Myanmar Diabetes Care Model: Bridging the Gap Between Urban and Rural Healthcare Delivery

Latt, Tint Swe; Aye, Than Than; Ko, Ko; Myint, Ye; Thant, Maung Maung Myo; Myint, Kyar Nyo Soe; Sanda, Khin; Lwin, Khaing Zar; Khin, Htet Htet; Aung, Tin; Oo, Kyaw Myint

doi:10.15605/jafes.030.02.16

Cited by 5 publications

(8 citation statements)

References 9 publications

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“… 21 26 The results indicate a considerable number of people living with undetected DM in Myanmar. Health assistants and midwives are the primary healthcare givers for the rural DM people without specialists at the Rural Health Centre level, 27 while urban dwellers can at least consult a general practitioner. 28 In Myanmar, health insurance systems have yet to be established, so patients with DM need to spend out-of-pocket money for treatment.…”

Section: Discussionmentioning

confidence: 99%

Urban–rural differences in the prevalence of diabetes mellitus among 25–74 year-old adults of the Yangon Region, Myanmar: two cross-sectional studies

et al. 2018

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ObjectivesTo investigate the association between urban–rural location and the occurrence of diabetes mellitus (DM) in the Yangon Region, and to estimate the proportion of urban and rural participants already diagnosed with DM, and of those, the proportion under treatment and under control.DesignTwo cross-sectional studies, using the WHO STEPs methodology.SettingThe Yangon Region of Myanmar, urban and rural areas.ParticipantsMen and women, aged 25–74 years, included during the study period from September–November 2013 (urban) and 2014 (rural areas) (n=1372). Institutionalised people, physically and mentally ill person, monks and nuns were excluded.ResultsThe age-standardised prevalence of DM was 12.1% in urban and 7.1% in rural areas (p=0.039). In urban areas, the prevalence of DM was lowest in the highest educational groups (p<0.001). There were no differences in DM prevalence between gender or income levels. In rural areas, those who were physically inactive had a low intake of fruit and vegetable and were overweight/obese had a higher DM prevalence than others. In a logistic regression, the OR for DM in rural compared with urban areas was 0.38 (0.22, 0.65), adjusted for sociodemographic variables and behavioural risk factors. In urban areas, 43.1% of participants had the experience of receiving blood glucose measurements by a doctor or health worker, and 61.5% of all cases of DM were already diagnosed, 78.7% were under treatment and 45.8% were under control. The corresponding proportions in rural areas were 26.4%, 52.4%, 78.1% and 32.0%, respectively.ConclusionThe prevalence of DM in the Yangon Region was high, and significantly higher in urban than in rural areas. More health services are needed to serve this population with a large proportion of undiagnosed diabetes. Preventive measures to halt and reduce the prevalence of DM are urgently needed.

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Section: Discussionmentioning

confidence: 99%

Urban–rural differences in the prevalence of diabetes mellitus among 25–74 year-old adults of the Yangon Region, Myanmar: two cross-sectional studies

et al. 2018

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“…In the healthcare setting of Myanmar, urban inhabitants can easily consult a general practitioner for their health [9] while rural dwellers rely on health assistants and midwives [14]. Different access to quality care and health information [35] might lead to differences in awareness and treatment levels between urban and rural inhabitants.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the country has a high burden of communicable diseases [13]. The health care system is facing challenges in addressing the rise in DM care, such as the supplementation of essential drugs and equipment for diabetes care, capacity building of endocrinologists, inequality of DM care between urban and rural areas, an inappropriate referral system in DM care and health information system and lack of dieticians and physical activity instructors [14]. Data on DM prevalence in Myanmar is scarce.…”

Section: Introductionmentioning

confidence: 99%

Trends in Diabetes Prevalence, Awareness, Treatment and Control in Yangon Region, Myanmar, Between 2004 and 2014, Two Cross-Sectional Studies

Aung

Bjertness

Htet

et al. 2019

IJERPH

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Myanmar is currently facing the burden of non-communicable diseases due to changes in lifestyle and dietary patterns linked to socio-economic development. However, evidence is scarce about changes in the prevalence of diabetes mellitus (DM) over time. We aimed to investigate changes in the prevalence, awareness, treatment and control of DM from 2004 to 2014, among adults aged 25–74 years, in the Yangon region. Two cross-sectional household-based studies, according to World Health Organization STEPwise approach to surveillance (WHO STEPS) methodology, were conducted in 2004 (n = 4448) and 2014 (n = 1372). The overall age-standardized prevalence of DM was 8.3% (95% CI 6.5–10.6) in 2004 and 10.2% (7.6–13.6) in 2014 (p = 0.296). The DM prevalence increased between the study years among elderly participants only, from 14.6% (11.7–18.1) to 31.9% (21.1–45.0) (p = 0.009). Awareness of having DM increased from 44.3% (39.2, 49.6) to 69.4% (62.9–75.2) (p < 0.001). Among participants who were aware of having DM, the proportion under treatment increased from 55.1% (46.8–63.1) to 68.6% (61.5–74.8) (p = 0.015). There was no change in proportion with controlled DM. Adjusted for age, sex and education, mean fasting plasma glucose levels in 2014 were 0.56 mmol/L (0.26–0.84) higher than in 2004. Preventive measures to halt future increases in DM prevalence and to increase the detection of undiagnosed DM cases are needed.

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“…Yangon Region, the most populated in Myanmar and the former capital is known to have the highest prevalence (18.2%) of diabetes in Myanmar. 7 The PA is the cornerstone of lifestyle modification aimed at preventing and managing T2DM and its related morbidities. PA has been shown to improve glycaemic control through increased insulin sensitivity and glucose tolerance.…”

Section: Introductionmentioning

confidence: 99%

Physical Activity of Type 2 Diabetes Mellitus Patients and Non-Diabetes Participants in Yangon, Myanmar: A Case-Control Study Applying the International Physical Activity Questionnaires (IPAQ-S)

Ahmad¹,

Aung²,

Ueno³

et al. 2021

DMSO

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Background: Despite the evidence that physical activity (PA) can prevent type 2 diabetes mellitus (T2DM), limited research investigated the level of PA among diabetes and nondiabetes in Myanmar, where there is the escalating prevalence of diabetes recently. We investigated PA as modified the risk of diabetes, in a case-control study. Methods: We conducted a case-control study which included 150 cases and 150 controls age 25-74 years (Mean age 43.3±14.7 years) among the cases and (55.1±10.9 years) among the controls, both sex and residence in Yangon. Cases were newly diagnosed with T2DM within six months before data collection, with laboratory-confirmed fasting blood glucose level ≥126mg/dl. Controls were community residents, without diabetes, confirmed with a laboratory test. The IPAQ-S was used to assess the PA level. Multiple logistic regression analysis was applied in STATA 15, using the interaction terms for age and PA, adjusting age, sex and BMI. Results: In comparison to controls, cases were older and having less PA knowledge. The levels of vigorous PA were mean 254.9±standard deviations (SD) 845.6 METs min.wk−1 among controls, 73.06±392.1 cases, moderate PA 631.5±1240.8 METs min.wk−1 among controls and 1050.9±1601.6 cases and walking PA 569.8±1060 METs min.wk−1 among controls and 777.4 ±1249 cases, respectively. The multiple logistic regression analysis showed adjusted odds ratios (aOR) 3.84, 95% confidence interval (CI) 1.18-12.42 (P<0.05) for those aged 40 and older, with moderate PA and aOR 18.01, Cl 6.45-50.26 (P<0.001) for those aged 40 and older, with low PA. Comparing the strength of association, the risk of T2DM among people aged 40 and older with moderate PA is lower than age over 40 with low PA. Conclusion: PA lessened the risk of T2DM, posted by increasing age. The findings highlighted the importance of promoting PA to reduce the T2DM prevalence in the context of Yangon, Myanmar, a low-and middle-income Asian country.

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Myanmar Diabetes Care Model: Bridging the Gap Between Urban and Rural Healthcare Delivery

Cited by 5 publications

References 9 publications

Urban–rural differences in the prevalence of diabetes mellitus among 25–74 year-old adults of the Yangon Region, Myanmar: two cross-sectional studies

Urban–rural differences in the prevalence of diabetes mellitus among 25–74 year-old adults of the Yangon Region, Myanmar: two cross-sectional studies

Trends in Diabetes Prevalence, Awareness, Treatment and Control in Yangon Region, Myanmar, Between 2004 and 2014, Two Cross-Sectional Studies

Physical Activity of Type 2 Diabetes Mellitus Patients and Non-Diabetes Participants in Yangon, Myanmar: A Case-Control Study Applying the International Physical Activity Questionnaires (IPAQ-S)

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