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DIABETES

Early detection is cost-effective

Jens Sandahi Christiansen of the University of Aarhus in Denmark speaks on primary intervention

Star Business Report
A leading healthcare expert yesterday called for early detection of diabetes and primary intervention as improving diabetic care is more cost-effective than treating its complications.
Benefits from early detection are four times the cost of healthcare service and primary intervention can help recoup 12 times the spending, said Jens Sandahi Christiansen, a professor of medicine at the University of Aarhus in Denmark.
“Early diagnosis and enhanced treatment will reduce direct healthcare costs, improve the patient's quality of life and minimise lost productivity,” Christiansen said at a programme at Ruposhi Bangla Hotel in Dhaka.
The Danish expert highlighted the world's largest observational study ever into the safety and effectiveness of insulin treatment.
The world's biggest insulin maker Novo Nordisk has disseminated the results of Al chive, which is the largest ever study on the use of insulin therapy in type 2 diabetes, involving 66,726 people from 28 countries across Asia, Africa, Europe and Latin America.
Bangladesh was also a participant in the study with 1,093 patients and 48 doctors.
Before entering into the study, people were started on one of three Novo Nordisk insulin analogue regimens based on their physician's clinical judgement.
After 24 weeks of treatment with a Novo Nordisk insulin analogue, there was a significant reduction in blood glucose control or HbAlc levels of 2.1 percentage points from 9.5 percent to 7.4 percent.
Patients' reported quality of life improved significantly as well.
Christiansen said Alchieve is a fantastic achievement. "It gives us a lot of knowledge of what is going on in various countries in the developing world. It is a very helpful study. I think it will change a lot of clinical practices, also here in Bangladesh."
The study will allow physicians across the world to begin to see the results and how they can positively impact the treatment of people with diabetes in their own practice, he said.
He said the burden of diabetes is already enormous and is going to be significantly worse in the years to come. "The global epidemic of diabetes has to be managed. We need to do something for it. I am not sure whether we will be able to prevent it."
The expert prefers to go for primary prevention to tackle diabetes. "But we have two problems. We are not absolutely sure what we should do and we are certainly very much in doubt of how we should do
He said the westernised lifestyle is a major problem, he told The Daily Star in an interview.
Christiansen said they will see new analogues coming on the market. "We have already seen some. I am pretty sure in 10 years' time we will see all availability of insulin. We will have clever insulin which acts when the glucose is high, thereby elim-
inating all the risk of hypoglycaemia." He said the study was conducted in evolving economies. In developing countries, the care of diabetes, in some areas, is certainly in need of improvement.
Christiansen said there are significant costs to individuals and the wider economy. Direct costs include healthcare costs, particularly treatment of complications, and indirect costs include suboptimal performance/time off work, and financial losses.
Much of this cost comes from treatment of diabetic complications. As diabetes prevalence increases, future costs associated with treatment will increase as well, he said.
Officials of Novo Nordisk Pharma (Pvt) Ltd say the incidence of diabetes is increasing by the day, and at present one new case of diabetes is diagnosed every 10 seconds in the world.
In Bangladesh also, the scenario is threatening. About six million Bangladeshis are said to be suffering from diabetes. The number is expected to cross 10 million in the next 20 years due to changes in lifestyle, rapid urbanisation, obesity, lack of physical work and ageing of people.
Novo Nordisk has already tied up with Eskayef Bangladesh Ltd, a leading local pharmaceutical company, and set up a high-tech insulin manufacturing plant in Bangladesh amid hopes of providing worldclass medicines to the country's growing diabetic patients.
The Danish company enjoys more than 80 percent share in the insulin segment of diabetic care market in Bangladesh.
Transcom Distribution Company Ltd is the distributor of Novo Nordisk.
Prof AK Azad Khan, president of Diabetic Association of Bangladesh, Prof Hajera Mahtab, professor emeritus and chief consultant of medicine at BIHS Hospital, Prof Nazmun Nahar, director general of BIRDEM and Md Faruque Pathan, a professor of Department of Endocrinology at BIRDEM, and A Rajan Kumar, managing director of Novo Nordisk Pharma (Pvt) Ltd, also spoke.