Challenges in diabetes mellitus type 2 management in Nepal: a literature review

Abstract

Background and objectivesDiabetes has become an increasingly prevalent and severe public health problem in Nepal. The Nepalese health system is struggling to deliver comprehensive, quality treatment and services for diabetes at all levels of health care. This study aims to review evidence on the prevalence, cost and treatment of diabetes mellitus type 2 and its complications in Nepal and to critically assess the challenges to be addressed to contain the epidemic and its negative economic impact.DesignA comprehensive review of available evidence and data sources on prevalence, risk factors, cost, complications, treatment, and management of diabetes mellitus type 2 in Nepal was conducted through an online database search for articles published in English between January 2000 and November 2015. Additionally, we performed a manual search of articles and reference lists of published articles for additional references.ResultsDiabetes mellitus type 2 is emerging as a major health care problem in Nepal, with rising prevalence and its complications especially in urban populations. Several challenges in diabetes management were identified, including high cost of treatment, limited health care facilities, and lack of disease awareness among patients. No specific guideline was identified for the prevention and treatment of diabetes in Nepal.ConclusionsWe conclude that a comprehensive national effort is needed to stem the tide of the growing burden of diabetes mellitus type 2 and its complications in Nepal. The government should develop a comprehensive plan to tackle diabetes and other non-communicable diseases supported by appropriate health infrastructure and funding.

Abnormal Liver Parameters among Individuals with Type 2 Diabetes Mellitus Nepalese Population

“…Whole world is in the peril of non-communicable diseases which is almost half of the total disease burden. The prevalence rate of type-II Diabetes Mellitus is around 4.5% in adult population as per the data reported by IDF atlas 2013 in Nepal and the trend is escalating [10]. A higher incidence of liver function test (LFT) abnormalities has been associated with individuals suffering from type 2 diabetes than individuals without diabetes [11].…”

Tanshinone IIA improves diabetes mellitus via the NF‑κB‑induced AMPK signal pathway

“…DM is also an heterogeneous disease, which can be classified into type 1 and type 2 DM (3). Diabetic cardiomyopathy is often caused by metabolic disorders and microvascular lesions in patients with DM, and diabetic cardiomyopathy is responsible for inflammation and apoptosis of myocardial tissue (2)(3)(4). Diabetic cardiomyopathy is a major risk factor for the development of insulin resistance in patients with DM (5).…”

National Consensus Statement on the Management of Type 2 Diabetes Mellitus in Nepal

“…68 The management of T2DM in Nepal is hampered by inadequate health care facilities, unaffordable treatment, limited awareness of T2DM and lack of national guidelines for healthcare providers. 69 Although the international management guidelines for T2DM are well-established, the essential diagnostics and medications are found to be missing at primary healthcare facilities in Nepal. 70 Lifestyle interventions as well as technology-assisted tools will be useful components of any behavioural program for preventing T2DM.…”