Diabetes in Nepal – Future and Perspectives

Before We Start Think Yourself
• What are the three main diabetes-related problems in your area?

• Which groups are the worst-affected or the most vulnerable in relation to each of these problems?

• What solutions to these problems are already in place?

• From your point of view, what solutions could be implemented? What are your expectations in relation to the management of this disease?

Risk factors for type 2 diabetes

• Genetic susceptibility
• Increasing age
• Reduced physical activity
• Central obesity
• CV disease & HTN
• Low birth weight
• Medications

800,000 diabetic people in Nepal 

• Almost Half undiagnosed

• Estimated cost to economy 10,000,000,000 NRs (140 million US$) every year

• Those undiagnosed develop complications

• Premature death of adult at the peak of their career

NATIONAL LIST OF ESSENTIAL DRUGS

NEPAL (Third Revision) 2002 18.5 Insulins & Antidiabetic drugs
• Insulin - injection (soluble) - injection, 40 IU / ml in 10- ml vial,
• Intermediate acting insulin - injection, 40 IU / ml in 10- ml vial,
(as compound insulin zinc suspension or isophane insuline ) • Metformin - tablet, 500mg
• Glibenclamide - tablet, 2.5mg, 5 mg
• Protamine Zinc Insulin – injection - 40 IU / ml (long acting) 100 IU / ml in 10- ml vials
• Complementary list: – Glipizide - tablet, 2.5 mg, 5 mg
Local Self Governance Act (LSGA) 1999 Health Systems Decentralization
• Decentralizing local health facilities to local bodies to
– promote efficiency
– generate financial resources
– encourage people’s participants
– Enhance management capacity.
• 1433 health facilities from 28 districts have been handed over to local bodies
• Encouraging results but political process stuck at the local level which has impeded this Diabetes clinics
• Bir Hospital
• TU Teaching Hospital
• Patan Hospital
• Ganga Lal Hospital
• Other private hospital