Diabetes soars in Pakistan’s urban centres

Cory CouillardThe prevalence of type 2 diabetes is skyrocketing throughout Pakistan’s urban centres that grow daily as migrants arrive from rural areas. In response, the International Diabetes Federation and Diabetic Association of Pakistan lead awareness, education and prevention campaigns peaking on World Diabetes Day.

In Pakistan, approximately 120 000 people die annually of diabetes-related complications. Even more staggering, up to 50 per cent of diabetic sufferers are unaware of the diagnosis and are inching closer to heart disease, stroke, kidney failure, blindness and limb amputation.

Unknowing victims are commonly diagnosed incidentally through blood or urine tests associated with other active health conditions. Because early detection and prompt treatment can reduce the burden of diabetes and its complications, screening for diabetes is an appropriate prevention strategy.

Increasing amounts of evidence supports the diagnosis of pre-diabetes. Pre-diabetes occurs when blood sugar levels are higher than normal but not yet high enough to be diagnosed as diabetes. Screening for pre-diabetes is important because more than 10 per cent of pre-diabetics become diabetic within three years.

Nearly half of the people in Pakistan who die of diabetic complications are under the age 60. Anyone older than age 45 is advised to receive an initial blood sugar screening, and if the results are normal, be proactively screened every three years thereafter.

Good diabetic care generally means keeping one’s blood sugar levels within the normal range. This can often be effectively achieved through maintaining a healthy body weight, engaging in sufficient physical activity, eating a well-balanced diet and avoiding substances of abuse such as alcohol and tobacco.

Physical activity is one of the most important aspects in maintaining a healthy body weight and preventing type 2 diabetes. Maintaining one’s body weight improves insulin control, keeps blood sugar in check and reduces harmful cholesterol and blood pressure that is linked to life threatening complications.

Unhealthy diets, especially the excessive consumption of energy, saturated fat, trans fat, salt and sugar could cause at least 40 per cent of all deaths from diabetes. To prevent or reverse diabetes – reduce sugar intake, eliminate processed food items, reduce portion size and increase consumption of vegetables.

Smoking can promote the development of diabetes by at least 30 per cent. Smoking is one of the leading causes of inflammation, scarring of the arteries and atherosclerosis – leading risk factors for heart disease, stroke and premature death.

The World Diabetes Day campaign is led by the International Diabetes Federation and its member associations. It engages millions of people worldwide in diabetes advocacy and awareness. To prevent diabetes and help support a local campaign, please visit: http://www.idf.org/worlddiabetesday


Dr Cory Couillard is an international health columnist that works in collaboration with the World Health Organization’s goals of disease prevention and global health care education. Views do not necessarily reflect endorsement.

Email: drcorycouillard@gmail.com
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Twitter: DrCoryCouillard



  1. Zeeshan Zahoor says

    Thank you for writing this blog Dr. Cory. Unfortunately things have become worse than they used to be. Let me share my experience. I used to work with a diabetes clinic in Islamabad. We conducted a program for diabetes awareness a few months back in a village side area near Islamabad. We also did the basic tests for sugar screening like HBA1C, BSF, BSR and lipid profile. Results were more drastic than what we anticipated. More than 22 % of the participants were diagnosed diabetic for the first time with grossly increased HBA1C and spot sugar. Participants who were already diabetic were not using any medicines for their diabetes at all. They were having their diabetes treated by a local mystic. Most of them also had started developing diabetes complications.
    I am sorry to say that the authorities working in any part of the health sector only focus on the people who already have the basic education to understand and to fight against the disease.
    Countries like Pakistan who have their major population living in villages require a special attention from national as well as international authorities to help them fight against this ‘‘SILENT KILLER’’.

  2. javed ismail says

    No doubt heart diseases and diabetese are in an epidemic proportion, but it’s not only individuals to blame, competent official authorities are also responsible to it. NCD is not on the agenda of Pakistan, as for many low income countries. Even persons who know the preventive strategies or positive life style modification and wanted to adopt it can not do so, as healthy diet is too expensive to purchage even for a moderately good income group, no facilities for park or gym to engage in physical activities, law and order situation in major cities are such that no one is safe in streets for a walk, junk food is cheaper to buy than healthy food, children go to school where there are no play grounds, not even enough space to walk for a meter when all the kids are out in their recess time, hundreds of TV channels which require an hour only to surf it, internet, dirt cheap mobile phond packages to talk for whole night, depression and anxiety on rise, even children show sign of depression and anxiety. In the discussed senario are we promoting a healthy nation and providing enough conducive environment to adopt a healthy life style? if the present situation persists I am afraid that more devastating situation is to be expected in the future.

  3. Ali Pasha says

    I am a public health student in Pakistan and I definitely feel that one reason why it is spreading so fast here is because it is often thought of one those diseases that patients would forego treatment for, because it is so expensive. But I have often wondered of our dietary habits are a causal factor in this?

  4. Cory Couillard says

    Some urban settings may lead to a better quality of life but rapid growth and unplanned urbanization have created cities that may hinder an individual’s ability to live healthily.

    City dwellers are more likely to be exposed to marketing schemes and advertisements for unhealthy foods, tobacco and alcohol.

    Cities often discourage physical activity and encourage sedentary lifestyle habits.

    Urbanization encourages heavily processed convenience foods that are often high in sugar, salt, saturated and trans fats leading to an increase in diabetes and CVD risk.

    • Fatima M says

      I have always been an advocate of including the NCDs into the post-2015 agenda and I feel that it is time policy-makers take this epidemic more seriously in that respect

  5. Nadia says

    This is such an eye-opener! There should be wider campaigns in the country and in other developing countries where the number of diabetic patients is increasing.

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