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Latest Annual report
Annual Report (September 2011- September 2012)
Activity 1
  Pilot project for screening of diabetic retinopathy among known diabetics at Diabetic Association of Pakistan & WHO Collaborating Centre for the prevention and control of diabetes related blindness.

Explanation
Duration of project 2009- July 2012
Study population 14825 diabetic patients
Aims of the study are
  • To establish a screening system for diabetic patients at Diabetic Association of Pakistan for diabetic retinopathy

  • To prevent/treat occurrence or progression of the disease, and establish data base to check the prevalence and patterns of diabetic retinopathy

  • To determine the usefulness and cost effectiveness of the pilot project and provide recommendations for its future use.

Executing partners Diabetic Association of Pakistan - Fred Hollows Foundation, Australia and Al-Ibrahim Eye Hospital Karachi
Outcome Screening of 14825 diabetic patients has been completed in July 2012 for Diabetic Retinopathy. Screening was done by Non Mydriatic Fundus Camera.
Fundus Photographs were taken of all the subjects in this study. Diabetic Retinopathy was diagnosed in 2771subjects. Intervention needed in 1151 subjects. Laser advised to 977 subjects, FFA to 9 subjects and retinal surgery to 27 subjects.
Activity 2
  Pilot project for screening and prevention of Nephropathy in type 1 diabetic patients – Pakistan perspective

Explanation
Duration of project August 2009 – April 2012
Study population 342 Type 1 diabetic patients.
Aims of the study are
  • To screen type 1 diabetic patients attending the Diabetic Association of Pakistan for the prevalence of diabetic nephropathy

  • Appropriate management of patients with diabetic nephropathy

  • To establish a data base to check the prevalence and patterns of diabetic nephropathy in the screened diabetics

Executing partners Diabetic Association of Pakistan and WHO Collaborating Centre, Kidney Foundation Karachi, Pakistan and Baqai Institute of Diabetes and Endocrinology
Outcome Data collection has been completed, the study is in analysis phase
Activity 3
  To increase the awareness of policy makers on the public health impact of diabetes in Pakistan.

Explanation
Public Awareness Programmes 09 major public awareness programmes were conducted all over Pakistan which were largely attended by the policy makers, public health officials, people with diabetes, their relatives and friends.
Collaboration of Sanofi with the Diabetic Association of Pakistan (DAP) Collaboration of Sanofi Pakistan with the Diabetic Association of Pakistan (DAP) to improve the standard of diabetes care in Pakistan under a nationwide initiative. Through “Sanofi Kawish programme”, the Diabetic Association of Pakistan will conduct 20 workshops to educate 1000 healthcare professionals from smaller towns and cities in early detection, better disease management and management of complications in people with diabetes. The focus of this Educational Programme is to educate the family physicians who are the first contact point of a diabetic patient, playing most important role in the diabetes management to avoid the late complications of diabetes. This collaboration is based on educational grant from Sanofi and has no commercial angle.
Collaboration of Nestle with the Diabetic Association of Pakistan (DAP) Nestle and IDF have recently signed a 3-year partnership. Nestle in partnership with Diabetic Association of Pakistan is planning to create awareness about diabetes by Healthy Kids Programme. The objective of the Healthy Kids Programme is to raise nutrition and health awareness and promote physical activity among school-age children around the world by giving them information about the right food choices and portion guidance
Continuing Medical Education (CME’s)
  • Number of CME’s on Diabetes...13

  • Number of CME’s on foot.......... 3

  • Basic and advanced courses for foot care teams (123 teams participated. Each team consisted of 1 doctor and 1 assistant)

  • School awareness programmes…………12

Insulin Workshops Number of Insulin Workshops conducted….. 4
Diabetes Centres 33 Diabetes Outpatient Clinics which were established in 17 districts of Sindh province are now fully functional.

Besides providing treatment free of cost to poor patients, awareness and education is also provided at these Centres for patients and allied health professionals.

22nd Advanced Course on Diabetes, 17-22 October, 2011
23rd Advanced Course on Diabetes, 10-15 September, 2012

22nd and 23rd Advanced courses on diabetes for family physicians, post graduate students, and registrars were organised by the Diabetic Association of Pakistan and WHO collaborating centre, Karachi. Ten lectures on various aspects of diabetes were delivered in each course by senior members of the medical profession. Certificate of attendance were given at the end of each course.
World Diabetes Day, November 13, 2011 World diabetes day was organised by the Diabetic Association of Pakistan in Karachi on 13 November 2011

The World Diabetes Day activities were given wide coverage by the print and electronic media.

Scientific Sessions for doctors, allied health professionals, people with diabetes and their relatives were held at different Universities, Medical Colleges, Diabetes Care Centres, Schools and Colleges all over Pakistan.
Other Activities
  • Diabetes awareness programmes by leading experts and Diabetes Facts Promos on different TV and radio channels.

  • Diabetes walk was held on the World Diabetes Day.

  • Monument Lighting at different cities in blue.

  • Diabetes branded Billboards in different cities of Pakistan.

  • Tent cards with messages about WDD in leading Hotels & restaurants

  • Patient Awareness Programmes using Diabetes Conversation maps by Diabetes Nurse Educators

  • Blood Glucose Screening Camps involving Diabetes Nurse Educator

Activity 4
  In collaboration with the Ministry of Health, work on the integration of diabetes prevention and care into the primary health care.

Explanation
1) Diabetes Prevention Trials for high-risk subjects in Low Resource Environment

Study population -  1825 high risk subjects screened.
-  400 subjects identified as IGT and divided into 4 groups
-  18 months follow up
-  Total 325 subjects completed the study
Duration of the project Three years (2006 - 2009)
Aims of the study are
  • To observe the rate of conversion of IGT to diabetes

  • The usefulness of an insulin sensitizer (Metformin 500 mg BD)

  • To evaluate the impact of intervention with life style modification

Executing partners Diabetic Association of Pakistan- Baqai Institute of Diabetology & Endocrinology - University of Oslo
Outcome The following papers have been published from the project
  1. Depression and diabetes in high risk Urban population of Pakistan
    Published in: The Open Diabetes Journal, 2010 3, 1-5
    Author: Fariha Faisal, Shaheen Asgher, M. Zafar Iqbal Hydrie, Asher Fawwad,Abdul Basit, A Samad Shera, Akhter Hussain
  2. Detecting Insulin Resistance in Pakistani Subjects by Fasting Blood Samples
    Published in: The Open Diabetes Journal, 2012, 5, 20-24
    Authors: M. Zafar Iqbal Hydrie, Abdul Basit, Asher Fawwad, Muhammad Yakoob Ahmedani, A Samad Shera, Akhtar Hussain
  3. Effect of intervention in subjects with high risk of Diabetes Mellitus in Pakistan
    Published in: Journal of Nutrition and Metabolism Volume 2012 (2012), Article ID 867604, 07 pages
    Authors: Muhammad Zafar Hydrie, Abdul Basit, A Samad Shera and Akhtar Hussain
  4. Risk assessment of Pakistani Individuals for Diabetes (RAPID)
    Published in: Primary Care Diabetes (Accepted for publication) 2012 May 3 Epub ahead of point
    Authors: Musarat Riaz, Abdul Basit, M.Zafa Iqbal Hydrie, Fariha Shaheen, Akhtar Hussain, Rubina Hakeem, A. Samad Shera

2) Integrated and comprehensive management of children/ people with type 1 diabetes to prevent complications in a low resource society of Sindh Pakistan
Duration of project January 2010 - January 2013
Project Objectives Providing standardized Type 1 Diabetes care to the people of Sindh and creating awareness on this condition, through
  • Establishing 33 Diabetes Centres
  • Training thirty three doctors from all over Sindh
  • Training thirty three Diabetes Educators from all over Sindh
  • Providing insulin and medical supplies free of cost to the non affording diabetic subjects
  • Designing educational material in local languages (urdu & sindhi) for diabetic subjects
  • Educating children with type 1 diabetes and their families regarding home based management of type 1 diabetes
  • Introducing the concept of self empowerment for children with type 1 diabetes, reaching adolescence
  • Creating awareness in the school teachers regarding type 1 diabetes
  • Creating awareness in the common people
  • Preparing a provincial type 1 diabetes registry.
Executing partners Diabetic Association of Pakistan - Baqai Institute of Diabetology & Endocrinology.
Update of Project
  • 33 Diabetes Centres are fully functioning in 17 districts of Sindh, Pakistan.
  • Electronic database has been developed for registering patients with type 1 diabetes
  • Activity is ongoing
Outcome -  Total 470 camps have been done till July 23 2012
-  Total 257,930 letters sent to school teachers for awareness
-  Total 52 advertisements have been published in newspapers
-  Total 30 FM radio programmes have been done
-  Total 4 TV programmes have been telecasted
-  Total 1782 patients have been registered
Activity 5
  Published studies from September 2011 – September 2012

  1. Detecting Insulin Resistance in Pakistani Subjects by Fasting Blood Samples
    Published in:
    The Open Diabetes Journal, 2012, 5, 20-24
    Authors: M. Zafar Iqbal Hydrie, Abdul Basit, Asher Fawwad, Muhammad Yakoob Ahmedani, A Samad Shera, Akhtar Hussain

  2. Effects of 16 Genetic Variants on Fasting Glucose and Type 2 Diabetes in South Asians: ADCY5 and GLIS3 Variants May Predispose to Type 2 Diabetes
    Published in:
    Plos One, September 2011, Vol 6 , Issue 9, e24710
    Authors: Simon D. Rees, M. Zafar I. Hydrie, J. Paul O'Hare, Sudhesh Kumar, A. Samad Shera, Abdul Basit, Anthony H. Barnett, M. Ann Kelly

  3. Circadian Gene Variants and susceptibility to Type 2 Diabetes: a pilot study
    Published in:
    Plos One 7(4) : 2012
    Authors: M Ann Kelly, Simon D. Rees, M. Zafar I. Hydrie, A. Samad Shera, Srikanth Bellary,J.Paul O’Hare, Sudhesh Kumar, Shahrad Taheri, Abdul Basit, Anthony H. Barnett, DIAGRAM consortium”, SAT2D consortium

  4. Risk assessment of Pakistani Individuals for Diabetes (RAPID)
    Published in:
    Primary Care Diabetes (Accepted for publication) 2012 May 3 Epub ahead of point
    Authors: Musarat Riaz, Abdul Basit, M.Zafa Iqbal Hydrie, Fariha Shaheen, Akhtar Hussain, Rubina Hakeem, A. Samad Shera

  5. Effect of intervention in subjects with high risk of Diabetes Mellitus in Pakistan
  6. Published in: Journal of Nutrition and Metabolism Volume 2012 (2012), Articles ID 86076045, 7 Pages
    Authors: Muhammad Zafar Hydrie, Abdul Basit, A. Samad Shera and Akhtar Hussain