In the Name of ALLAH, Ever Beneficent, Infinitely Merciful

Transcription

1 In the Name of ALLAH, Ever Beneficent, Infinitely Merciful

2 Director, Baqai Institute of Diabetology and Endocrinology (BIDE) Joint Secretary, Diabetic Association of Pakistan (DAP) Chair- elect IDF MENA Region Founder member, Diabetes in Asia Study Group (DASG) Founder, National Association of Diabetes Educators of Pakistan (NADEP) Chairman, Pakistan Working Group on Diabetic Foot (PWGDF)

3 Conflictof Interest Disclosure I have no conflict of interest to declare

4 Screening and Prevalence Prioritization Strategies Capacity Building Management updates Future Directions

5 National Diabetes Survey Pakistan Ministry of National Health Services, Regulation and Coordination Pakistan Health Research Council Diabetic Association of Pakistan ;WHO Collaborating Centre Baqai Institute of Diabetology and Endocrinology Partners of Survey Screening and Prevalence

6 Screening and Prevalence National Diabetes Survey Pakistan % Type 2 Diabetes 7.14% new cases 19.05% known cases Prevalence of Diabetes in Pakistan This means on average, 1 in 4 person have type 2 diabetes in Pakistan Diagnosis on the basis of 2-hours OGTT criteria

7 National Diabetes Survey Pakistan Screening and Prevalence 14.47% Pre-Diabetes Prevalence of Pre-Diabetes in Pakistan This means on average, 3 in 20 person is at risk of diabetes in Pakistan Diagnosis on the basis of 2-hours OGTT criteria

8 Screening and Prevalence Prioritization Strategies Capacity Building Management updates Future Directions

9 Prioritization Strategies 1. Diabetes education 2. Diabetic foot 3. Diabetes and children

10 165 Educators trained Prioritization Strategies

11 A.Basit and A.Nawaz. Preventing diabetes related amputations in a developing country steps in the right direction. Diabetes Voice 2013;58:36-39

12 ABCD Advisory Board for the Care of Diabetes Prof. Abdul Basit Chairman ABCD in Pakistan Director Baqai Institute of Diabetes & Endocrinology Professor of Medicine Karachi Assoc. Prof.Qazi Masroor Bahawal Victoria Hospital Quaid-e-Azam Medical College Bahawalpur Assoc. Prof. Bilal Bin Younus SIDER (Sakeena Institute of Diabetes & Endocrine Research) Lahore Asst. Prof. Abdul Waheed Iqbal Tehseel Head Quarter Hospital Dadyal Benazeer Bhutto Medical College District Mirpur Azad Kasmir Prof. Jamal Zafar Pakistan Institute of Medical Sciences Islamabad Prof. Zaman Shaikh Liaqat University of Medical and Health Sciences Hyderabad Assoc. Prof. Jehangir Khan Ayub Medical College Abbottabad National Diabetic Foot Advisory Board Meeting every Wednesday 9am Asst. Prof. Salma Tanweer Nishter Hospital & Medical College Multan Asst. Prof. Sobia Sabir Lady Reading Hospital Peshawar Assoc. Prof. Irshad Khoso Bolan Medical Complex Hospital Quetta Islamabad Multan 7 December 2016

13 Prioritization Strategies Insulin my life Centers established 34 Teachers sensitized Type 1 diabetes model clinics Subjects registered DAP- BIDE- WDF Free insulin vials distributed

14 Prioritization Strategies

15 Dr. Nazeer Soomro Prof. Jamal Zafar Prof. Yakoob Ahmedani Dr. Asif Brohi Dr. Veru Mal Dr. Pawan Kumar Dr. Bilal Bin Younus Prof. Abdul Basit Dr. Fareed Uddin Dr. Zahoor Shaikh Dr. Riasat Dr. Abdul Waheed Iqbal Dr. Asher Fawwad Dr. Farhan Baloch Dr. Muhammad Irfan Dr. Riaz Ahmed Dr. Salma Tanweer Dr. Zahid Miyan Dr. Fateh Dero Dr. Imtiaz Hasan Dr. Saif Ul Haque Dr. Sobia Sabir Dr. Asim bin Zafar Dr. Irshad Ahmed Dr. Ali Jawa Dr. Sanober Prof. Irshad Khoso Dr. Farhatullah Khan Dr. Kashif Dr. Jehangir Khan Dr. Shahid Prof. Abrar Shaikh Dr. Abdul Rasheed Joyo Dr. Merajuddin Nizami Dr. Qazi Masroor Dr. Shahjahan Mangi Prof. Jamal Raza Dr. Abdullah Memon Dr. Najma Samejo Dr. Ahsan Siddiqui Dr, Umeet Kumar Prof. Zaman Shaikh Dr. Aejaz Solangi Dr. Nazeer Khokar Dr. Ameer Memon Dr. Khurshid Khan Dr. A.H. Amir Dr. Abbas Raza Dr. Osama Ishtiaq

16 Screening and Prevalence Prioritization Strategies Capacity Building Management updates Future Directions

17 Capacity Building 17 Batches completed 450 Diploma holders

18 Capacity Building Specialists Training Aga Khan University hospital Jinnah-Allama Iqbal Institute Of Diabetes & Endocrinology Baqai Institute of Diabetology & Endocrinology Diabetes Setup at Hyattabad Med Complex Jinnah Postgraduate Medical Centre Diabetes Unit at PIMS

19 National health network for diabetes control and prevention Capacity Building NOMA programme 2005 M.Phil and Ph.D One year diploma in diabetology doctors trained Post fellowship fellowship 2009 Trained Faculty One year diploma in diabetes education educators trained Tertiary care diabetes centers MSPH in NCDs Aug 2018 Secondary care diabetes units 4 weeks certified courses for doctors Jan doctors to be trained 4 weeks certified courses for health educators Feb health educators to be trained 3000 Primary care diabetes clinics

20 Current Status of Diabetes Care in Pakistan Screening and Prevalence Prioritization Strategies Capacity Building Management updates Future Directions

21 Management updates Low-cost and effective strategies Basit A, et al,. BRIGHT Guidelines on self monitoring of blood glucose. PJMS 2014; 30:

22 Basit A, et al,. BRIGHT Guidelines on self monitoring of blood glucose. PJMS 2014; 30:

23 Management updates

24 EDITORS Management updates Prof. A Samad Shera Prof. Abdul Basit PROMPT Core Team Advisory Board for the Care of Diabetes (ABCD) Dr. Zahid Miyan Dr. Musarrat Riaz Co Contributors Dr. Asima Khan Dr. Riasat Ali Khan Prof. Zaman Shaikh Karachi Prof. Bilal Bin Younis - Lahore Dr. Sobia Sabir Peshawar Prof. Jamal Zafar Islamabad Prof. Qazi Masroor Bahawalpur Dr. Salam Tanveer Multan Prof. Irshad Khoso Quetta Dr. Jehangir Khan Abbottabad Prof. Waheed Iqbal Dr. Asher Fawwad Prof. Rubina Hakeem Dr. A. B. Zafar

25 Management updates MENA Regional Council Meeting 20 th August, 2016 Karachi- Pakistan

26 Management updates MENA Regional Council Meeting 20 th August, 2016 Karachi- Pakistan The PROMPT document has been approved by the MENA RC in Khartoum in Dec 2016 It has been finalized and submitted in Alexandria in May 2017

27 Current Status of Diabetes Care in Pakistan Screening and Prevalence Prioritization Strategies Capacity Building Management updates Future Directions

28 Future Directions Footwear For Every Diabetic (FED) group A joint Project of WDF BIDE (BMU), Karachi, Pakistan Establishment of 10 risk assessment clinics Low cost and durable footwear manufacturing technique 10 foot care assistants and 10 cobblers from BIDE to be trained 1 foot care assistant and 1 cobbler from each of the 10 project centres will be trained

29 Future Directions Footwear For Every Diabetic (FED) group 2016 to 2019 Insoles A joint Project of WDF BIDE (BMU), Karachi, Pakistan Development Machines

30 Future Directions Prof. Zahida Baqai Prof. Noorjahan Samad Prof. Abdul Basit Prof. Shabeen Naz Masood Dr. Musarrat Riaz Dr. Asmat Nawaz Dr. Shehla Naqvi Mr. Shokat Ali Javed

31 GDM project with WDF Future Directions A joint Project of WDF BIDE (BMU), Karachi, Pakistan

32 Future Directions Risk assessment of Pakistani individuals for diabetes (RAPID) Age Less than 40 years 0 Between 40 to 50 years 1 Greater than 50 years 3 Waist circumference - Males Less than 90 cm (35.5 inches) 0 90 cm (35.5 inches) or greater 2 Waist circumference - Females Less than 80 cm (31.5 inches) 0 80 cm (31.5 inches) or greater 2 Family history of diabetes No family history of diabetes 0 Any parent and/or siblings 1 A score of 4 or more predicts high risk of developing Type 2 diabetes Riaz M, Basit A, et al,. Risk assessment of Pakistani individuals for diabetes (RAPID). Prim Care Diabetes. 2012, 6;

33 Future Directions Diabetes Education Diabetic Foot Diabetes Registry Gestational Diabetes Diabetes Guidelines Diabetes and Ramadan Primary Prevention Program

34 Future Directions PAD registry XLPAD IDF Regional Council MENA Region M.V Hospital for Diabetes India Diabetes and Ramadan - DAR University of Birmingham International associations and collaborations University of Oslo Foundation of European nurses for diabetes GIFTS EU collaboration IDF centres of education D-Net Diabetes in Asia Study Group DASG University of Manchester Bangladesh University of Health Sciences International working group on Diabetic Foot IWGDF Qatar Diabetes Association Life for a Child Diabetes Specialist Center India

35 Future Directions Diabetic Association of Pakistan DAP Pakistan Nursing Council PNC Acknowledgements Pakistan Cardiac Society PCS Pakistan Hyperten League PHL Pakistan Society of Health Systems Pharmacist PSHSP National associations and collaborations Pakistan Nutrition and Dietetics Society PNDS Pakistan Working group on diabetic foot PWGDF PMDC CPSP HEC Pakistan Endocrine Society PES

36 Consultant Diabetologist Research Diabetic Foot Administration Prof. Yakoob Ahmedani Dr. Zahid Miyan Dr. Asim Bin Zafar Dr. Asher Fawwad Dr. Faraz Alvi Ms. Fariha Shaheen Dr. Farhat Ullah Dr. Adil Mr. Salman Dr. Musarrat Riaz Mr. Bilal Tahir Mr. Sabir hussain Mr. Hassan Moin Acknowledgement Dr. M. Saif Ul Haque Dietician Ms. Tahmina Rashid Ms. Sara Jaffri Ms. Raheela Naseem Ms. Sanober Aijaz Ms. Sadaf Mateen Mr. Farrukh Ahmed GDM Dr. Asmat Nawaz Mrs. Saira Shahid Ms. Hina Naz Ms. Zainab Akber Ms. Amna Khatoon Educationist Mrs. Rabia A. Rahman Ms. Erum Ghafoor Mr. Qutub Uddin Mr. Naimat Rehman Institutional Coordinator Mr. Kashif Ali Mr. Arsalan Saeed Ms. Huma Khan Mr. Arshad Akhter Mr. Furqan Uddin Mr. Rameez Ms. Aneela Insulin My life Mr. Iqbal Hussain Dr. Zafar Iqbal Abbasi Mr. Faizan Mahmood Mr. Abdul Rehman Mr. Osama Ul Haq Junior Doctors Dr. Majid Dr. Anam Butt Dr. Lal Chand Dr. Zaryab Dr. Naveed Dr. Shahzaib I.T Department Mr. Mansoor Siddiqui Mr. Kamran Adam Mr. Anwar ul Haq Mr. Rizwan Alam Mr. Sufran Ahmed

37 Thank You