Non Adherence to Diabetic Medication in Bangladesh – A Public Health Warning For Upcoming Burden on the Health System

INTRODUCTION: Diabetes possess a daunting challenge to the sustainable development of Bangladesh, as around 12% of the adult population of her is estimated to be affected by either Diabetes or Pre-diabetes. The Bangladesh demographic and health survey (BDHS) 2011, for the first time included testing for fasting blood glucose. The objective of this inclusion was to determine national status of this future development challenge. The best way of dealing with this situation is prevention backed by effective management system of people already suffering from the disease. However, small scale evidences show high rate of non adherence to diabetic medication in the country.  

METHODS: Women and men age 35 and older in 7543 households were sampled for blood glucose level tested. WHO (2006) cut-off points for measuring fasting plasma glucose was used for defining diabetes and pre-diabetes status. Along with any reported case with proper documentation was also taken under consideration for determining the prevalence rate.  

RESULTS: The BDHS findings shows almost 60% of women and 65% of men are not aware that their plasma glucose levels are elevated. Five percent of women and men know that they are diabetic but not treating it. More than one in five women and men are aware of their condition and are taking medication to lower the plasma glucose to normal values, but they are not successful in having it under control. Around 15% of women and 10% of men are aware that they have diabetes, are treating it, and have the plasma glucose level controlled within normal levels.

CONCLUSIONS: Evidence shows that only a small proportion of people with diabetes get diagnosed and an even smaller proportion receives proper treatment. This can lead to many diabetic co-morbidities and create burden to the already lumbered health system of the country.