World Diabetes Day: icddr,b's recent work on the silent killer

With the overarching theme 'Eyes on diabetes,' World Diabetes Day this year focuses on promoting screening to ensure early diagnosis of diabetes and treatment to reduce the risk of serious complications in low and middle income countries, including Bangladesh.

Tackling risks from non-communicable diseases (NCD), particularly diabetes, in a resource-poor setting like Bangladesh is especially challenging. The International Diabetic Federation (IDF) estimates that there are currently 7.1 million people with diabetes in Bangladesh.

Patient undergoing eye test session in Bangladesh. Photo: Kiran Ridley / Orbis. CC BY-NC-ND 2.0

The number is 8.4 million people according to the Diabetic Association of Bangladesh, which estimates that only half are aware of having the disease. The figure may rise due to an increase in sedentary lifestyles and rapid urbanization.


Tackling diabetic retinopathy in Bangladesh

Dr Aliya Naheed, head of icddr,b’s NCD initiative, and a team of researchers from icddr,b have been conducting a research among walk-in patients in hospitals to estimate the burden diabetic retinopathy a severe complication that leads to blindness among individuals suffering from diabetes. The study also aims assess the risk factors of diabetic retinopathy and develop strategies for the prevention of blindness among diabetic patients in Bangladesh. "Early detection of diabetic retinopathy and controlling diabetes can halt further damage and blindness as well as other complications including cardiovascular diseases, kidneys diseases and permanent damage of nerves," comments Dr Naheed

According to the American Journal of Medicine, primary prevention of diabetic retinopathy involves strict glycemic and blood pressure control. Adopting a healthy lifestyle, being diet-conscious and physically active, could be the key to controlling NCDs like diabetes and associated complications that many people are unaware about in Bangladesh. In fact, the findings in BioMed Central suggest that the impact of diabetes on health related quality of life in the Bangladeshi population is much higher than what is known from western populations and that unlike in western populations co-morbidities/complications are not the driving factor for this effect.


Healthy lifestyle could help keep blood sugar in check. Photo by Shehzad Noorani / icddr,b


Combating type-2 diabetes in Bangladesh

Type 2 diabetes and pre-diabetes are an increasing globally and often remain undiagnosed long after onset in low-income settings. Bangladesh has shown to perform poorly in reducing NCDs, revealed findings of a newly developed NCD scorecard. The findings, published in The Lancet last year, has shown the scorecard to have measured the performance of 23 low- and middle-income countries reducing their NCD burden.

Commenting on the Lancet editorial, Dr Naheed says, "The good news is that in recent times Bangladesh has made impressive progress in developing a 2016-2021 multi-sectoral plan for prevention and control of NCDs," she adds.

Dr Naheed and her team also has been conducting a lifestyle intervention trial in Bangladesh,which is a part of the multicounty intervention  program including India and Sri Lanka. The objective of the trial is to assess its impact on the prevention of type 2 diabetes among South Asian women who develop diabetes during pregnancy (gestational diabetes). “Outcome of the trial aims to establish a strong evidence of the benefit of a low cost intervention and help policymakers to adopt necessary strategies for preventing type 2 diabetes among women in the region” says Dr Naheed.

The studies, in collaboration with All India Institute of Medical Sciences (AIIMS), George Institute of Global Health, University of Sydney and University of Kelaniya, is being funded by National Health and Medical Research Council of Australia (NHMRC), Global Alliance for Chronic Diseases (GACD) and Indian Council of Medical Research (ICMR).

Recently, icddr,b researchers have also examined diabetes and related issues in Bangladesh and explored the links between depression and diabetesobesity and diabetes, and developed management and screening strategies for diabetes and depression in resource-poor settings.