National Academy of Medical Science, Nepal
I Dr. Dipak Mall have completed my MBBS Degree from Peoples friendship university of Russia in year 2004 and MD from Yangze University of China in year 2015.After my graduation I have been working in the department of endocrinology in one of the tertiary center in Kathmandu, Nepal. We as a team have been working to promote and encourage our patients to have early detection of diabetes mellitus and to prevent the complications.
Financial burden and outreach of diabetes clinics for patients in Nepal: In the capital city of Nepal,there are only two hospital based endocrinology referal centers,which is run 6 days a week with loads of around 120 patients a day with 2-3 doctors handling the burden. Most of the patients visiting higher centers are from remote areas of Nepal who travel for around half a day or whole day o reach doctors clinics. As per trend from 2006 to 2014 the per capita income of Nepal is increased by $327 to $ 426.48 according to world bank.Now we can see how much is a burden for patients who need oral hypoglycemic agents and insulin therapy everyday to fight with diabetes. Only few studies are being studies carried out in Nepal which states that the cost of intial visit to doctor with laboratory investigations and treatment cost around Nepalese Rupee 3000 to 4500($20 and $35) which patiens have to bear on self, which dosent include personal and travel cost. Though the tertiary centers are located in centers of the capital,most of the patients visiting government hospitals are from remote and nearby villages,who visit tertiery centers not as a initial presentation but with complications.Which states that the financial burden to the patients are increased more with screening for Diabetes retinopathy,Nephropathy,peripheral vascular diease,diabetes foot examination and use of insulin therapy.
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