Action for better control of diabetes in Bangladesh

Increasing rates of diabetes and its complications are a growing concern for overstretched health care services and people living with the disease or at risk of developing it. Diabetes can lead to premature death, greatly increase the risk of cardiovascular disease and if not managed well can lead to serious morbidities.

Underlying the increasing prevalence of diabetes are complex changes in diet, lifestyles and increases in other risk factors such as smoking and lack of exercise. Owing to the high burden of diabetes in Bangladesh, effective strategies to prevent and control diabetes are urgently needed, especially in rural areas.

Individual targeted strategies such as mobile phone technology (mHealth) have been shown to reduce the incidence of diabetes in India, however this approach has yet to be tested in a rural setting.

Participatory learning and action (PLA) is an approach that engages communities to identify and address their own problems. PLA has been shown to improve maternal and new-born survival in LMICs and could potentially be adapted to help prevent and control diabetes in rural communities.

mHealth and PLA interventions hence have the potential to be effective for prevention and control of diabetes in rural Bangladesh.

The award

The Bangladesh D-Magic Trial project involved the use of mHealth and PLA community mobilisation interventions as tools to inform rural communities about diabetes and encourage actions to prevent and manage diabetes.

The study was funded by the UK Medical Research Council from 2014 to 2017 and was conducted by researchers from University College London and the Diabetic Association of Bangladesh.

Key findings

The project found that both interventions were successful in raising awareness of diabetes and the PLA community mobilisation intervention also led to an absolute reduction of 20% in diabetes and intermediate hyperglycaemia prevalence.

The project team showed PLA community mobilisation to be a cost-effective approach that could reach up to 240,000 people in rural Bangladesh if scaled up.

Next steps

Further scale-up work is being conducted to see how to improve stakeholder involvement and subsequent uptake of PLA, replicating the project approach and results on a larger scale and piloting the deployment of the PLA method in an urban context.

The hope is that the project can be translated into a successful and cost-effective intervention that is applicable across Bangladesh and other countries.

Full case study: Action for better control of diabetes in Bangladesh