Economic and social impact of diabetes mellitus in a low‐income country: <scp>A</scp> case‐control study in <scp>S</scp>udan

Elrayah-Eliadarous, Hind; Östenson, Claes‐Göran; Eltom, Mohamed; Johansson, Pia; Sparring, Vibeke; Wahlström, Rolf

doi:10.1111/1753-0407.12540

Cited by 29 publications

(34 citation statements)

References 23 publications

(64 reference statements)

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“…A recent study to calculate the economic impact of DM in the country revealed that the annual expenditure on healthcare is 4 times higher in diabetics compared to non-diabetics (USD 579 vs. USD 148, respectively). Besides, diabetics were more likely to suffer from other chronic co-morbidities, such as heart disease and peripheral vascular disease [11].…”

Section: Context and Rationalementioning

confidence: 99%

Prevalence of Microvascular Complications in Type 2 Diabetics Attending a Primary Healthcare Centre in Sudan

Hussein

Menasri

2019

Dubai Diabetes Endocrinol J

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Background: Diabetes mellitus (DM) has become a global public health challenge. The increasing urbanisation and the significant lifestyle changes have resulted in an unprecedented rise in the rates of type 2 DM and, consequently, its microvascular complications which are the major outcome of the disease. It is the low- and middle-income countries where 80% of the diabetic patients live that face the greatest burden of the disease. Study Objectives: Our primary objective was to estimate the frequency of microvascular complications among patients diagnosed with type 2 DM. Our secondary objective was to investigate the relationship between the microvascular outcomes and the different characteristics and potential variables among patients with type 2 DM. Methodology: An observational descriptive clinic-based cross-sectional survey was conducted to calculate the prevalence of microvascular complications of type 2 DM and the associated risk factors in a lower middle-income country, Sudan. The study was carried out at Shambat Primary Healthcare Clinic during the period between May and June 2018. All patients aged 20 years and above visiting the clinic were included. Patients excluded from selection were those on steroid therapy and those having bilateral eye cataract. A total of 209 patients constituted the sample and were selected through systemic random sampling. Statistical analysis was carried out using SPSS software version 21. For the continuous variables, the mean was used as a measure of central tendency and the standard deviation as a measure of dispersion. The associations between the microvascular complications and the other variables were analysed using the χ2 test. The p value was used as a test for statistical significance. Results: The response rate to the survey was 72.6%. The age of the enrolled subjects ranged from 24 to 88 years. Males constituted 61.7% of the study sample and females 38.3%. The mean body mass index (BMI) was 26.92 ± 2.06. Out of 209 patients known to have type 2 DM, 96 (45.9%) developed any of the microvascular complications. Nephropathy was the most frequent with a prevalence of 38.8%, followed by retinopathy and neuropathy with a frequency of 23.9 and 22.5%, respectively. The presence of other co-morbidities, namely hypertension, ischaemic heart disease, chronic kidney disease and dyslipidaemia, was a predictor for the occurrence of the small-vessel conditions. Conclusions: This study is probably the first of its kind to shed light on the magnitude of the microvascular complications of DM in Sudan. The yielded results reveal a significant burden caused by microvascular complications in the country. The concurrent presence of other chronic medical disorders, namely hypertension, ischaemic heart disease, chronic kidney disease and dyslipidaemia, amplifies the risk for the development of microvascular sequelae. The mean BMI of the sample reflects an overweight trend. Facing the high tide of the metabolic syndrome and its sequelae requires a holistic perspective and a multidisciplinary approach. The health authorities and other stakeholders need to prioritise healthcare expenditure and invest more in DM research. A national diabetes registry will serve as a key player in guiding the efforts.

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Section: Context and Rationalementioning

confidence: 99%

Prevalence of Microvascular Complications in Type 2 Diabetics Attending a Primary Healthcare Centre in Sudan

Hussein

Menasri

2019

Dubai Diabetes Endocrinol J

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“…The fight against diabetes in these six countries does not seem to have had the expected effect and, like the approaches of the study in Sudan, the evidence highlights the urgency of strengthening public health policies directed more towards the promotion and prevention of diabetes and its complications at the local, regional and global levels, with greater urgency than what has been done in all countries until now. This is particularly important in LMICs where health systems are developing new universal coverage schemes with new prevention programs and with significant public funding.…”

mentioning

confidence: 76%

“…The economic and social effects of diabetes, as highlighted by Hind et al, are putting pressure on health systems and patients from low‐ and middle‐income countries (LMICs). The outlook for solving the demand for services for the diabetic population in these countries is not encouraging.…”

mentioning

confidence: 99%

Challenges of the economic and social effects of diabetes in low‐ and middle‐income countries

Arredondo

Azar

2018

Journal of Diabetes

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“…Results derived from cell lines are less reliable than those from primary cell cultures, while cells freshly isolated from human tissues may give more accurate findings. Although genetic manipulation techniques can rapidly unravel the functions of tested genes or molecules in animals, the development of human diseases, such as diabetes and osteoporosis, is much more complicated, involving multiple genetic, immunological and environmental factors, and is further influenced by social, economic and educational status . The sensitivity and response of animals to a certain stimulus or a tested drug may also differ from humans.…”

Section: Unmet Needsmentioning

confidence: 99%

Bone: Another potential target to treat, prevent and predict diabetes

Liu¹,

Mosialou

Liu

2018

Diabetes Obesity Metabolism

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Type 2 diabetes mellitus is now a worldwide health problem with increasing prevalence. Mounting efforts have been made to treat, prevent and predict this chronic disease. In recent years, increasing evidence from mice and clinical studies suggests that bone-derived molecules modulate glucose metabolism. This review aims to summarize our current understanding of the interplay between bone and glucose metabolism and to highlight potential new means of therapeutic intervention. The first molecule recognized as a link between bone and glucose metabolism is osteocalcin (OCN), which functions in its active form, that is, undercarboxylated OCN (ucOC). ucOC acts in promoting insulin expression and secretion, facilitating insulin sensitivity, and favouring glucose and fatty acid uptake and utilization. A second bone-derived molecule, lipocalin2, functions in suppressing appetite in mice through its action on the hypothalamus. Osteocytes, the most abundant cells in bone matrix, are suggested to act on the browning of white adipose tissue and energy expenditure through secretion of bone morphogenetic protein 7 and sclerostin. The involvement of bone resorption in glucose homeostasis has also been examined. However, there is evidence indicating the implication of the receptor activator of nuclear factor κ-B ligand, neuropeptide Y, and other known and unidentified bone-derived factors that function in glucose homeostasis. We summarize recent advances and the rationale for treating, preventing and predicting diabetes by skeleton intervention.

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Economic and social impact of diabetes mellitus in a low‐income country: A case‐control study in Sudan

Abstract: The high economic burden and adverse social effects on people with diabetes and their families in Sudan call for the development of evidence-based policy and program strategies for the prevention and management of diabetes, with an emphasis on low-resource communities.

Cited by 29 publications

References 23 publications

Prevalence of Microvascular Complications in Type 2 Diabetics Attending a Primary Healthcare Centre in Sudan

Prevalence of Microvascular Complications in Type 2 Diabetics Attending a Primary Healthcare Centre in Sudan

Challenges of the economic and social effects of diabetes in low‐ and middle‐income countries

Bone: Another potential target to treat, prevent and predict diabetes

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