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Diabetes goes boom in Vietnam

Urbanization, inactive lifestyles and fast food triple the number of diabetics over the past decade

Children at a fast food restaurant in Ho Chi Minh City. Unhealthy diets and a lack of physical activities have been blamed for the surging number of diabetics nationwide, especially in big cities. Photo by Hong Ky

Diabetes in Vietnam has increased more than three times in the number of patients over the past decade and is likely to become a pandemic of the century, with increasing prevalence among young people, doctors warned.

The non-communicable disease has been historically found among only the elderly and the very rich in Vietnam, but urbanization and changes in lifestyle have brought the chronic disease to every sector of society.

Diabetes can be fatal and the damages it inflicts on society as a whole costs Vietnam as much money as natural disasters do, according to doctors.

Diabetes describes a group of metabolic diseases in which the person has high blood glucose, either because insulin production is inadequate, or because the body's cells do not respond properly to insulin, or both. Patients with high blood sugar will typically experience frequent urination, they will become increasingly thirsty and hungry.

Do Thi Ngoc Diep, director of Ho Chi Minh City Nutrition Center, said the number of diabetics in Vietnam increased 211 percent from 2002-2012. There are more than 3 million diabetics in the country, putting Vietnam among the top ten countries in the world in terms of diabetes prevalence.

The fastest increase, of 300 percent, occurred in HCMC, where 11 percent of adults (30-69 years old) had diabetes in 2012, according to the center.

"This speed [of the increase] is extremely fast in comparison with the world average of 76 percent," she told Vietweek. "The more troubling thing is that more young people have diabetes and the number of people in the pre-diabetes stage is also increasing."

Caught unawares

Official Vietnamese statistics show a rapid increase in Type 2 diabetes, a form of the disease that is linked to diet and lifestyle, especially among the obese.

From just 1 percent of adults in 1991 - the year the first nationwide survey of diabetes was done in Vietnam - the rate increased to 6 percent last year.

According to the International Diabetes Federation, 371 million people were afflicted with diabetes worldwide last year. Four out of five people with the disease live in poor or middle-income countries.

Among serious complications from the disease is "diabetes foot" - an infection that often begins as a minor scrape but then develops into a gangrenous wound because the disease desensitizes patients and compromises the healing process.

Although there are no statistics on the number of amputations linked to diabetes in Vietnam, Dr. Thy Khue, a pioneering diabetes researcher in the country, says the problem is "severe".

Khue said diabetes was once a disease of only the very wealthy. But as people have moved from rice paddies to factories and offices, her patients today come from all walks of life.

She said diabetes is preventable but symptoms, which include frequent thirst and urination and weight loss, often develop slowly and many people have the disease for years without knowing it.

In Vietnam, up to 60 percent of people with pre-diabetes and diabetes are not diagnosed and treated because they are not aware of their problems, she said.

Eat to die

Diep, the director of HCMC Nutrition Center, called diabetes "a quiet killer" as it only makes its presence fully known once it is already severe. She also said it was spreading like an "epidemic".

"Why is there a high prevalence of diabetes in developing countries and big cities? Mostly because of lifestyles that are becoming unhealthy," she told Vietweek.

Unreasonable diets with too much protein, fat, glucose and industrial foods are among the main factors, she said.

"Another factor is a lack of physical exercise and increasing inactive time," she said. "These factors, in combination with low awareness of diabetes, lead to high prevalence of the disease."

According to the World Health Organization (WHO) Vietnam, the main risk factors for diabetes include environmental and social determinants of health such as aging, globalization, urbanization and poverty; behavioral risk factors including smoking, alcohol-abuse, unhealthy diet and physical inactivity; biological factors such as age, gender, race and genes; and metabolism risk factors such as obesity, hypertension, raised blood glucose, and cholesterol.

"Of the above-mentioned risk factors, behavioral risk factors are very important. They are the easiest and least costly to modify," the organization said in a statement in response to Vietweek queries on the issue.

In general, the Vietnamese diet is healthy but it is moving towards unhealthy trends including less vegetables, more saturated fat and calories from processed sugar and carbohydrates, it said, adding that fast food is low in nutrients and high in saturated fats, salt and sugars.

Eating too much fast food can raise blood pressure, cholesterol levels and increase the risk of obesity, according to WHO Vietnam.

The National Hospital of Endocrinology also reported rates of diabetes are rising in Vietnam's younger population and this is related to changing lifestyles, including diet, as many young people prefer fast food to traditional foods.

Preventable damages

According to International Diabetes Federation (IDF), globally, by the end of 2013, there will be 381 million people with diabetes and the disease will have caused 5.1 million deaths and cost US$548 billion in healthcare spending.

In Vietnam, the IDF estimates that by the end of 2013 there will be more than three million people living with diabetes. Diabetes related illnesses will claim about 55,000 lives this year while healthcare for a person with diabetes costs about $127.8 per annum.

Diep said it is easy to prevent diabetes and other noncommunicable diseases by maintaining a healthy lifestyle and diet.

"People should implement healthy lifestyles that include nutritious and healthy diets, regular physical activity, and avoiding tobacco use and alcohol consumption. People should be aware of the risk of diabetes and other chronic diseases and get regular medical check-ups," she said.

Diep said it costs about VND7.37 trillion ($350 million) a year to treat diabetics in Vietnam.

"This amount does not include relevant damages due to reduced working ability and time. Millions of chronic patients with complications are also a burden for the medical system," she said.

"Without timely actions, diabetes will degrade the life quality, reduce the country's GDP, ruin family happiness and personal health and cause great damage to the economy."


- Conduct health education and communication to raise public awareness about diabetes and other non-communicable diseases

- Develop and implement laws that promote and protect people's health such as legislation for tobacco and alcohol control

- Develop and implement policies to provide supportive environments that are easy, available and affordable to encourage healthy lifestyles, such as create public bike lanes and foot paths to encourage physical activity.

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