Nearly four in 10 people aged 20-79 living with diabetes in Bangladesh were unaware of their condition in 2024, raising concerns over delayed diagnosis and the risk of developing serious complications before receiving treatment.
According to the International Diabetes Federation (IDF), 39.1% of people in this age group with diabetes did not know they had the disease. An estimated 1.39 crore adults were living with diabetes in Bangladesh in 2024, accounting for 13.2% of the country’s adult population.
The consequences of delayed diagnosis are already evident. A study at Birdem General Hospital in Dhaka found that 52.7% of newly diagnosed type 2 diabetes patients had at least one diabetes-related complication when the disease was detected.
Experts warn that type 2 diabetes can remain undetected for years because it often causes few or no noticeable symptoms. Many patients discover the disease only after suffering a heart attack, stroke, kidney complications or vision problems.
They stress the need for regular screening, early diagnosis and wider risk assessments at the primary healthcare level to prevent complications.
The concerns come ahead of World Diabetes Day, observed on 14 November. This year’s theme, “Early action on diabetes”, highlights the importance of early diagnosis, access to comprehensive care and reducing the stigma surrounding the disease.
According to the World Health Organization (WHO), more than 40% of people with diabetes worldwide remain undiagnosed. While type 1 diabetes often develops rapidly, type 2 diabetes typically progresses gradually and may cause few or no noticeable symptoms.
Complications before diagnosis
The Birdem study, titled “Frequency of Microvascular and Macrovascular Complications among Newly Detected Type 2 Diabetes Mellitus Patients Attending in a Tertiary Care Hospital”, examined 311 newly diagnosed patients.
It found that 164 patients, or 52.7%, already had at least one diabetes-related complication. Of them, 40.2% had microvascular complications, 7.7% had macrovascular complications and 4.8% had both.
Diabetic neuropathy was the most common complication, affecting 20.6% of patients, followed by nephropathy (16.4%) and retinopathy (8.03%).
Among macrovascular complications, coronary artery disease was the most prevalent, affecting 6.4% of patients.
App-based risk assessment
To identify people at risk before symptoms appear, the Bangladesh Diabetic Samity (Badas), through its Centre for Global Health Research (CGHR), has been using a Diabetes Risk Calculator (DRC) app at the community level for the past two and a half years.
Nearly 25,000 people have undergone risk assessments through the app. Of them, 50.37% were at high risk of type 2 diabetes, 41.96% at moderate risk and only 6.20% at low risk.
Professor Dr Bishwajit Bhowmik, professor of diabetology and project director of CGHR at Badas, told TBS that many people at risk of type 2 diabetes feel healthy despite the disease developing silently.
Reaching people before symptoms appear is crucial, as risk assessments can help provide preventive advice and identify those requiring further tests, he said.
The Community Clinic Health Assistance Trust has authorised the app’s use at 816 community clinics in Narsingdi, Cumilla and Cox’s Bazar. App-based risk assessment has also been incorporated into the national protocol for managing diabetes and hypertension at the primary healthcare level.
However, the app only assesses diabetes risk. Blood glucose tests are necessary to confirm the disease.
Screening recommended from age 35
Professor Dr Tanjina Hossain, head of the Department of Endocrinology and Metabolism at Green Life Hospital, told TBS that nearly half of people with diabetes in Bangladesh were unaware of their condition.
Many discover it only after being hospitalised with a heart attack, stroke, retinal haemorrhage or kidney complications, she said.
She recommended diabetes screening for everyone aged 35 and above. Younger people who are overweight, have a family history of diabetes, high blood pressure, polycystic ovary syndrome (PCOS) or a history of gestational diabetes should also undergo early screening.
Blood glucose, oral glucose tolerance (OGTT) and HbA1c tests can detect the disease, she said.
Patients should also undergo eye, kidney, nerve and foot circulation examinations, alongside cardiovascular risk assessments, from the time of diagnosis to prevent complications.
Badas estimates that nearly two crore people in Bangladesh are now living with diabetes.
Dr Md Nurul Islam, director of the Hospitals and Clinics Division of the Directorate General of Health Services, said diabetes prevalence was rising rapidly.
The 2022 STEPS survey found that one in 10 people had diabetes, while current estimates put the figure at one in eight, he said.
NCD corners at upazila and district hospitals provide free blood glucose and blood pressure tests, treatment and medicines.
The government is also considering telemedicine services at upazila health complexes to address the shortage of specialist doctors. An initiative has also been taken to establish a national institute for the treatment and research of metabolic and endocrine diseases, with a site already selected.
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