Lancet study says that India accounts for over a quarter of global diabetes cases, with approximately 21.2 crore people affected.

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Key Findings of the Study

• Global Diabetes Prevalence: An estimated 82.8 crore people globally had diabetes in 2022, marking a more than fourfold increase since 1990.
  • Other countries with high diabetes rates include China (14.8 crore), the U.S. (4.2 crore), Pakistan (3.6 crore), and Brazil (2.2 crore).
  • The highest increases have occurred in low- and middle-income countries (LMICs).
• Untreated Diabetes Burden: Stagnation in diabetes treatment rates in Low and Middle Income Countries (LMIC) has left 44.5 crore adults with diabetes untreated globally.
• India’s Specific:
  • Nearly one-third of untreated diabetes cases worldwide (13.3 crore adults) reside in India.
• Challenges with Untreated Diabetes: Undiagnosed diabetes can lead to severe complications like diabetic retinopathy, a condition causing vision loss due to retinal damage.

Study on Diabetes in India

• The SMART India study is a statistical and economic modeling study on a cross-sectional and prospectively recruited participants from community-based screening in order to accurately identify people at risk of diabetes, pre-diabetes and complications of diabetes in India.
• Sample: Conducted across 10 Indian states and one union territory by researchers, including those from Chennai’s Sankara Nethralaya.
  • Involved 6,000+ diabetic patients aged 40 and above.
• Key Finding: Revealed that 12.5% of diabetes patients in India (around 30 lakh people) had diabetic retinopathy, with 4% at immediate risk of vision-threatening conditions.
• Better screening: The study emphasizes the need for regular diabetic retinopathy screenings.

Factors contributing to the high prevalence of diabetes in India

• Genetic Predisposition : Certain ethnic groups, including Indians, have a higher genetic predisposition to develop type 2 diabetes.
• Insulin Resistance: Indians tend to have higher levels of insulin resistance, making them more susceptible to the disease.
• Urbanization and Sedentary Lifestyle: The rapid urbanization and adoption of sedentary lifestyles have led to decreased physical activity and increased risk of obesity, both major risk factors for diabetes.
• Dietary Changes: The shift towards a more Westernized diet, high in processed foods, sugary drinks, and unhealthy fats, has contributed to the rise in diabetes.
• Lack of Awareness: Many people in India are unaware of their risk factors for diabetes and the importance of early detection and prevention.
• Limited Access to Healthcare: In rural areas, access to quality healthcare, including diabetes screening and management, can be limited.
• Socioeconomic Disparities: Poverty and socioeconomic inequalities can exacerbate the risk of diabetes by limiting access to healthy food, healthcare, and education.

Preventive and Policy Recommendations

• Healthy Lifestyle: Prevention through diet and exercise is critical to managing diabetes.
• Policy Initiatives: Restrict unhealthy foods, make healthier options more affordable, provide subsidies for nutritious foods, and introduce free healthy school meals.
• Enhanced Exercise Access: Promote safe public spaces for physical activity, like parks and fitness centers with free access.
• Innovative Approaches to Diabetes Diagnosis
  • Workplace and community-based screening programs.
  • Flexible healthcare hours to increase accessibility.
  • Integrating diabetes screening with other healthcare programs (e.g., HIV/AIDS, TB).
  • Utilize trusted community healthcare providers to improve diagnosis rates in underserved areas.

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Initiatives Taken In India To Reduce Diabetes Burden

• National Diabetes Policy: Launched in 2017, the policy aims to decrease the prevalence of diabetes in India by 20% by 2025.
• National Programme for Prevention & Control of Non-Communicable Diseases (NP-NCD): Under NP-NCD, glucometer and drugs for diabetes are provided as per the proposals received from the states.
• Population based screening under National Health Mission: Aims to prevent, control, and screen for common Non-Communicable Diseases (NCDs), including diabetes, hypertension, and cancers.
  • The initiative specifically targets individuals over 30 years of age for screening.
• Eat Right India: The ‘Eat Right India’ movement was initiated by FSSAI under the aegis of the Ministry of Health & Family Welfare to curb consumption of sugar, salt and fat.
• Fitness Initiatives: Fit India and Khleo India movements are implemented by the Ministry of Youth Affairs and Sports, and various Yoga related activities are carried out by the Ministry of AYUSH.
• Medicine Availability: Quality generic medicines including insulin are made available at affordable prices to all, under ‘Pradhan Mantri Bhartiya Janaushadhi Pariyojana’ (PMBJP), in collaboration with the State Governments.

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