在孟加拉国人口中实施TRACK

Mohiuddin Ak
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摘要

孟加拉国有数百万未被发现的糖尿病患者,到2025年这一数字将翻一番[10]。Das等人[11]报道,男性和女性受试者的血脂异常患病率均超过70%,这表明生活方式干预策略的紧迫性,以预防和管理这一重要的健康问题和风险因素。在孟加拉国不同医院的8400名中风患者中,随着低收入和中等收入国家(LMIC)非传染性疾病负担的增加,高血糖等生物风险因素是孟加拉国的一个主要公共卫生问题。迫切需要通过积极的生活方式改变来优化糖尿病管理,以预防合并症和并发症,从而降低成本。据《英国医学杂志》报道,糖尿病患者的住院治疗天数是非糖尿病患者的2倍,门诊就诊次数是非糖尿病病人的1.3倍,药物使用次数几乎是非糖尿病的10倍。令人惊讶的是,80%患有这种所谓的“富人病”的人生活在中低收入国家。根据美国医学会最近的一项研究,中国和印度共有近1.1亿糖尿病患者。到2035年,该地区的糖尿病患病率预计将增加71%。在2010-2011年期间,孟加拉国被列为糖尿病人口第8高的国家。在孟加拉国,2011年成年人糖尿病患病率估计为9.7%,预计到2045年这一数字将达到1370万。孟加拉国的糖尿病护理费用相当高,主要是由药品和住院费用推动的。根据孟加拉国统计局的数据,2017年,每名2型糖尿病患者的年平均费用为864.7美元,占孟加拉国人均GDP的52%,是普通医疗费用的9.8倍。对于不住院的患者来说,药品是直接费用的最高来源(约85%)。在不久的将来,糖尿病治疗的私人和公共融资将受到严重限制,这对孟加拉国人民的健康构成威胁。
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TRACK Implementation among Bangladeshi Population
million people with undetected diabetes in Bangladesh and this number will be double by 2025 [10]. Das et al. [11] reported prevalence of dyslipidemia was over 70% to both male and female subjects, which indicates the urgency of lifestyle intervention strategies to prevent and manage this important health problem and risk factor. Among 8400 stroke patients from different hospitals in Bangladesh over Abstract With the increasing burden of non-communicable diseases in low-income and middle-income countries (LMICs), biological risk factors, such as hyperglycemia, are a major public health concern in Bangladesh. Optimization of diabetes management by positive lifestyle changes is urgently required for prevention of comorbidities and complications, which in turn will reduce the cost. Diabetes had 2 times more days of inpatient treatment, 1.3 times more outpatient visits, and nearly 10 times more medications than non- diabetes patients, as reported by British Medical Journal. And surprisingly, 80% of people with this so called “Rich Man’s Disease” live in low- and middle-income countries. According to a recent study of American Medical Association, China and India collectively are home of nearly 110 million diabetic patients. The prevalence of diabetes in this region is projected to increase by 71% by 2035. Bangladesh was ranked as the 8th highest diabetic populous country in the time period of 2010-2011. In Bangladesh, the estimated prevalence of diabetes among adults was 9.7% in 2011 and the number is projected to be 13.7 million by 2045. The cost of diabetes care is considerably high in Bangladesh, and it is primarily driven by the medicine and hospitalization costs. According to Bangladesh Bureau of Statistics, in 2017 the annual average cost per T2DM was $864.7, which is 52% of per capita GDP of Bangladesh and 9.8 times higher than the general health care cost. Medicine is the highest source of direct cost (around 85%) for patients without hospitalization. The private and public financing of diabetes treatment will be severely constrained in near future, representing a health threat for the Bangladeshi population.
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