27.3% of this is in the age group of 014 years , and 20% in the age group of 1524 years . the life expectancy at birth in bhutan has increased from 66.1 in 1994 to 68.9 in 2010 . the crude birth rate ( births per 1000 population ) has decreased consistently from 39.9 in 1994 to 17.9 in 2012 , and crude death rate ( deaths per 1000 population ) from 9.0 in 1994 to 6.2 in 2012 . there has been a consistent decrease in the under - five mortality rate ( deaths per 1000 live births ) from 96.9 in 1994 to 37.3 in 2012 , in infant mortality rate ( deaths per 1000 live births ) from 70.7 in 1994 to 30.0 in 2012 , and in maternal mortality ratio ( deaths per 100,000 live births ) from 380 in 1994 to 86 in 2012 . the sex ratio at birth ( males per 100 females ) has remained almost the same from 105 in 1994 to 104 in 2012 . bhutan has a very low burden of type 1 diabetes mellitus ( t1 dm ) , while that of type 2 diabetes mellitus ( t2 dm ) is very high and increasing at alarming rates . there have been different figures , quoted by different studies , regarding the t1 dm prevalence in bhutan , in past . who has also conducted a survey and the results are expected to be published shortly . bhutan , despite being a hilly country where people are forced to undergo high daily physical stress , has a notably high proportion of over - weight and obese population . the steps survey in 2007 reported hypertension in 26% of the population , t2 dm in 8.2% , impaired fasting glucose in 21.6% , overweight in 52.4% , obesity in 12.1% , and hypertriglyceridemia in 21% , with 5.6% daily smokers , and 82.9% not engaging in vigorous physical activity . the incidence of diabetes per 10,000 population has increased consistently from 38 in 2009 to 80 in 2013 . the dietary habits of people in bhutan include suja ( salted butter tea ) in 56.7% of the population , ezay ( salted chili pickle ) in 55.5% , dry meat in 25.1% , whereas two - thirds of the population consume fruits with < 5 servings per day . first case of t1 dm was detected in 2006 in an 18-month female who was referred as a case of pneumonia . thereafter , three more cases were detected who presented as severe dehydration , coma and pneumonia , of which the child with diabetic coma succumbed to the disease . of these cases , one patient has delivered a baby at the age of 18 years and is currently on treatment and doing well . the challenges in t1 dm management include lack of knowledge among health care workers and patients , and limited access to health care services because of the difficult terrain . the actions required for meeting these challenges are training and education of health care workers with a strong awareness on the burden of diabetes , improving infrastructure and equipment , patient education , ensuring quality of treatment , and establishing a diabetes registry . the tentative strategies for the management of t1 dm include sensitizing the government and undertaking a scientific study about salt consumption ; reducing salt intake through media publicity and public health campaigns , establishing school health campaigns to emphasize salt reduction , and by sensitizing the food industry .
bhutan is a south asian country with a total population of 733,643 . 
 bhutan has a very low burden of type 1 diabetes mellitus ( t1 dm ) , while that of type 2 diabetes mellitus is very high and increasing at alarming rates . 
 bhutan has a notably high proportion of over - weight and obese population . 
 first case of t1 dm was detected in 2006 and all the detected patients are in the age range of 1415 years . 
 the challenges in t1 dm management include lack of knowledge among health care workers and patients , and limited access to health care services because of the difficult terrain .