Examining the Impact of Aging and Interventions towards Burden of Diabetes Mellitus in Lao Population: A Model-Based Study / Lao Medical Journal

ABSTRACT

@#Background: Diabetes Mellitus (DM) is a major public health concern, but with minimal data on how this affects the Lao population. We aimed at predicting the impact of the burden of DM, and determine the effectiveness of DM screening techniques to reduce related mortality in Lao PDR. Methods: A compartmentally deterministic model was created to reflect the demography in 2005 and 2015, and DM prevalence in 2015 of the Vientiane capital population. The parameters were retrieved from calibration and literature reviews. The model predicted demographic structure and DM in 2035. The effectiveness of DM screening tests, either Fasting Plasma Glucose (FPG) or glycated hemoglobin (HbA1c), was examined in term of mortality reduction. Results: By 2035, the Vientiane population is expected to have annual grow of 0.89% with higher proportion of more elderly people; those aged 45 years old and older are expected to account for 39.3% in 2035. Overall prevalence of DM was expected to rise from 9.65% in 2015 to 13.4% in 2035 as a result of the aging population. The model predicts that the prevalence of DM would double (28.42%) in those aged >60 years old by 2035. The mortality rate is expected to increase more than double from 890 in 2015 to 1,808 deaths per 100,000 people in 2035, with the highest rate in those with undiagnosed diabetes and those older than 60 years. Screening by FPG test at an initial age of 35 years old is estimated to reduce mortality by 17.93%, and 16.80% for initial age screening at 45 years. Screening by HbA1c test would slightly increase the mortality reduction by approximately 1.20% at both initial screening ages. Conclusion: This mathematical modeling projected the steadily increase of prevalence and death related to DM over 30 years of simulation. Early screening by glycemia would reduce the mortality.