Diabetes has become an overwhelming public health concern. Globally diabetes affects more than 371 million people where more than 70.3 million are from South Asia. According to WHO South-East Asia Region prevalence of diabetes has projected from 436000 in 2000 to 1328 000 in 2030. The number of diabetes cases was found to be 506,727 in Nepal. According to a study the prevalence of diabetes in Nepal will rise to 15.11% and 17.49% in 2015 and 2020 respectively. The Nepal Diabetes Association (NDA) had reported that among people aged 20 years and older living in urban areas, 15% are affected by this disease. Among people aged 40 years and older in urban areas, this number climbed to 19%. Nepal is also facing the consequences of urban lifestyle leading to obesity and metabolic syndrome. Studies have shown ageing population, sedentary lifestyle, obesity and unhealthy diets to be the major cause of diabetes. Moreover, the lack of proper education on diabetes and poor self-care practices have contributed to poor glycemic control and complications like diabetic neuropathy, diabetic retinopathy and neuropathy. The rapid industrialization and urbanization have led to the alarming manifestation of diabetes. Doctors with long-term involvement in treating diabetic patients said that the Nepal is at high risk of diabetes.
According to research it is proven that lifestyle change is the new trend for managing a patients with diabetes. Factors such as family history, urban residence, advanced age, higher Body Mass Index (BMI), central obesity, genetic susceptibility, poor lifestyle, cardiovascular diseases and hypertension were found to be the major drivers behind the increasing prevalence of diabetes. There are essentially seven key behaviors in patients with diabetes that predict healthy outcomes, precisely eating well, being physically active, monitoring blood sugar regularly, compliance and adherence to the medications prescribed, good problem-solving skills, healthy coping skills and risk-reduction behaviors. All seven of these behaviors have showed a positive correlation with good glycemic control, reduction of complications and improvement in quality of life. As advised by the Mayo Clinic getting more physical activities, eating more fibers and whole grains, controlling portions of every meal, reducing extra weight and regular blood sugar screening can help to keep diabetes at bay. Individuals with diabetes have been shown to make a drastic impact on the advancement and development of their disease by partaking in their own care. Despite this fact, when looking at a longer-term change in individuals, compliance and adherence to these activities is incredibly low in Nepal.
The level of diabetes knowledge among the diabetes patients is very poor in Nepal deferred by age, level of education, occupation, family history of diabetes and marital status. Studies and proper research should be done to assess the level of knowledge about diabetes and compliance of patients to treatment. There is a lack of reliable and representative data on the prevalence of diabetes in Nepal. In order to control the emerging burden of the disease it is paramount to inform policy makers at the local and national level by collecting more evidences. There is a high need to prioritize diabetes on the public health care agenda in Nepal through the promotion of preventive measures such as dietary pattern, exercises, and periodic check-up.
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