In Cambodia diabetes prevalence is surprisingly high. The Cambodian Diabetes Association, with assistance from the World Health Organisation (WHO), conducted a survey in a rural area and one in a semi-rural area. It showed respective rates of 5% and 10% diabetes among adults over 25 years old (Lancet, 2005). These rates are surprising, because there are for the moment few Cambodians who are overweight compared with other countries.

In Cambodia there is not yet a body of best practices for diabetics that are safe, work well and keep the costs down from the patient’s perspective. This applies to prescribing the most cost effective drugs of good quality, to the best nutritional advice, to the right laboratory tests at the right time. The public health system has no protocols for diabetes in effect. That means that in practice people with a lot of money receive a lot of services and people without money get little or no service.

Most people with diabetes in Cambodia do not live long. The average reported lifespan of diabetes among a group of more than 500 diabetes patients was four years. Only one in ten diabetics could report a history of more than ten years. People, mostly children, who develop Type 1 diabetes, in general do not survive at all. Most of the type 1 children die before they get diagnosed. Cambodian doctors report that they have never seen such children, but there should be 2,000 of them alive today in Cambodia. This shows that it is not just a problem of patients lacking information, but that the health services need to be improved as well, with training, revision of standard protocols and supplies. For an overview of the situation, please read the article in Diabetes Voice of June 2009.

Diabetes is one of the biggest and growing silent killers in Cambodia. It often kills people when they are still in the prime of their productive life. But before it kills, it has drained households of its assets and financial resources, forcing parents to make their children drop out of school, sell cattle and land, leaving the household in a debt from which its members cannot escape. [ Please see ” I wish I had AIDS” ]