With the increasing burden of noncommunicable 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 nondiabetes patients, as reported by the 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 the 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 eighth 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 the 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 healthcare 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.
Ali N, Akram R, Sheikh N, et al. Sex-specific prevalence, inequality and associated predictors of hypertension, diabetes, and comorbidity among Bangladeshi adults: results from a nationwide cross-sectional demographic and health survey. BMJ Open 2019;9(9):e029364. DOI: 10.1136/bmjopen-2019-029364.
Mohiuddin AK. Diabetes fact: Bangladesh perspective. Int J Diabet Res 2019;2(1):14–20. DOI: 10.17554/j.issn.2414-2409.2019.02.12.Available from: URL: http://www.ghrnet.org/index.php/ijhr/article/view/2457.
Afroz A, Alam K, Ali L, et al. Type 2 diabetes mellitus in Bangladesh: a prevalence based cost-of-illness study. BMC Health Serv Res 2019;19(1):601. DOI: 10.1186/s12913-019-4440-3.
Islam JY, Zaman MM, Bhuiyan MR, et al. Prevalence and determinants of hyperglycaemia among adults in Bangladesh: results from a population-based national survey. BMJ Open 2019;9(7):e029674. DOI: 10.1136/bmjopen-2019-029674.
Salahuddin T, The rising threat of NCDs in Bangladesh. The Daily Star, January 06, 2019.
Salahuddin T, Obesity is increasing among the younger generation in Bangladesh. The Daily Star, September 23, 2018.
Star Online Report. 80 lakh Bangladeshis suffering from diabetes: State minister. The Daily Star, April 06, 2016.
Islam FM, Chakrabarti R, Islam MT, et al. Prediabetes, diagnosed and undiagnosed diabetes, their risk factors and association with knowledge of diabetes in rural Bangladesh: the Bangladesh population-based diabetes and eye study. J Diabetes 2016;8(2): 260–268. DOI: 10.1111/1753-0407.12294.
Fottrell E, Ahmed N, Morrison J, et al. Community groups or mobile phone messaging to prevent and control type 2 diabetes and intermediate hyperglycaemia in Bangladesh (DMagic): a cluster-randomised controlled trial. Lancet Diabetes Endocrinol 2019;7(3):200–212. DOI: 10.1016/S2213-8587(19)30001-4.
Shariful Islam SM, Lechner A, Ferrari U, et al. Healthcare use and expenditure for diabetes in Bangladesh. BMJ Glob Health 2017;2(1):e000033. DOI: 10.1136/bmjgh-2016-000033.
Das H, Banik S. Prevalence of dyslipidemia among the diabetic patients in southern Bangladesh: a cross-sectional study. Diabetes Metab Syndr 2019;13(1):252–257. DOI: 10.1016/j.dsx.2018. 09.006.
Mohammad QD, Habib M, Mondal BA, et al. Stroke in Bangladeshi patients and risk factor. Mymensingh Med J 2014;23(3):520–529.
Afroz A, Zhang W, Wei Loh AJ, et al. Macro- and micro-vascular complications and their determinants among people with type 2 diabetes in Bangladesh. Diabetes Metab Syndr 2019;13(5):2939–2946. DOI: 10.1016/j.dsx.2019.07.046.
National Institute of Health (UK). Stay on TRACK To Prevent Blindness From Diabetes. Available From: https://www.nei.nih.gov/sites/default/files/nehep-pdfs/NDM_SM_Toolkit_2015.pdf.
American Association of Diabetes Educators. Resources for People Living with Diabetes (Monitoring). Available From: https://www.diabeteseducator.org/living-with-diabetes/aade7-self-care-behaviors/aade7-self-care-behaviors-monitoring.
Mohiuddin AK. Domination of nephrotic problems among diabetic patients of Bangladesh. Archives of Nephrology and Urology 2018;1(01):009–016. DOI: 10.26502/anu.2644-2833002.
Vanderlee L, Ahmed S, Ferdous F, et al. Self-care practices and barriers to compliance among patients with diabetes in a community in rural Bangladesh. Int J Diabetes Dev Ctries 2016;36(3):320. DOI: 10.1007/s13410-015-0460-7.
Azad A, How climate change will affect your health. CNN health, October 12, 2018.
Diabetic Association of Bangladesh. WDF-494 Extension of Diabetic Retinopathy Care in Bangladesh. Available from: https://www.dab-bd.org/sub-page.php?sub_category=35.
Azad K. Type 1 diabetes: the Bangladesh perspective. Indian J Endocrinol Metab 2015;19(Suppl 1):S9–S11. DOI: 10.4103/2230-8210.155344.
Alam MM, Hawlader MDH, Wahab A, et al. Determinants of overweight and obesity among urban school-going children and adolescents: a case-control study in Bangladesh. Int J Adolesc Med Health 2019(0):pii:/j/ijamh.ahead-of-print/ijamh-2018-0034/ijamh-2018-0034.xml.10.1515/ijamh-2018-0034.
Al Muktadir MH, Islam MA, Amin MN, et al. Nutrition transition - pattern IV: Leads Bangladeshi youth to the increasing prevalence of overweight and obesity. Diabetes Metab Syndr 2019;13(3):1943–1947. DOI: 10.1016/j.dsx.2019.04.034.
Goon S, Bipasha MS, Islam S. Fast food consumption and obesity risk among university students of Bangladesh. Eur J Prev Med 2014;2(6):99–104. DOI: 10.11648/j.ejpm.20140206.14.
World Diabetes Day 2018. “Access to insulin is a human right” In conversation with Professor AK Azad Khan, President, Diabetic Association of Bangladesh. The Daily Star, November 14, 2018.
Hasib NI, Children getting type 2 diabetes ‘alarmingly’ in Bangladesh. bdnews24.com 06 April, 2016.
Hossain MS, Siddiqee MH, Ferdous S, et al. Is childhood overweight/obesity perceived as a health problem by mothers of preschool aged children in Bangladesh? a community level cross-sectional study. Int J Environ Res Public Health 2019;16(2):pii: E202 10.3390/ijerph16020202.
Chaity AJ, Obesity blamed for alarming rise in childhood diabetes DhakaTribune November 13th, 2017.
Bipasha M, Goon S. Fast food preferences and food habits among students of private universities in Bangladesh. South East Asia J Public Health 2014;3(1):61–64. DOI: 10.3329/seajph.v3i1.17713.
Hoque ME, Long KZ, Niessen LW, et al. Rapid shift toward overweight from double burden of underweight and overweight among Bangladeshi women: a systematic review and pooled analysis. Nutr Rev 2015;73(7):438–447. DOI: 10.1093/nutrit/nuv003.
Tanwi TS, Chakrabarty S, Hasanuzzaman S, et al. Socioeconomic correlates of overweight and obesity among ever-married urban women in Bangladesh. BMC Public Health 2019;19(1):842. DOI: 10.1186/s12889-019-7221-3.
Banik S, Rahman M. Prevalence of overweight and obesity in Bangladesh: a systematic review of the literature. Curr Obes Rep 2018;7(4):247–253. DOI: 10.1007/s13679-018-0323-x.
Biswas T, Garnett SP, Pervin S, et al. The prevalence of underweight, overweight and obesity in Bangladeshi adults: data from a national survey. PLoS ONE 2017;12(5):e0177395. DOI: 10.1371/journal.pone.0177395.
Chowdhury MAB, Mohiuddin Adnan MD, Zakiul Hassan MD. Trends, prevalence and risk factors of overweight and obesity among women of reproductive age in Bangladesh: a pooled analysis of five national cross-sectional surveys. BMJ Open 2018;8(7):e018468. DOI: 10.1136/bmjopen-2017-018468.
Biswas T, Uddin MJ, Mamun AA, et al. Increasing prevalence of overweight and obesity in Bangladeshi women of reproductive age: findings from 2004 to 2014. PLoS ONE 2017;12(7):e0181080. DOI: 10.1371/journal.pone.0181080.
Guthold R, Stevens GA, Riley LM, et al. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants. Lancet Glob Health 2018;6(10):e1077–e1086. DOI: 10.1016/S2214-109X(18)30357-7.
Mahbub I, Why Is Diabetes on The Rise in Bangladesh? Web Future Startup October 25, 2016. Available From: https://futurestartup.com/2016/10/25/why-is-diabetes-on-the-rise-in-bangladesh/.
Tareq S. Obesity is increasing among the younger generation in Bangladesh The Daily Star September 23, 2018.
Uddin R, Khan A, Burton NW. Prevalence and sociodemographic patterns of physical activity among Bangladeshi young adults. J Health, Populat Nutrit 2017;36(1):31. DOI: 10.1186/s41043-017-0108-y.
Moniruzzaman M, Ahmed MSAM, Zaman MM. Physical activity levels and associated socio-demographic factors in Bangladeshi adults: a cross-sectional study. BMC Public Health 2017;17(1):59. DOI: 10.1186/s12889-016-4003-z.
Vancampfort D, Firth J, Schuch F, et al. Physical activity and sedentary behavior in people with bipolar disorder: a systematic review and meta-analysis. J Affect Disord 2016;201:145–152. DOI: 10.1016/j.jad.2016.05.020.
Bishwajit G, O'Leary DP, Ghosh S, et al. Physical inactivity and self-reported depression among middle- and older-aged population in South Asia: world health survey. BMC Geriatr 2017;17(1):100. DOI: 10.1186/s12877-017-0489-1.
WHO Bangladesh. Double trouble: diabetes and depression. Available from: http://www.searo.who.int/bangladesh/depressiondoubletrouble/en/.
Aowsaf SMA, Diabetes management service launched in Bangladesh. DhakaTribune, September 25th, 2018.
Fottrell E, Ahmed N, Shaha SK, et al. Diabetes knowledge and care practices among adults in rural Bangladesh: a cross-sectional survey. BMJ Glob Health 2018;3(4):e000891. DOI: 10.1136/bmjgh-2018-000891.
Fottrell E, Ahmed N, Shaha SK, et al. Distribution of diabetes, hypertension and non-communicable disease risk factors among adults in rural Bangladesh: a cross-sectional survey. BMJ Glob Health 2018;3(6):e000787. DOI: 10.1136/bmjgh-2018-000787.
Palma P, A worrying picture of diabetes in Bangladesh. The Daily Star, November 14, 2018.
Health Tips. Screening reduces mortality for detectable type 2 diabetics. The Daily Star, August 27, 2017.
Hasan MK, WHO: Tobacco responsible for 1 in 5 deaths in Bangladesh. DhakaTribune, June 01, 2018.
Bergman BC, Perreault L, Hunerdosse D, et al. Novel and reversible mechanisms of smoking-induced insulin resistance in humans. Diabetes 2012;61(12):3156–3166. DOI: 10.2337/db12-0418.
Kong C, Nimmo L, Elatrozy T, et al. Smoking is associated with increased hepatic lipase activity, insulin resistance, dyslipidaemia and early atherosclerosis in type 2 diabetes. Atherosclerosis 2001;156(2):373–378. DOI: 10.1016/s0021-9150(00)00664-x.
Schofield JD, Liu Y, Rao-Balakrishna P, et al. “Diabetes dyslipidemia.” diabetes therapy: Research, treatment and education of diabetes and related disorders. 2016;7(2):203–219. DOI: 10.1007/s13300-016-0167-x.
Facchini FS, Hollenbeck CB, Jeppesen J, et al. Insulin resistance and cigarette smoking. Lancet 1992;339(8802):1128–1130. DOI: 10.1016/0140-6736(92)90730-q.
Bajaj M. Nicotine and insulin resistance: when the smoke clears. Diabetes 2012;61(12):3078–3080. DOI: 10.2337/db12-1100.
Harris KK, Zopey M, Friedman TC. Metabolic effects of smoking cessation. Nat Rev Endocrinol 2016;12(5):299–308. DOI: 10.1038/nrendo.2016.32.
Calcaterra V, Winickoff JP, Klersy C, et al. Smoke exposure and cardio-metabolic profile in youth with type 1 diabetes. Diabetol Metab Syndr 2018;10(1):53. DOI: 10.1186/s13098-018-0355-0.
Srinivasa Rao CH, Emmanuel Subash Y. The effect of chronic tobacco smoking and chewing on the lipid profile. J Clin Diagnos Res: JCDR 2013;7(1):31–34. DOI: 10.7860/JCDR/2012/5086.2663.
Gossett LK, Johnson HM, Piper ME, et al. Smoking intensity and lipoprotein abnormalities in active smokers. J Clin Lipidol 2009;3(6):372–378. DOI: 10.1016/j.jacl.2009.10.008.
Wasifuzzaman C. A review of prevalence, complications, risk factors, knowledge assessment, self-management, consciousness and treatment of diabetes mellitus in Bangladesh. Available From: http://dspace.bracu.ac.bd/xmlui/handle/10361/10674.
Nargis N, Hussain AG, Goodchild M, et al. A decade of cigarette taxation in Bangladesh: lessons learnt for tobacco control. Bull World Health Organ 2019;97(3):221–229. DOI: 10.2471/BLT.18.216135.
Alam DS, Jha P, Ramasundarahettige C, et al. Smoking-attributable mortality in Bangladesh: proportional mortality study.”. Bull World Health Organ 2013;91(10):757–764. DOI: 10.2471/BLT.13. 120196.
Nargis N, Thompson ME, Fong GT, et al. Prevalence and patterns of tobacco use in Bangladesh from 2009 to 2012: evidence from international tobacco control (ITC) study. PLoS ONE 2015;10(11):e0141135. DOI: 10.1371/journal.pone.0141135.
Khan MK, Hoque HE, Ferdous J. Knowledge and attitude regarding national tobacco control law and practice of tobacco smoking among Bangladesh police. Mymensingh Med J 2019;28(4):752–761.
Tribune Desk. Temperature in Bangladesh to rise to deadly heights by end of century. Dhaka Tribune, August 03, 2017.
Mohiuddin AK. Domination of pollutant residues among food Products of South-east Asian countries. South Asian Res J Agri Fish 2019;1(2):50–53. DOI: 10.36346/sarjaf.2019.v01i02.003.
Paul SK, Islam MS, Hasibuzzaman MM, et al. Higher risk of hyperglycemia with greater susceptibility in females in chronic arsenic-exposed individuals in Bangladesh. Sci Total Environ 2019;668:1004–1012. DOI: 10.1016/j.scitotenv.2019.03.029.
Chaity AJ, 15% pregnant women diagnosed with diabetes. DhakaTribune, November 14, 2017.
Goon S, Islam MS. Breakfast skipping and obesity risk among urban adults in Bangladesh. Int J Public Health Sci 2014;3(1):15–22. DOI: 10.11591/ijphs.v3i1.4670.
Khan A, Khan SR, Burton NW. Missing breakfast is associated with overweight and obesity in Bangladeshi adolescents. Acta Paediatr 2019;108(1):178–179. DOI: 10.1111/apa.14553.
Kabir A, Miah S, Islam A. Factors influencing eating behavior and dietary intake among resident students in a public university in Bangladesh: a qualitative study. PLoS ONE 2018;13(6):e0198801. DOI: 10.1371/journal.pone.0198801.
Bener A, Yousafzai MT. Effect of Ramadan fasting on diabetes mellitus: a population-based study in Qatar. J Egypt Public Health Assoc 2014;89(2):47–52. DOI: 10.1097/01.EPX.0000451852.92252.9b.
Yeoh EC, Zainudin SB, Loh WN, et al. Fasting during Ramadan and associated changes in glycaemia, caloric intake and body composition with gender differences in Singapore. Ann Acad Med Singapore 2015;44(6):202–206.
Bener A, Al-Hamaq AOAA, Öztürk M, et al. Effect of Ramadan fasting on glycemic control and other essential variables in diabetic patients. Ann Afr Med 2018;17((4):196–202. DOI: 10.4103/aam.aam_63_17.
Ahmed M, Husain N, Elmadhoun W, et al. Diabetes and Ramadan: a concise and practical update. J Family Med Prim Care 2017;6(1):11–18. DOI: 10.4103/2249-4863.214964.
Malinowski B, Zalewska K, Węsierska A, et al. Intermittent fasting in cardiovascular disorders-an overview. Nutrients 2019;11(3):673. DOI: 10.3390/nu11030673.
Siaw MYL, Chew DEK, Toh MPHS, et al. Metabolic parameters in type 2 diabetic patients with varying degrees of glycemic control during Ramadan: An observational study. J Diabetes Investig 2016;7(1):70–75. DOI: 10.1111/jdi.12374.
Khaled BM, Belbraouet S. Effect of Ramadan fasting on anthropometric parameters and food consumption in 276 type 2 diabetic obese women. Int J Diabetes Dev Ctries 2009;29(2):62–68. DOI: 10.4103/0973-3930.53122.
Ali SA, Parveen N, Ali AS. Links between the Prophet Muhammad (PBUH) recommended foods and disease management: a review in the light of modern superfoods. Int J Health Sci 2018;12(2):61–69.
Mohiuddin A. The mysterious domination of food/Drinking water contaminants and adulterants in Bangladesh. Pharma Tutor 2019;7(1):42–58. DOI: 10.29161/PT.v7.i1.2019.42.
Tan T, Zhang Y, Luo W, et al. Formaldehyde induces diabetes-associated cognitive impairments. FASEB J 2018;32(7):3669–3679. DOI: 10.1096/fj.201701239R.
Hipkiss AlanR. Depression, diabetes and dementia: Formaldehyde may be a common causal agent; Could carnosine, a pluripotent peptide, be Protective?. Aging Dis 2017;8(2):128–130. DOI: 10.14336/AD.2017.0120.
Tulpule K, Dringen R. Formaldehyde in brain: an overlooked player in neurodegeneration? J Neurochem 2013;127(1):7–21. DOI: 10.1111/jnc.12356.
Grotton C, Research Update: Protect Against Formaldehyde Exposure. Life Extension Magazine®, Issue: Jan 2019.
Mohiuddin AK. Chemical contaminants and pollutants in the measurable life of Dhaka city. European Journal of Sustainable Development Research 2019;3(2):em0083. DOI: https://doi.org/10.29333/ejosdr/5727.
Ullah A, Sale of Adulterated Spice Powder: Public health at risk. The Daily Sun, October 16, 2019.
Staff Correspondent. Food adulteration rings alarm bell: STAR-RDRS roundtable told most food items adulterated, pose lethal risks to public health. The Daily Star, 2011.
Majed N, Real MIH, Akter Mand Azam HM. Food adulteration and bio-magnification of environmental contaminants: a comprehensive risk framework for Bangladesh. Front Environ Sci 2016;4:34. DOI: 10.3389/fenvs.2016.00034.
Chowdhury MFI. Evaluating position of Bangladesh to combat ‘adulterated food’ crisis in light of human rights. OSR J Human Soc Sci (IOSR-JHSS) 2014;19(3):45–54. DOI: 10.9790/0837-19364554Ver. VI.
Child Marriage in Bangladesh. Marry Before Your House is Swept Away. Human Rights Watch, June 9, 2015.
Kamal SM, Hassan CH, Alam GM, et al. Child marriage in Bangladesh: trends and determinants. J Biosoc Sci 2015;47(1):120–139. DOI: 10.1017/S0021932013000746.
Hossain MG, Mahumud RA, Saw A. Prevalence of child marriage among Bangladeshi women and trend of change over time. J Biosoc Sci 2016;48(4):530–538. DOI: 10.1017/S0021932015000279.
Zahangir MS, Hasan MM, Richardson A, et al. Malnutrition and non-communicable diseases among Bangladeshi women: an urban-rural comparison. Nutrit Diabet 2017;7(3):e250. DOI: 10.1038/nutd. 2017.2.
Silva-Zolezzi I, Samuel TM, Spieldenner J. Maternal nutrition: opportunities in the prevention of gestational diabetes. Nutr Rev 2017;75(Suppl 1):32–50. DOI: 10.1093/nutrit/nuw033.
Tunçer M, Tunçer M. Fetal malnutrition in infants born to diabetic mothers. Turk J Pediatr 1982;24(4):245–249.
Independent Online Desk. Malnutrition major cause of premature child birth in Bangladesh. The Independent, 23 March, 2018.
Das S, Mia MN, Hanifi SM, et al. Health literacy in a community with low levels of education: findings from Chakaria, a rural area of Bangladesh. BMC Public Health 2017;17(1):203. DOI: 10.1186/s12889-017- 4097-y.
Mehzabin R, Hossain K, Moniruzzaman M, et al. Association of functional health literacy with glycemic control: a cross sectional study in urban population of Bangladesh. J Med 2019;20(1):19–24. DOI: 10.3329/jom.v20i1.38816.
Islam FMA, Kawasaki R, Finger RP. Factors associated with participation in a diabetic retinopathy screening program in a rural district in Bangladesh. Diabetes Res Clin Pract 2018;144:111–117. DOI: 10.1016/j.diabres.2018.08.012.
Siddique MKB, Islam S, Banik PC, et al. Diabetes knowledge and utilization of healthcare services among patients with type 2 diabetes mellitus in Dhaka, Bangladesh. BMC Health Serv Res 2017;17((1):586. DOI: 10.1186/s12913-017-2542-3.
Ahmed T, Mahfuz M, Ireen S, et al. Nutrition of children and women in Bangladesh: Trends and directions for the future. J Health, Populat Nutrit 2012;30(1):1–11. DOI: 10.3329/jhpn.v30i1.11268.