National Diabetes Surveys Conducted in Pakistan

The first National Diabetes Survey of Pakistan (1st NDSP) was done by the DAP in collaboration with WHO between 1994 and 1998. Overall, glycemic dysregulation (diabetes plus pre-diabetes) was reported to be 22.04%and 17.15% in urban and rural areas, respectively. The prevalence of diabetes as assessed by fasting plasma glucose had doubled from 7.2% in 2002 to14.2% in 2009 in the rural areas of Baluchistan. Furthermore, studies conducted in school-age children had also warned of arise in childhood obesity. Pakistan Health Research Council (PHRC) conducted a questionnaire-based survey using STEPS, a ‘WHO STEP wise approach to surveillance’, in the provinces of Punjab and Sindh. This survey along with other studies reported the prevalence of diabetes between 13.1% and 26.9%. Hence the epidemic of diabetes was predicted nearly a decade ago. Most of these studies had been smaller scale, focusing on specific towns or villages and because of diversified ethnic groups within Pakistani population, could not accurately reflect the prevalence of diabetes in Pakistan.

The International Diabetes Federation (IDF) has estimated an increase in prevalence of type 2 diabetes mellitus (DM) to be 463 million in 2019 and projected to reach 578 million by 2030, and 700 million by 2045, worldwide. According to the IDF Atlas 9th edition 2019, age-adjusted comparative prevalence of diabetes in Pakistan is 19.9% and pre-diabetes 8.8% in adults (20-79 years) based on the recent second National Diabetes Survey of Pakistan (NDSP) 2016-2017 using oral glucose tolerance test (OGTT). Second NDSP (2016–2017) was conducted by the Ministry of National Health Services, Regulation and Coordination (MNHSRC) with the collaboration of Pakistan Health Research Council (PHRC), Diabetic Association of Pakistan (DAP) and WHO Collaborating Center, and Baqai Institute of Diabetology and Endocrinology (BIDE).Another Diabetes Prevalence Survey of Pakistan (DPS-PAK) conducted in same duration from April 2017 to November 2017 has reported the prevalence of type 2 diabetes was 16.98% and prediabetes was 10.91% using HbA1c as diagnostic criteria

The findings of the second NDSP (2016-2017) imply that diabetes has reached epidemic proportion and urgently need national strategies for early diagnosis and effective management as well as cost-effective diabetes primary prevention programs in Pakistan.