The estimated prevalence of diabetes in Bangladesh was about 5% in 2006 and there is a rapidly increasing trend with predictions indicating the number to rise to 9% in 2025. The total estimated number of people with diabetes over 20 years of age is now almost 4 million.According to the IDF Diabetes Atlas, Bangladesh will have more than 10 million with diabetes in 2025.The Diabetes Association of Bangladesh (DAB) now serves about 900,000 people with diabetes registered through 80 health care facilities all over the country owned by itself and its affiliated associations. Even this seemingly big number constitutes only around 20% of the estimated population with diabetes in the country. Bangladesh thus faces a great challenge in providing health care services to its high number of people with diabetes which is also increasing at an alarming rate.The project aims to define and pilot strategies for lifestyle intervention in the primary prevention of diabetes in Bangladesh and to develop guidelines for a long term National Diabetes Prevention Programme.
The Diabetes Association of Bangladesh (DAB) has been engaged in organising and delivering care for people with diabetes for the last 50 years.Although DAB has become fairly successful in clinic based care for people with diabetes, it has not yet been able to start a properly organised primary prevention programme throughout the country. With this project DAB seeks to give due emphasis to prevention.Primary prevention of diabetes is now a well established strategy for reducing the burden of diabetes and its complications, but effective strategies of primary prevention vary from region to region and race to race. The project recognises that prevention programmes need to be adjusted for each society.The project will develop and implement a pilot prevention programme for Bangladesh, based mainly on lifestyle intervention which will give proper importance to beliefs, faiths and taboos.Tools like faith based teaching and mass media communications, such as workshops, radio/TV programmes, websites, conferences, meetings etc will be used.The project will draft, test and implement each of the modes by using the infrastructure facilities of DAB throughout the country and if possible, collaborate with relevant public and private organizations.Short-term and long-term impact of each of the modes will be determined and compared to make an appropriate national prevention policy.The present project has been visualized as a pilot to develop guidelines and strategies for a countrywide primary prevention programme for diabetes.The National Diabetes Prevention Programme will after project completion be disseminated and integrated into the routine services of all 53 affiliated associations of the Bangladesh Diabetes Association (DAB).The project WDF05-131 focusing on nutritional factors in Bangladesh supported by WDF will provide tested inputs on nutritional aspects of the prevention programme. WDF also funds WDF06-195 - a project aiming at training diabetes educators for improved patient education and self-care in Bangladesh.
• A national policy for diabetes prevention has been prepared and endorsed by the Ministry of Health and Family Planning.• Information material has been developed including contribution to a diabetes guide book and messages for community doctors and religious leaders. In addition a Bengali theatre movie on primary prevention of diabetes has been produced, featuring the President of BADAS.• A manual for Training of Trainers on primary prevention of diabetes mellitus has been developed.• Six leaflets describing the steps of prevention at different levels of society have been produced in Bangoli (individual level; family & friend level; school level; social/cast level; health service provider; employer and media).• Folk singers have been associated to the project to sing songs that incorporate messages on healthy living and risk factors of NCDs. Audio records have been produced and are being used during training sessions, gatherings and in electronic media.• Religious leaders are being involved in delivering messages on healthy living which are taking form from religious texts.• School teachers are involved in delivering messages on primary prevention, however, so far without any visual aids.• A one-day training workshop on primary prevention has been conducted in a t total of 1,197 doctors and 128 community counsellors.• 87 students participated in the 18 days Diabetes Educators Programme under WDF06-195.• 126 employees and employers in Dhaka and Gazipur were trained in diabetes awareness, risk factors and lifestyle interventions.