Bangladesh pioneered World Diabetes Day, yet still has no specialised institute

Diabetes is taking a severe toll in Bangladesh. A large share of the country's population is now affected by the disease. Nearly half of all adults are either living with full diabetes or at risk of pre-diabetes. Most worrying of all, nearly 50 percent of those affected do not even know they have diabetes.

Yet it was Bangladesh that first proposed, at the United Nations in 2006, recognising 14 November as World Diabetes Day. In a country that earned such international honour, there is still no government-run specialised national institute for diabetes.

Medical experts shared these facts at a roundtable titled 'World Diabetes Day: What We Must Do', held on Monday (9 November) at the East West Media Group conference hall in the capital's Bashundhara residential area. The roundtable was organised by Bangladesh Pratidin, with overall scientific support from the Association of Clinical Endocrinologists and Diabetologists of Bangladesh (ACEDB) and sponsorship from Opsonin Pharma Ltd. It was moderated by Mahbub Liton, news editor of Bangladesh Pratidin.

Citing data from the International Diabetes Federation (IDF), speakers said around 12.5 to 14 million people in Bangladesh currently have diabetes. In addition, nearly 30 percent of adults are in a pre-diabetic state and could develop full diabetes at any time. The number is feared to rise to 23 million by 2050. Diabetes is rising at an alarming rate among children and adolescents as well as adults, especially in urban areas, because of physical inactivity, unhealthy eating habits and obesity.

In his speech as chief guest, Dr Md Zahirul Islam Shakil, secretary general of the Doctors Association of Bangladesh (DAB), said building a disease-prevention system is the main foundation of the current government's health policy. There is no alternative to public awareness for controlling diabetes and preventing it early, he said. Diabetes is the leading cause of blindness, kidney failure (CKD), heart disease and fatty liver. To protect people from this disease, rapid detection of diabetes, stronger primary healthcare and the establishment of a government 'one-stop' specialised diabetes institute are extremely urgent.

Prof Dr Farid Uddin, president of ACEDB and founding chairman of the endocrinology department at Bangladesh Medical University, said the United Nations recognised World Diabetes Day in 2006 on Bangladesh's proposal. 'That is a great honour for us. But sadly, even today, no government-run national diabetes institute has been built in the country,' he said.

He said people of all ages are now affected by diabetes. If not controlled in time, diabetes becomes the main cause of non-traumatic blindness and amputation of the leg. Simply by changing one's lifestyle, 50 percent of diabetes can be prevented. For that, coordinated initiatives and wider access to scientific treatment are needed.

In his welcome speech, Loton Ekram, editor of Bangladesh Pratidin, said diabetes is now a national crisis. According to international data, nearly 13.2 percent of adults in the country suffer from the disease. The roundtable was organised to build public awareness about such a serious disease and to assist government policymaking, he said.

Dr Md Nurul Islam, director (hospitals and clinics) of the Directorate General of Health Services, said that although diabetes is not fully curable, patients can stay healthy through proper management and control. The government is upgrading 50-bed upazila hospitals to 151 beds and providing free sugar tests and medicines through NCD corners there. Work is under way to expand telemedicine services and strengthen screening activities down to the grassroots level, he said.

Dr Syed Mehboob Ul Kadir, director of the National Institute of Ophthalmology and Hospital, said nearly 33 percent of people with diabetes suffer from diabetic retinopathy, which later leads to blindness. However, if detected at an early stage, blindness can be prevented at the institute through laser treatment, digital colour fundus photography and free anti-VEGF injections. For that, a strong referral system for retina and eye examinations must be built as soon as diabetes is diagnosed, he said.

Speaking about gestational diabetes and women's health, Prof Dr Firoza Begum, president of the Obstetrical and Gynaecological Society of Bangladesh, said more than half of the country's population is women. During pregnancy, nearly 25 percent of women develop some form of diabetes, which raises the risk of miscarriage, birth defects and maternal death. Screening and control before conception are essential, she said. She also drew the government's attention to building a single 'Women's Health Institute and Research Centre' for women's overall treatment in Bangladesh.

Dr M A Halim Khan, associate professor of endocrinology at Suhrawardy Medical College, and Dr Mahmudul Hossain, associate professor at Kurmitola Multicare Specialized Hospital, demanded an end to physical inactivity at workplaces, the introduction of annual screening in offices, and the spread of specialised endocrine services to all 64 districts, not just Dhaka.

Prof Dr Mir Mosharrof Hossain, head of the endocrinology department at Holy Family Red Crescent Medical College, expressed strong anger over fake advertisements and quack treatment on social media. He said the false propaganda on social media — stopping insulin, uprooting diabetes in seven days, or curing diabetes by drinking tea — is pushing people towards death. Any health-related advertisement must be strictly banned through legal process without prior approval from the health ministry, BSTI or the health directorate, he said.

At the roundtable, Prof Dr Indrajit Prasad, general secretary of ACEDB, presented some specific proposals to the government. Notable among them were: formally allocating the designated 3 acres of land for the rapid construction of a 'National Institute of Endocrinology and Metabolism' in Dhaka; arranging free diabetes screening for all citizens above 35 at upazila, district and community clinics; ensuring uninterrupted supply of insulin, medicines and glucometer strips at NCD corners; creating endocrinologist posts in every district hospital and appointing nutritionists and diabetes educators; taking strict legal action in coordination with the health directorate, BMDC and consumer rights bodies against fake advertisements and quack treatment for diabetes on social media; imposing additional tax on sugary drinks and junk food and preserving playgrounds and walking paths; making screening mandatory during pregnancy and providing free insulin and services to children with type-1 diabetes; and creating a reliable 'National Diabetes Registry' to know the true statistics.

The experts expressed hope that if these proposals for diabetes prevention are implemented quickly, the overall public health picture of the country will change.