Optimized health care for subjects with type 1 diabetes in a resource constraint society: A three-year follow-up study from Pakistan

Abstract

BACKGROUNDInadequate health infrastructure and poverty especially in rural areas are the main hindrance in the optimal management of subjects with type 1 diabetes (T1D) in Pakistan.AIMTo observe effectiveness of diabetes care through development of model clinics for subjects with T1D in the province of Sindh Pakistan.METHODSA welfare project with name of “Insulin My Life”, was started in province of Sindh, Pakistan. This was collaborative work of Baqai Institute of Diabetology and Endocrinology, World Diabetes Foundation and Baqai Medical University between February 2010 to February 2013. Under this project thirty-four T1D clinics were established. Electronic database was designed for demographic, biochemical, anthropometric and medical examination. Monthly consultation was part of the standardized diabetes care. All the recruited subjects with T1D were provided free insulins and related materials.RESULTSOut of 1428 subjects, 795 (55.7%) were males and 633 (44.3%) were females. Subjects were categorized into ≤ 5 years of age 103 (7.2%), between 6-12 years 323 (22.6%), between 13–18 years 428 (29.7%) and ≥ 19 years of age 574 (40.2%) groups. Glycemic control as assessed by HbA1c was significantly improved (P < 0.0001) at three years follow up as compared to baseline in all age groups. Decreasing trends of mean self-monitoring blood glucose were observed at different meal timings in all age groups. No significant change was found in the frequency of neuropathy, nephropathy and retinopathy during the study period (P > 0.05).CONCLUSIONThis study gives us long-term longitudinal data of people with T1D in a resource constraint society. With provision of standardized and comprehensive care significant improvement in glycemic control without any change in the frequency of microvascular complications was observed over 3 years.

Real World Data about the Characteristics of Adult Diabetes Mellitus Patients Visiting Outpatient Department of a Tertiary Care Hospital

“…Recent data has highlighted increasing trends in the incidence of type-1 DM. 18 We observed that neuropathy was the most frequent complications observed in 45.5% DM patients while gastrointestinal, cardiac and renal complications were observed in 15.5%, 9.5% and 9.5% DM patients respectively. A study done by Lakhair MA et al among newly diagnosed type-2 DM patients revealed 32.7% patients to have peripheral neuropathy at the time of diagnosis.…”

Association Between Exclusive Breastfeeding and Type 1 Diabetes Mellitus

“…2 According to the International Diabetes Federation (IDF), in the year 2015, Pakistan witnessed over 7 million recorded instances of diabetes, with around 2% of those individuals being afflicted with Type 1 Diabetes (T1D). 3 The reported incidence of Type 1 Diabetes (T1D) in Pakistan is 1.02 per 100,000 individuals annually. 4 A multitude of environmental exposures are believed to significantly contribute to the onset of Type 1 Diabetes (T1D).…”

Linear Growth and Final Height in People With Type 1 Diabetes: A Study From Karachi, Pakistan

“…According to the International Diabetes Federation Atlas 9th edition 2019 estimates, around 1.98 billion children (0-14 years) and 2.58 billion adolescents (0-19 years) have type 1 diabetes globally [ 2 ]. In Pakistan, the incidence of T1DM has been reported to be 1.02 per 100,000 per year [ 3 ]. As the incidence of this disease is increasing worldwide, diabetic complications have come to represent a major concern despite the advances in treatment.…”