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The country rankings of diabetes prevalence have been published by Wisevoter and Pakistan has earned the dubious distinction of becoming number one in diabetes prevalence at 30.8%. It means that almost every third person in the country is diabetic.
To put it in perspective, global average rate of diabetes is 8.8%. On the contrary, the incidence of obesity in Pakistan is only 8.6% against a global average of 19.1%. The point I wish to raise here is that the primary reason for diabetes in Pakistan is not obesity, though obesity is directly implicated in the type 2 diabetes, also called Maturity Onset Diabetes Mellitus. About three decades back, it was understood to start after the age of forty years, but later this age mark was blurred with the reporting of MODY – Maturity Onset Diabetes of the Young.
Diabetes is a metabolic disorder, marked by high blood sugar levels. Longstanding diabetes is known to cause complications of kidneys, eyes, nerves, heart, and circulatory system. Diabetes is classified into Type1 which is Insulin Dependent, and Type2 which is Non-insulin dependent. Many Type2 patients remain controlled on tablets but may progress to insulin later. The above prevalence rate is mainly based on Type2 Diabetes Mellitus (T2DM).
Pakistan is followed by Kuwait at 24.9% Diabetes prevalence with 37.9% obesity; Nauru, a tiny island country in south pacific ocean with a population of about 13,000 people under Australian control, with 23.4% diabetes and 61% obesity; followed by New Caledonia, another small island country in southwest pacific ocean, having around 25% of world’s nickel resources, and under French control, with 23.4% diabetes (obesity not counted); followed by Northern Mariana Island, a group of 14 islands in north pacific ocean under US control, at 23.4% also (obesity data not given); followed by Marshall Islands, located in the western pacific ocean, under pact with the US, at 23% diabetes with 52.9% obesity.
I would like to share some more data of the developed/developing countries to make sense of where we stand vis-à-vis prevalence of diabetes. The reasons for higher prevalence shall be subject of another post.
I may mention here that obesity is based on BMI – Body Mass Index calculation. BMI is calculated by dividing weight in kgs with height in meter square. For example, a person with 70kg weight and 1.7 meter height will be calculated like this – 70 / (1.7×1.7) = 70 / 2.89 = 24.22 BMI. BMI figure Between 18.5 and 24.9 is healthy range; between 25 and 29.9 is overweight; between 30 and 39.9 is obese; and 40 and above is server obesity. You may calculate your own BMI quickly and find for yourself where do you belong.
- Pakistan has 30.8% diabetes with 8.6% obesity.
- Egypt has 20.9% diabetes with 32% obesity.
- Qatar has 19.5% diabetes with 35.1% obesity.
- Malaysia has 19% diabetes with 15.6% obesity.
- Sudan has 18.9% diabetes with 8.6% obesity.
- Saudi Arabia has 18.7% diabetes with 35.4% obesity.
- UAE has 16.4% diabetes with 31.7% obesity.
- Turkey has 14.5% diabetes with 32.1% obesity.
- Bangladesh has 14.2% diabetes with 3.6% obesity.
- Singapore has 11.6% diabetes with 6.1% obesity.
- Sri Lanka has 11.3% diabetes with 5.2% obesity.
- Afghanistan has 10.9% diabetes with 5.5% obesity.
- United States of America has 10.7% diabetes with 36.2% obesity.
- Indonesia has 10.6% diabetes with 6.9% obesity.
- China has 10.6% diabetes with 6.2% obesity.
- India has 9.6% diabetes with 3.9% obesity.
- Iran has 9.1% diabetes with 25.8% obesity.
- Brazil has 8.8% diabetes with 22.1% diabetes.
- Canada has 7.7% diabetes with 29.4% diabetes.
- Germany has 6.9% diabetes with 22.3% obesity.
- Japan has 6.6% diabetes with 4.3% obesity.
- United Kingdom has 6.3% diabetes with 27.8% obesity.
- New Zealand has 6.2% diabetes with 30.8% obesity.
- Russia has 5.6% diabetes with 23.1% obesity.
- France has 5.3% diabetes with 21.6% obesity.
- Ghana, Burkina Faso, Guinea, Guinea-Bissau, Ivory Coast, Liberia, Mali, Mauritania, Sierra Leone, Togo, Zimbabwe, have 2.1% diabetes with obesity ranging from 8% to 15%.
The more we look at this, the more it baffles us. It has long been considered that obesity id the main precipitating factor for diabetes, but the relationship is not coming clear in this data. If we consider stress to be the major factor, then the African countries, particularly at the end of the list are under severe stress but the rate of diabetes is low. If genetic predisposition is the main factor, then Indians and Pakistani come from the same stock, but there is a huge difference in the incidence. In depth studies are required to understand it, which should be done by the medical fraternity.
I have seen couple of research articles which I shall discuss in the next post.
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