THE Diabetes Atlas (9th Edition) of the International Diabetes Federation (IDF) noted the prevalence of diabetes in Pakistan to be 17.1 per cent, which is 148pc higher than what was previously reported. In 2019, over 19 million adults in Pakistan were estimated to be living with diabetes, putting them at risk of lifethreatening complications. Around 8.5 million of these 19 million are undiagnosed, and, as a result, are particularly at risk. The disease, called the `silent killer` is on a rampage, it seems.

The rise in the number of people with type 2 diabetes is driven by a complex interplay of socioeconomic, demographic, environmental and genetic factors. Key contributors include urbanisation, an ageing population, decreasing levels of physical activity and increasing levels of overweight and obesity. For reasons unknown, type 1 diabetes is also on the rise.

Where does Pakistan stand in handling the risk factors associated with diabetes? Pakistan is ranked 165 out of 194 countries in terms of its overweight population, with 22.2pc of individuals over the age of 15 crossing the threshold of obesity. This ratio roughly corresponds with other studies, which reported that one in four Pakistani adults is overweight.

Pakistan has an estimated prevalence of childhood obesity between 15pc and 20pc. The proportion of obese and overweight children in Karachi was found to be 6pc and 19pc, respectively. During 2015-18, 36.3pc children and adolescents aged 2-19 years consumed fast food on a given day. And that can only add to the burden of obesity.

A knowledge, attitudes and practices (KAP) survey in Pakistan indicated that the obesity rate was 20pc higher than that for the rest of the world (20pc in class I, 7pc in class II, and 7pc in class III). Pakistani population is the ninth most obese in the world, and around 3.4 million Pakistanis died because of obesity in 2010 alone.

The risk factors of obesity have been interpreted as a high-fat diet, sedentary work and motor transport. The main reason for the increase in obesity in Pakistan is lack of exercise.

Pakistan is ranked as sixth mostpopulous country in the world. As elderly population is rising worldwide, similar trend is witnessed in Pakistan. It is estimated that 7pc of the population, about 14 million, is over 60 years of age in the country. Alarmingly, it is expected to reach 8.5pc and 12.9pc in 2030 and 2050, respectively. Therefore, the probability of diabetes will also increase.

A total of 4,063 patients, with mean age 55.86±12.37 years and male preponderance, were included in the study.

ST-elevation myocardial infarction (ST EMI) was most prevalent (2,723; 67pc) type of myocardialinfarction(M1)among the study participants.

Most of our schools and colleges function in houses having no room for any physical activity, and public parks have been snatched by the builders` mafia.

Junk food chains are promoting their food to involve children, and the number of our elderly is rising. There is every reason tobelieve thatthe nation is marching towards becoming the number one diabetic country in the world. And this is scary, to say the least.

Dr Asghar Naqvi & Faheem Khan Karachi