Monday, July 12, 2010

Warning that diabetes will be Asia's biggest medical emergency

July 12, 2010
ABC Radio Australia

It's being referred to as Asia's new epidemic. Type two diabetes is taking hold of the region, affecting some 89 million Asians. But the vast majority of those cases are going undiagnosed.

Presenter: Helene Hofman
Speakers: Dr Nguyen Thy Khue, President, Endocrinology and Diabetes Association of Vietnam; Professor Tuan Nguyen, Senior Research Fellow, Garvan Institute of Medical Research; Professor Paul Zimmet, Emeritus Director, Baker IDI Heart and Diabetes Institute


Dr Nguyen Thy Khue is the President of the Endocrinology and Diabetes Association of Vietnam:

According to Professor Tuan Nguyen from the Garvan Institute, those tests are too expensive for many people in Asia, but he's come up with a simple solution.

Prof Paul Zimmet, emeritus director of the Baker IDI Heart and Diabetes Institute in Melbourne, agrees.


HOFMAN: The figures are astounding.

In India there are 33 million cases. In China 22 million.

And right across the region, from the industrial powerhouse of Japan to the more agrarian economies of Bangladesh and Cambodia, type 2 diabetes is making its mark.

Or at least that's what the estimates suggest.

NGUYEN THY KHUE: Vietnam is a developing country and you know that a lot of people are undiagnosed. Although we have a screening program for that disease not the whole country can access the screening program because you know in the countryside, sometimes half-hour away from the city, it is very difficult for the people over there to have blood sugar testing.

HOFMAN: And the situation in Vietnam is echoed right across Asia.

An increasingly fatty diet combined with a more-sedentary lifestyle has created the ideal breeding ground for type 2 diabetes, but most people - around two-thirds - aren't even aware they have the condition.

Australia's Garvan Institute of Medical Research in Sydney has just released the findings of its study into the prevalence of diabetes in Vietnam.

Researchers tested a random sample of more than 21-hundred people in Ho Chi Minh City. On top of the 4 per cent already diagnosed, 12 per cent of women and 11 per cent of men were found to have the disease.

Separate studies in Thailand and China have turned up similar findings.

In Australia, diabetes is usually detected through a blood or a glucose-tolerance test.

NGUYEN: What we have done is that we have developed a very simple tool so that the doctors and health workers in general can identify people who are at high risk of undiagnosed diabetes. We only use systolic blood pressure and waist-to-hip ratio and we these two measures, we can estimate the likelihood that the individual will have diabetes. So, we have done a lot of what we call internatal evalutation in our studio and we found that the accuracy of the tool is about 70 to 75 per cent so I think our tool can be used as an initial screening tool to identify people for further testing. We are going to implement the diagnostic tool probably in a website, so anyone in the region can input the two figures and they can get the probability of diabetes for an individual.

HOFMAN: Professor Tuan Nguyen expects to have that website up-and-running by the end of the year.

He says that if the condition is detected early, the risk of people developing heart disease, vision loss or kidney failure can be reduced .

He suggests that a risk factor questionnaire, like the one he helped develop with the support of the Australian government, could be just as useful as the the waist-to-hip ratio method.

However, he points out that getting people diagnosed is only part of the problem.

ZIMMET: Asia now has the largest number of people with type two diabetes in the world. We're sitting on probably one of the largest epidemics in history and many Asian countries don't have the resources not alone to diagnose but also to treat people with diabetes so there could be a lack of enthusiasm at some public health levels because they're so scared there's such an untapped and large number people with type two diabetes that they could never treat them in any case.

HOFMAN: The World Health Organization estimates that 177 million people worldwide currently have diabetes.

They expect that figure to surpass 300 million by 2025 and Asia will acount for over 60 per cent of those cases, presentling the region with a major health care challenge.

3 comments:

John Vink said...

Pictures on diabetes in Cambodia: http://johnvink.com/story.php?title=Cambodia_Discovers_Diabetes

Anonymous said...

i think 90% of the case of diabetes can be prevented with proper diet and physical activities, etc...

Anonymous said...

95% of Khmers would not have diabete because they don't eat enough food and they always move..