper-income countries; indeed, most developing countries lack the resources for tackling the challenges of diabetes care delivery and effective management of its complications. There is now abundant evidence that type 2 diabetes (which accounts for greater than 90 % of diabetes worldwide) can be prevented: the challenge is how best to translate the results of clinical trials globally to communities with disparate resources and capabilities. This chapter makes the compelling case for primary prevention of diabetes as an imperative for developing countries and discusses how that can be accomplished, including the novel concept Community Diabetes Prevention Centers. Title of host publication Diabetes Mellitus in Developing Countries and Underserved Communities Continue reading >>

Childhood Diabetes Mellitus And The Double Burden Of Malnutrition: An Emerging Public Health Challenge In Developing Countries

Childhood Diabetes Mellitus And The Double Burden Of Malnutrition: An Emerging Public Health Challenge In Developing Countries

College of Medicine, University of Nigeria Nsukka and Honorary Consultant Pediatrician, University of Nigeria Teaching Hospital Enugu, Nigeria Citation: Uwaezuoke SN (2015) Childhood Diabetes Mellitus and the ‘Double Burden of Malnutrition’: An Emerging Public Health Challenge in Developing Countries. J Diabetes Metab 6:597. doi:10.4172/2155-6156.1000597 Copyright: © 2015, Uwaezuoke SN. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Journal of Diabetes & Metabolism Abstract The ‘double burden of malnutrition’ refers to the simultaneous existence of both undernutrition and overnutrition in the same population across the life course. Diabetes mellitus (DM) - a major non-communicable disease - has been linked to both chronic undernutrition and obesity; the latter is now assuming prominence in developing countries. The present review aims to highlight the global burden of this non-communicable disease in children and its relationship with the ‘double burden of malnutrition’. Type 2 DM has rapidly evolved from a disease of the Western world to a global disease; from a disease of affluence to a disease that now afflicts the poor; and from an adult-onset disease to a disease that is gaining prominence in the pediatric population. Estimates from the International Diabetes Federation show that diabetes affects at least 285 million people worldwide out of which two-thirds occur in developing (low-to middle-income) countries. The global epicenter of diabetes epidemic is located in China and India as Asia has undergone rapid economic development, ur Continue reading >>

Diabetes, Obesity A Growing Problem In Developing World

Diabetes, Obesity A Growing Problem In Developing World

The obesity and diabetes epidemic is spreading to parts of the world where historically the problem has been less pronounced, a new study finds, and it is linked to increased TV, car and computer ownership. The study, published in the Canadian Medical Association Journal, looked at obesity and Type 2 diabetes in households in "low income" countries, like Bangladesh, Zimbabwe, Pakistan and India; "middle income" countries, like Argentina and China; and "high income" countries, like Canada and Sweden. Participants were asked if they owned a car, a TV or a computer. They were also asked about their diets and level of physical activity, and their measurements and weight were recorded. More than 100,000 households participated. What the study found was that as households in the lower income countries added televisions, cars and other modern conveniences, obesity rates more than quadrupled, and rates of Type 2 diabetes more than doubled. In the higher income countries, the difference was only marginal, presumably, the researchers said, because the negative impact from the modern day devices had already occurred. Continue reading >>

The Face Of Type 1 Diabetes In Developing Countries

The Face Of Type 1 Diabetes In Developing Countries

WRITTEN BY: Dr. Graham Ogle Meet Tazul, a young man from Bangladesh. He is 23 years old, and grew up in Gopalganj, a district on the bank of the Modhumoti River. Gopalganj is located in the southwest region of the country and can be considered a lower-income district. A quarter of the population live below the national poverty line of $2 per day, and child malnutrition rates are currently at 48 percent. Tazul is like any other 23–year-old, except for one significant difference. When Tazul was 17, he was diagnosed with Type 1 diabetes, a condition that is manageable with the appropriate medical and psychological support. However, like many other children in the area, Tazul came from a poor background, which meant that he did not have access to the resources needed to treat his condition. As a less-resourced country, Bangladesh does not have the infrastructure and resource networks to fully support, educate and manage Type 1 diabetes. Diabetes is a lifelong condition and the essential insulin and additional supplies required can represent a significant proportion of the family’s income. Since many people in developing countries live below the poverty line, countless children are not able to access optimal care, and may face a considerably shortened lifespan. In larger cities, a child living with Type 1 diabetes has a life expectancy of around 20 years, but in more rural parts of Africa, it’s less than one year. Growing up with diabetes, children also face debilitating complications. Social stigma and subsequent depression may affect job options and marriage prospects. Type 1 diabetes is a constant and unrelenting condition. Balancing regular blood glucose testing, multiple daily injections of insulin, healthy food choices and physical activity can be very demanding. Continue reading >>

Primary Prevention Of Type 2 Diabetes: An Imperative For Developing Countries

Primary Prevention Of Type 2 Diabetes: An Imperative For Developing Countries

Abstract The global prevalence of diabetes currently exceeds 400 million and is projected to increase to more than 600 million affected persons by the year 2035. Developing countries will account for the greater proportion of the projected increase in diabetes prevalence. Indeed, if current trends remain unabated, people with diabetes in developing countries will comprise >70 % of the global diabetes burden by the year 2035. Diabetes is now the leading cause of blindness, end-stage renal failure, nontraumatic limb amputations, heart disease, and stroke. These expensive complications inflict a major drain on the economies of even upper-income countries; indeed, most developing countries lack the resources for tackling the challenges of diabetes care delivery and effective management of its complications. There is now abundant evidence that type 2 diabetes (which accounts for greater than 90 % of diabetes worldwide) can be prevented: the challenge is how best to translate the results of clinical trials globally to communities with disparate resources and capabilities. This chapter makes the compelling case for primary prevention of diabetes as an imperative for developing countries and discusses how that can be accomplished, including the novel concept Community Diabetes Prevention Centers. Continue reading >>

Diabetes Prevention And Control Programs In Developing Countries

Diabetes Prevention And Control Programs In Developing Countries

DOI:10.1093/acprof:oso/9780195317060.003.0026 This chapter discusses diabetes prevention and control in developing countries. Diabetes is a major health care burden in both developed and developing countries. There is evidence from well-planned, randomized, controlled prevention programs that primary prevention of type 2 diabetes is possible in developing countries. Lifestyle modification and metformin have been shown to be highly effective in reducing incident diabetes in high-risk groups. With the help of the American Diabetes Association, the International Diabetes Federation, the World Health Organization, and similar organizations, national diabetes control programs have been initiated even in several developing nations. Oxford Scholarship Online requires a subscription or purchase to access the full text of books within the service. Public users can however freely search the site and view the abstracts and keywords for each book and chapter. Please, subscribe or login to access full text content. If you think you should have access to this title, please contact your librarian. To troubleshoot, please check our FAQs , and if you can't find the answer there, please contact us . DOI:10.1093/acprof:oso/9780195317060.003.0013 This chapter summarizes the changes in diabetes mortality for the entire population and among persons with diabetes. It examines sociodemographic differences in deaths from diabetes and the contribution of diabetes to other causes of death. Factors that are related to mortality, especially modifiable factors, are discussed. Measurement issues, such as factors associated with diabetes when diabetes is listed as the underlying rather than a related cause of death on death certificates, are also discussed. Oxford Scholarship Online requires a subscri Continue reading >>

The Mysteries Of Type 2 Diabetes In Developing Countries

The Mysteries Of Type 2 Diabetes In Developing Countries

More research is needed in low- and middle-income countries where the epidemic of type 2 diabetes is on the rise. KM Venkat Narayan talks to Fiona Fleck. KM Venkat Narayan is one of the world’s leading researchers on type 2 diabetes. He directs the Emory Global Diabetes Research Center. Prior to joining Emory University in 2006, he spent 10 years at the United States Centers for Disease Control and Prevention, leading the science efforts in his role as Chief of the Diabetes Epidemiology Section and later the Epidemiology and Statistics Branch. Narayan worked on the first diet-exercise intervention study as part of the Pima Indian Study of diabetes at the National Institute of Diabetes and Digestive and Kidney Diseases from 1992 to 1996, where he helped to develop the Diabetes Prevention Program (DPP). Before that, he worked in India, the United Arab Emirates and the United Kingdom of Great Britain and Northern Ireland as a tenured public health physician. He graduated in medicine in 1980 from St John's Medical College, Bangalore, India and subsequently qualified in geriatric medicine, public health and management. He is a member of several international and national committees on type 2 diabetes and other noncommunicable diseases. In 2015 he won the American Diabetes Association’s Kelly West Award for outstanding achievement in epidemiology and is the Danish Diabetes Academy visiting professor at the University of Copenhagen. Bulletin of the World Health Organization 2016;94:241-242. doi: Q: How did you become interested in type 2 diabetes research? A: When I was a physician and public health person working largely on cardiovascular diseases (CVD) in the early 1990s, a leading cause of death in Scotland at the time, I was invited to join a study of people with type Continue reading >>

Depression And Type 2 Diabetes In Developed And Developing Countries

Depression And Type 2 Diabetes In Developed And Developing Countries

Sir, Diabetes patients are more exposed to depression. This association might yield higher rates of mortality, morbidity and costs of health-care.[1] The world evaluation of depression prevalence in diabetes patients seems to vary according to the prosperity and health-care system of each country.[2] Hence, what are the factors of impact on the gap of depression rate within type 2 diabetes (T2D) in developing and developed countries? What are the care possibilities to reduce the depression rate in developing countries compared with developed countries? To answer this question, we achieved a transversal study in the University Hospital of Fez, Morocco. The study included 142 T2D patients. The average age of patients was 56.68-year-old, without significant difference in gender ration. The depression prevalence in our patients was 33.1%. Factors connected to the depression of MoroccanT2D are summarized in Table 1. The prevalence of T2D was significantly higher compared with the general population. It varies between 12% and 44%. Indeed, the prevalence of T2D is lower in western countries; it is elevated in developing countries.[3,4] The literature review revealed that depression of T2D patients is mostly associated to unchangeable factors such as the duration of evolution and arterial hypertension, which are common factors in developed and developing countries.[3] Besides, depression of T2D patients is strongly connected the low educational level of patients, a lack of social security. These two factors are dominant in developing countries.[5] Indeed, in developing countries factors such as lack of social, lower educational level, strong poverty level and resources and financial difficulties constitute the economical outline of stress responsible for insecurity feeling towa Continue reading >>

Prevention Of Type 2 Diabetes And Its Complications In Developing Countries: A Review.

Prevention Of Type 2 Diabetes And Its Complications In Developing Countries: A Review.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a significant global public health problem affecting more than 285 million people worldwide. Over 70% of those with T2DM live in developing countries, and this proportion is increasing annually. Evidence suggests that lifestyle and other nonpharmacological interventions can delay and even prevent the development of T2DM and its complications; however, to date, programs that have been specifically adapted to the needs and circumstances of developing countries have not been well developed or evaluated. PURPOSE: The purpose of this article is to review published studies that evaluate lifestyle and other non-pharmacological interventions aimed at preventing T2DM and its complications in developing countries. METHODS: We undertook an electronic search of MEDLINE, PubMed, and EMBASE with the English language restriction and published until 30 September 2009. RESULTS: Nine relevant publications from seven studies were identified. The reported interventions predominantly used counseling and educational methods to improve diet and physical activity levels. Each intervention was found to be effective in reducing the risk of developing T2DM in people with impaired glucose tolerance, and improving glycemic control in people with T2DM. CONCLUSIONS: The current evidence concerning the prevention of T2DM and its complications in developing countries has shown reasonably consistent and positive results; however, the small number of studies creates some significant limitations. More research is needed to evaluate the benefits of low-cost screening tools, as well as the efficacy, cost-effectiveness, and sustainability of culturally appropriate interventions in such countries. More Information Divisions: Faculty of Health and Social Sciences Continue reading >>

Type 2 Diabetes Screening & Treatment

Type 2 Diabetes Screening & Treatment

Countries across PSI’s global network are implementing programs aimed to increase awareness, detection and management of Type 2 diabetes among populations at greatest risk. Type 2 diabetes is the most common form of the disease. It currently affects over 415 million people worldwide, with 80% of cases in low- and middle-income countries. The International Diabetes Federation estimates that over 65 million men and women in India alone are living with Type 2 diabetes. Almost half of the cases of diabetes worldwide (46%) remain undiagnosed. When left untreated, Type 2 diabetes can lead to serious health problems, including heart attacks, strokes, kidney disease, blindness, amputation of extremities, and death. Often, diabetes increases risk for development of other serious conditions, such as cardiovascular disease and tuberculosis. Certain medications, including some used for people living with HIV, have also been shown to increase risk of development of Type 2 diabetes. Maintaining blood glucose, blood pressure and cholesterol at – or close to – normal levels can delay or prevent diabetes complications. For these reasons, people with diabetes need regular monitoring. Active and effective participation of people with diabetes in the control and treatment of their disease is an essential component of good diabetes care. Given the large number of undiagnosed diabetes, PSI programs strive to provide relevant information on the importance of diabetes prevention and control for the general population, as well as those at high risk for disease. We also work to ensure that providers are trained to offer their patients relevant tools and resources and knowledge to make informed choices and improve health. Continue reading >>

An Economic Evaluation Of Physical Activity In The Management Of Type 2 Diabetes In Developing Countries

An Economic Evaluation Of Physical Activity In The Management Of Type 2 Diabetes In Developing Countries

An economic evaluation of physical activity in the management of type 2 diabetes in developing countries In Sub-Saharan Africa, the rapid increase in the prevalence of diabetes has resulted in significant public health and socioeconomic liability in the face of scarce resources. Faced with a growing pandemic of non-communicable diseases, developing countries need to be proactive in investigating alternative cost-effective interventions, with the primary aim being to minimize illness and maximize health benefits relative to the limited available resources. The aim of this research study was to quantify the economic impact of an exercise intervention as a preventative strategy for type 2 diabetes in a developing country. The research also sought to investigate if there was an economic case for physical activity as a primary and secondary preventative measure in the management of non-communicable diseases. The study was quantitative in nature and used both primary and secondary data to conduct the cost analysis. A questionnaire was administered to 40 patients at a diabetic clinic in a peri-urban community health care centre. Secondary data, consisting of clinic records and an extensive literature review, was used to source the remaining inputs needed for the cost analysis. Results revealed that the implementation costs of a physical activity intervention exceeded the costs of a pharmaceutical programme. Physical activity resulted in decreased productivity loss, with significant economic implications at a household level. Evidence reviewed in the literature suggested that physical activity could be used in primary prevention as a viable substitute to pharmaceutical therapy. For secondary disease prevention, however, physical activity was complementary in the production of h Continue reading >>

Diabetes

Diabetes

Key facts The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014 (1). The global prevalence of diabetes* among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 2014 (1). Diabetes prevalence has been rising more rapidly in middle- and low-income countries. Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation. In 2015, an estimated 1.6 million deaths were directly caused by diabetes. Another 2.2 million deaths were attributable to high blood glucose in 2012**. Almost half of all deaths attributable to high blood glucose occur before the age of 70 years. WHO projects that diabetes will be the seventh leading cause of death in 2030 (1). Healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use are ways to prevent or delay the onset of type 2 diabetes. Diabetes can be treated and its consequences avoided or delayed with diet, physical activity, medication and regular screening and treatment for complications. What is diabetes? Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar. Hyperglycaemia, or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body's systems, especially the nerves and blood vessels. In 2014, 8.5% of adults aged 18 years and older had diabetes. In 2015, diabetes was the direct cause of 1.6 million deaths and in 2012 high blood glucose was the cause of another 2.2 million deaths. Type 1 diabetes Type 1 diabetes (previously known as insulin-dependent, juvenile or childhood-onset) is charact Continue reading >>

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