Background  
Pakistanis are an ethics group having an inherent predilection to develop diabetes. But in rising in diabetes incidence and prevalence is associated with demographics, an increase in life expectancy and social pattern consumption of unhealthy diets and physical inactivity leading to obesity is a part of urbanization and social development further contributes to the existing trends. But more than 46% of diabetes women patients are unaware of their condition especially in the rural areas and small towns of Pakistan. The high number of people in the pre-diabetic state or with undiagnosed diabetes represents a large pool of individuals in rural areas.

Aim  
Prevention and control of diabetes-related Hypertension and Obesity need to be structured at all levels of prevention. There is clear potential in reducing diabetes Hypertension Obesity and -related mortality and morbidity by addressing risk, both primary and secondary prevention levels. Any attempt aimed at reducing diabetes should ideally encompass prevention and treatment of diabetes and it’s complications.

Method  
This Only 30% of the patients reviewed Cardiology / Medicine departments Outdoor clinics of Dow University Health and Sciences Karachi for treatment and prevention achieved benefit. All Women attending the OPD from the rural areas and small towns of Pakistan were tested for diabetes for free. Data on their age, height, weight diabetes status, and blood pressure was also taken. The basal mass index was calculated and stratified as per WHO classification. 706 persons were screened out of 2,120 but complete data for all persons was available for analysis

Results  
A total of 706 people who attended the OPD were known diabetics with mean age was 47.5 years with 66% being above 40. 60.2% had poor glycemic control using an optimum of &lt;7.8 mmol/L. (&gt;140mg/dl), 54.59% had poor glycemic control with blood sugars exceeding 10 mmol/L (&gt;180mg/dl). HBA1c &lt; 7% with about 50% being hypertensive in spite of the treatment. 62% of women were either overweight or obese with 33.3% of the women. BMI above 30 kg/m2 as measure obesity was found in 32%. Of all those who were known diabetics. 12% (92) of those not known to have diabetes had either impaired glucose tolerance of were newly diagnosed diabetics.

Discussion  
In our Study the Large proportion of diabetics with poor glycemic control in our study. The majority of known diabetes patients are at risk of long-term complications owning to overweight and obesity (58%), Poorly controlled blood pressure (59.4%), Poor glycemic control (60.2%), Emphasis should be on the promotion of early detection of diabetes through screening and diabetes education. Weight control, Strict blood pressure and glycemic control essential for prevention of long-term complications of diabetes in under develop areas of Pakistan.

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Poor Trends in glycemic, weight and blood pressure control during screening in women among small town of Pakistan