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World Diabetes Day and the Scenario of Diabetes in Bangladesh

World Diabetes Day holds every year on November 14, initially crafted in 1991 by the International Diabetes Foundation and the World Health Organization. Diabetes is a chronic disease where the pancreas doesn’t produce enough insulin if any at all. It also leads to serious health conditions and, in many ways, can be preventable. That’s why this day is to spread awareness and education.

Diabetes is the common name for a range of conditions including diabetes mellitus type one and diabetes mellitus type two, diabetes insipidus and gestational diabetes. These are all conditions, which affect how the pancreas (an organ in the digestive system) secretes insulin or how the body reacts to this hormone. Depending on the type and severity, diabetes is controlled by dietary measures, weight loss, oral medication or injected or inhaled insulin. There is a wide range of short and long-term complications of diabetes including foot and eye problems and vascular diseases. It is estimated that one in three residents of the United States will develop diabetes at some point in their life.

There are three main types of diabetes – type 1, type 2 and gestational.

  • Type 1 diabetes can develop at any age but occurs most frequently in children and adolescents. When you have type 1 diabetes, your body produces very little or no insulin, which means that you need daily insulin injections to maintain blood glucose levels under control.

  • Type 2 diabetes is more common in adults and accounts for around 90% of all diabetes cases. When you have type 2 diabetes, your body does not make good use of the insulin that it produces. The cornerstone of type 2 diabetes treatment is a healthy lifestyle, including increased physical activity and a healthy diet. However, over time most people with type 2 diabetes will require oral drugs and/or insulin to keep their blood glucose levels under control.

  • Gestational diabetes (GDM) is a type of diabetes that consists of high blood glucose during pregnancy and is associated with complications to both mother and child. GDM usually disappears after pregnancy but women affected and their children are at increased risk of developing type 2 diabetes later in life.

Some 80-lakh people in Bangladesh suffer from diabetes. It causes 6.4 percent of total deaths in the country. A survey by the Bangabandhu Sheikh Mujib Medical University (BSMMU) on 2,000 adults in Dhaka slums in 2016 found 19 percent of adults (15.6 percent men and 22.5 percent women) had diabetes.

At least 22.6 percent of babies in Bangladesh are born with low birth weight (below 2.5kg), according to the National Low Birth Weight Survey Bangladesh 2015. Low birth weight is linked to child marriage and malnutrition of mothers, it is suggested that ensuring mothers' nutrition during pregnancy can play a major role in preventing diabetes.

Another major factor is unplanned urbanization in the cities where people have very limited scope for physical activities. Even in the rural areas people now take rickshaw vans or other rides to go to marketplaces.

According to a study by icddr,b in 2016, diabetes patients had two times more days of inpatient treatment, 1.3 times more outpatient visits and 9.7 times more medications than those who don't have diabetes. The study found that annual per-capita expenditure on medical care was 6.1 times higher for diabetic patients than non-diabetic ones (USD 635 vs USD 104 respectively).

People from low-income groups who cannot buy insulin have only one option: death unless insulin is made available to them through charity. The government should provide free insulin to poor people suffering from type-1 diabetes.

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