Indian Journal of Endocrinology and Metabolism

LETTER TO THE EDITOR
Year
: 2014  |  Volume : 18  |  Issue : 1  |  Page : 118--119

Diabetes and Endocrinology in Nepal


Resham Raj Poudel 
 Department of Medicine, Institute of Medicine, Kathmandu, Nepal

Correspondence Address:
Resham Raj Poudel
Institute of Medicine, Kathmandu
Nepal




How to cite this article:
Poudel RR. Diabetes and Endocrinology in Nepal.Indian J Endocr Metab 2014;18:118-119


How to cite this URL:
Poudel RR. Diabetes and Endocrinology in Nepal. Indian J Endocr Metab [serial online] 2014 [cited 2021 Apr 17 ];18:118-119
Available from: https://www.ijem.in/text.asp?2014/18/1/118/126593


Full Text

Sir,

Nepal is a Himalayan country with a population surpassing approximately 30 millions. Although lacking sufficient studies and database to appropriately quantify the burden of endocrine problems, the morbidity is highly prevalent; especially of diabetes and thyroid problems. A study reported the prevalence of pre-diabetes: diabetes in Nepal to be 19.5:9.5%. [1] WHO South-East Asia Region Prevalence of diabetes has projected prevalence from 436 000 in 2000 to 1 328 000 in 2030. [2] The Nepal Diabetes Association (NDA) had reported a year back that among people aged 20 years and older living in urban areas, 15% are affected by this disease. Among people aged 40 years and older in urban areas, this number climbed to 19%. Nepal is also facing the consequences of urban lifestyle leading to obesity and metabolic syndrome. Studies have shown prevalence of overweight and obesity in certain sections of the population to be as high as 32.9% and 7.2%, respectively. [3] In a hospital based cross sectional study, the prevalence of metabolic syndrome in diabetes patients as per NCEP/ATP III and IDF criteria were 71% and 82%, respectively. [4] Iodine deficiency is endemic in Nepal and thyroid dysfunction is a major public health problem. A recent hospital based study done in the western region of the country has shown the prevalence of thyroid dysfunction to be 17.42%. [5] Disorders of pituitary, adrenal, and other endocrine disorders are also encountered, but data are lacking.

Nepal is still lacking sufficient health care providers. Appropriate referrals and consultations are not a common practice. Osteoporosis is treated mostly by orthopedicians. Members of the endocrine society have established an osteoporosis society jointly with gynecologists, radiologists, and orthopedicians to help resolve some of these issues. Diagnostics have only improved in the last few years in Nepal but only marginally. Laboratories are centered in the capital and lack quality control, and there are only a handful of reliable laboratories. Hormone assays are still sent to the laboratories in India, except few. Nuclear medicine and advanced radiology are still lacking. Challenges lie in funding, central database system, support from trained personnel, referral system, and patient education.

However to be hopeful, Endocrinology is a growing field in Nepal. National Academy of Medical Sciences (NAMS) has started specialization course (DM in Endocrinology), and there are few trained endocrinologists currently providing specialty care in the capital. Organizations like Nepal Diabetes Association, Astha Nepal regularly conduct public awareness programs, and free health camps to help reduce diabetes problems. Although there has been no major high quality scientific research in the field of endocrinology, research works and publication trend among Nepalese scholars in national and international endocrinology journals is gradually rising. Most of them are hospital-based cross sectional studies, community-based screenings, case control studies or perspective reviews.

References

1Ono K, Limbu YR, Rai SK, Kurokawa M, Yanagida J, Rai G, et al. The prevalence of type 2 diabetes mellitus and impaired fasting glucose in semi-urban population of Nepal. Nepal Med Coll J 2007;9:154-6.
2WHO'S certified [Internet]. Country and regional data on diabetes. WHO South-East Asia Region. Prevalence of diabetes in the WHO South-East Asia Region. Available from: http://www.who.int/diabetes/facts/world_figures/en/index 5.html[Last accessed on Mar 30, 2013].
3Vaidya AK, Pokharel PK, Nagesh S, Karki P, Kumar S, Majhi S, et al. Association of obesity and physical activity in adult males of Dharan, Nepal. Kathmandu Univ Med J 2006;4:192-7.
4Bhattarai S, Kohli SC, Sapkota S. Prevalence of metabolic syndrome in type 2 diabetes mellitus patients using NCEP/ATP III and IDF criteria in Nepal. Nepal J Med Sci 2012;1:79-83.
5Yadav RK, Magar NT, Poudel B, Yadav NK, Yadav B. A prevalence of thyroid disorder in Western part of Nepal. J Clin Diagn Res 2013;7:193-6.