Social and economic impact of diabetics in Bangladesh: protocol for a case–control study

Abstract

BackgroundDiabetes affects both individuals and their families and has an impact on economic and social development of a country. Information on the availability, cost, and quality of medical care for diabetes is mostly not available for many low- and middle-income countries including Bangladesh. Complications from diabetes, which can be devastating, could largely be prevented by wider use of several inexpensive generic medicines, simple tests and monitoring and can be a cost saving intervention. This study will provide an in-depth and comprehensive picture of social and economic impacts of diabetes in Bangladesh and propose clear recommendations for improving prevention and management of diabetes. The objectives of the study are:1) To study the association between diabetes and other health problems and its social impacts2) To estimate the economic impact of diabetes including total direct and indirect costs3) To measure the impact of diabetes on quality of life among diabetes patients in Bangladesh4) To study the impact of diabetes on the health care systemMethodsThis is a case–control study comparing cases with type 2 diabetes to controls without diabetes matched on age, sex and place of residence. 564 cases and 564 controls will be selected from the outpatient department of a tertiary hospital in Dhaka, Bangladesh. Data on socioeconomic status, health utility index, direct and indirect costs for diabetes, medication adherence, quality of life, treatment satisfaction, diet, physical activity, mental state examination, weight, height, hip and waist circumference, blood pressure, pulse, medication history, laboratory data and physical examination will be conducted.Outcome measures: The primary outcome measures will be association between diabetes and other health problems, cost of diabetes, impact of diabetes on quality of life and secondary outcome measures are impact of diabetes on healthcare systems in Bangladesh.DiscussionThis study will provide an in-depth and comprehensive picture of social and economic impacts of diabetics in Bangladesh and propose clear recommendations for improving prevention and management of diabetics. It will help to develop programs and policies for better management of Diabetics and cost effective strategies in Bangladesh context.

Nutrition transition in South Asia: the emergence of non-communicable chronic diseases

“…Prevalence of obesity is higher in urban areas as compared to the rural areas, since these are most affected by rapid changes in nutritional pattern and sedentary life style ( Shariful Islam et al , 2013). Rapid urbanization has been associated with a shift in labor force from agriculture to service sector which has reduced average physical activity status of the population.…”

“…In 2000, 44% of the burden of disease in this region measured in disability adjusted life years (DALYs) was attributed to non-communicable diseases ( Basnyat & Rajapaksa, 2004). According to WHO guidelines for Asian populations, a third of the South Asian adult population is classified as obese, and 50% as overweight, by 2030 NCDs (T2DM, CVDs, COPD, cancer) and are going to account for 72% of total mortality by 2030 in South Asia ( Shariful Islam et al , 2013; Singh et al , 2011). In India, although under-nutrition and micronutrient deficiencies continue to be major public health problems, over-nutrition and obesity are also emerging as a major problem in many states(Kerala, Tamil Nadu).…”

“…Out of pocket expenditure for NCDs in India increased from 31.6% in 1995–96 to 47.3 percent in 2004, and hospital stays more than doubled during the same time ( Jaime & Lock, 2009). Among the NCDs, diabetes is the most costly and is also a major risk factor for a variety of life-threatening and expensive complications such as heart attack, renal disease, neuropathy, visual impairment ( Shariful Islam et al , 2013). NCDs are also responsible for unhealthy aging and increases the burden of medical spending in later years which put huge pressure on savings and household assets.…”

Patients’ perspective of disease and medication adherence for type 2 diabetes in an urban area in Bangladesh: a qualitative study

“…Diabetes is a serious disease that imposes heavy financial burden in affected individuals, their families and the nation at large [8, 9]. A recent study conducted on patients with type 2 diabetes attending an urban clinic in the capital city of Dhaka found that almost two-third of the patients had uncontrolled diabetes [10].…”

Quality of life of type 2 diabetic patients in Erbil city

“…A study in Bangladesh demonstrated that around 90% of all diabetic patients did not check their sugar levels frequently had faced many clinical problems. 24 A study in Egypt showed that 38.6% of the patients had uncontrolled diabetes based on HbA1c levels with lower health-related QOL scores, 25 and a study in Oman showed that patients with less than 8% HbA1c levels showed a significant better QOL. 26 In our study, diabetic patients with complications showed a significantly lower score in the psychological domain.…”