Diabetes Mellitus for 2025

Assess, identify and manage the cases of Diabetes to the community

Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood sugar levels due to either insufficient insulin production or the body's inability to effectively use insulin. This leads to impaired carbohydrate metabolism and, consequently, high blood glucose levels. There are three major variants that are distinguished:

• Type 1 Diabetes: An autoimmune disease where the body's immune system destroys insulin-producing cells in the pancreas. Patients with Type 1 Diabetes require lifelong insulin injections. 

• Type 2 Diabetes: The most common form, where the body either doesn't produce enough insulin or the cells become resistant to its effects. In many cases Type 2 Diabetes is associated with obesity and lifestyle factors.

• Gestational Diabetes: Occurs during pregnancy and typically resolves after childbirth. Gestational Diabetes increases the risk of developing type 2 diabetes later in life. 

According to the International Diabetes Federation, it is estimated that between 1.8% and 8% of people between 20 and 79 years of age living in Tanzania are living with diabetes, where about one third of these are undiagnosed. The vast majority of individuals with diabetes are living with type 2 diabetes. 

In the areas where Karimu operates, only patients showing symptoms are tested for diabetes. This results in a high number of undiagnosed cases and missed opportunities for early intervention. The Tanzanian government decided to intensify awareness and treatment of diabetes, which spurred Karimu to accelerate the execution of this intervention. A close alignment with the government is essential to ensure a consistent supply of diabetes medication and sufficient availability of test kits at all healthcare facilities.

Karimu extends its guidelines for testing to support early detection of diabetes: all dispensaries in the areas where Karimu operates should conduct Random Blood Glucose (RBG) and Fasting Blood Glucose (FBG) tests for all pregnant women at week 28 and for all patients at high risk, e.g. patients with high blood pressure. In addition, educational activities are provided to all communities to increase awareness about prevention, early detection and management of the disease. 

The success of the program will be measured according to the following metrics: 

• Number of adults screened for diabetes

• Number of pregnant women at week 28 of Gestational age tested for diabetes

• Number of patients identified with diabetes

• Number of medicine provided by the government

• Number of medicine provided by Karimu

• Number of test kits provided by the government

• Number of test kits provided by Karimu

The project is planned to run for three years with the following termination criteria: 

• 100% of pregnant women at week 28 of Gestational age are tested

• 100% of patient at high risk to develop diabetes are tested, e.g. patients with high blood pressure

• 100% of patients identified with diabetes are treated (including returning for recurring treatment) and records are kept

• At least 95% of medicine and test kits are provided by the government, ensuring consistent access to essential resources for patient care

Benefits:

• Ensure high rate of testing and identification for patients with diabetes

• Ensure appropriate treatment and medication for patients identified with diabetes

• Increase knowledge about prevention, early detection and treatment through educational activities in all communities