Sarhad J. Agric. Vol. 23, No. 4, 2007

PREVALENCE OF DIABETES MELLITUS IN MIRPUR AND KOTLI DISTRICTS OF AZAD JAMMU & KASHMIR (AJ&K)

Saleem Khan *, M. Abbas *, Fozia Habib ** , Iftikhar H. Khattak *, and N. Iqbal *

ABSTRACT Prevalence of Diabetes Mellitus was investigated in the two districts of AJ&K, Mirpur and Kotli. A total of 600 families were randomly selected from both districts for the study. A questionnaire, containing information about diabetes and diet, was filled from a responsible individual of above 30 years of each family. The mean prevalence of diabetes mellitus was 1.77% in the target area. The prevalence was higher in male (1.01%) than female (0.76%). The consumption of milk and meat of people in the area was lower than the recommended amount. The findings indicated that at present, the prevalence of diabetes is not of great concern in AJ&K. However, preventive measure should be taken to avoid the serious consequences of this killer disease.

Keywords: Azad Jammu and Kashmir, Diabetes mellitus, Nutrition, Pakistan, Prevalence

INTRODUCTION Diabetes mellitus is a major health problem around MATERIALS AND METHODS the globe (King and Rewers, 1993). According to The survey was conducted in the districts Kotli and WHO, prevalence of diabetes mellitus in Pakistan Mirpur of Azad Jammu & Kashmir (AJ&K) from ranked 8 in the world and with present lifestyle this April 20 to September 23, 2005. One city, one ratio will increase (King and Rewers, 1993; King town and one village were selected from each et al., 1995). The prevalence of diabetes in the district as shown in Table I. North West Frontier Province (NWFP) of Pakistan was reported to be 1.49% (Khan and Ahmad, Hundred families were randomly selected from 1993). Similarly, the mean prevalence of diabetes each targeted location. In this way a total of 600 in the Muzaffarabad, Bagh and Poonch districts of families were selected from both districts. In the Azad Jammu & Kashmir (AJ&K) was 0.95% sample selection, the consideration was given to (Danish and Khan, 2002). variation in culture, customs, dietary pattern and socioeconomic status. The selected locations were Diabetes mellitus is a disorder of blood glucose at sufficient distance from each other. regulation, usually caused by insufficiency or relative ineffectiveness of insulin (Whitney and A questionnaire was developed for the survey. The Hamilton, 1984). There are various health questionnaire had the information about the age, hazards/disorders associated with diabetes occurrence of diabetes, and dietary intake pattern. mellitus. It also affects the metabolism of fat and A responsible individual of above 30 years from protein. In its advance stages, rapid loss of body each family was interviewed. The collected data weight and ketosis are observed. Other was analyzed for means and standard deviations complications include diabetic coma, diabetic using the statistical software Microsoft Office retinopathy, peripheral neuropathy, diabetic Excel, 2006. nephropathy, atherosclerosis and possibly skin infection. The long-term complications of the RESULTS AND DISCUSSIONS disease reduce life expectancy by one third Prevalence of diabetes mellitus has been reported (Bhandari and Grover, 1998). in various countries (Bhandari and Grover, 1998; Taha et al . 1983; Omar et al . 1985; Zimmet, 1982). Diabetes is a health problem of all populations. It In Pakistan, prevalence of this disorder has been mainly affects people in a very productive period investigated in the North West Frontier Province of life. Therefore, it is important to explore its (NWFP), some districts of AJ&K and Northern prevalence among various sections of society to Areas (King et al . 1998; Khan and Ahmad, 1993; adopt preventive measures. The prevalence of King et al . 1984). diabetes in Kotli and Mirpur districts of AJ&K has not been reported. Therefore this work was In this study, prevalence of diabetes in districts designed to produce prevalence data of diabetes Kotli and Mirpur of AJ&K was investigated and and its relationship with diet in these selected areas presented in Table II. The data indicated that 41 of AJ&K. (1.26%) individuals out of 3226 were found diabetic in district Kotli. The prevalence was higher in kotli city (2.39%) followed by Nikyal

* Department of Human Nutrition, NWFP Agricultural University, Peshawar - Pakistan ** Department of Gynae and Obstetrics, Khyber Teaching Hospital, Peshawar - Pakistan

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(1.50%) and Sehensa (1.12%). The data also shows districts of AJ&K is presented in Table III. The that the prevalence of diabetes was more in male milk intake was highest in Mirpur city (7±3 ((0.74%) than female (0.52%). In district Mirpur, servings per week) and lowest in Chaksawari (3±2 41 (1.92%) individuals out of 2135 were diabetic. servings per week). Meat intake ranges from 8±6 Mirpur city (2.67%) has the higher prevalence as to 5±4 servings in Mirpur city and Nikyal, compared to Chaksawari (2.42%) and Dudyal respectively. Kotli city (10±3) leads the selected (0.58%) in district Mirpur. Again, there were more areas in fruits/vegetables intake. The male diabetics (1.08%) than the females (0.84%). fruits/vegetables intake was lowest in Sehensa & Chaksawari (6±4 servings each). The intake of The overall mean prevalence in both districts was cereals was highest in Mirpur city (30±6) and 1.52 %. Out of the six locations, the highest lowest in Kotli city (19±3). The overall mean prevalence rate was found in Mirpur (2.67%) intake of milk, meat, fruits/vegetables and cereal followed by Chaksawari (2.42%) and kotli groups in both districts of AJ&K was 5±3, 7±4, (2.39%). The lowest prevalence of the disease was 7±3 and 25±4, respectively. in the Dudyal (0.58%) followed by Sehensa (1.12%) and Nikyal (1.50%). Moreover, the Diet plays an important role both in the prevalence of diabetes was more in males (0.87%) development and control of diabetes (Khan and than females (0.65%). Ahmad, 1994). In this study, the weekly intake of the four food groups (milk, meat, fruits/vegetables The present study shows that the prevalence of & cereals) of the dwellers was determined and diabetes in district Kotli and Mirpur is relatively compared with the recommended intake of these higher as compared to the prevalence of diabetes in food groups (Whitney and Hamilton, 1984). The other districts of AJ&K, Northern areas and overall mean consumption of all the groups was NWFP. lower than the recommended intake. The low prevalence of diabetes in these areas may be due to It was assumed that the prevalence of the disease the use of table salt instead of sugar in the tea. would be higher in more populous and urbanized cities. As reported by Khan and Ahmad (1993), the CONCLUSION prevalence of diabetes in Peshawar and Mardan The observed data indicated that the prevalence of cities was 3.57% and 3.53%, respectively. This diabetes mellitus is not a serious health concern in survey also showed that the prevalence of diabetes Azad Jammu & Kashmir. However, it is in AJ&K was relatively high in cities than the imperative to take preventive measures in order to towns and particularly villages. avoid the serious consequences of this killer disease. The mean intake of various food groups per week in the selected cities, towns and villages of the two

Table-I. Selected Cities, Towns and Villages for the Survey District Selected Cities, Towns and Villages KOTLI Kotli City, Nikyal & Sehensa MIRPUR Mirpur City, Chaksawari & Dudyal

Table-II. Prevalence of Diabetes in AJ&K

Location No. of No. of Male Diabetics Female Both Sexes families Individuals Diabetics District City, Town, Village No. % No. % No. % Kotli 100 752 10 1.33 08 1.06 18 2.39 Kotli Nikyal 100 869 08 0.92 05 0.58 13 1.50 Sehensa 100 892 06 0.67 04 0.45 10 1.12 Total 300 3265 24 0.74 17 0.52 41 1.26 Mirpur 100 748 12 1.60 08 1.07 20 2.67 Mirpur Chaksawari 100 703 08 1.14 09 1.28 17 2.42 Dudyal 100 684 03 0.44 01 0.15 04 0.58 Total 300 2135 23 1.08 18 0.84 41 1.92 Mean - - - 0.87 - 0.65 - 1.52

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Table-III. Mean intake of Food Groups per week in the selected areas. City, Town & Village Servings of Food Groups eaten per week Milk Meat Fruits/ Cereals Vegetables Kotli City 5±4 7±4 10±3 19±3 Sehensa 4±2 6±3 6±4 24±6 Nikyal 6±3 5±4 7±3 27±4 District Kotli 5±3 6±4 8±3 23±4 Mirpur City 7±3 8±6 8±2 30±6 Chaksawari 3±2 6±3 6±4 27±4 Dudyal 6±3 7±2 7±3 22±3 District Mirpur 5±3 7±4 7±3 ±4 Mean 5±3 7±4 8±3 25±4

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