Growing Epidemic: On Diabetes and India

There is an alarming global rise in diabetes cases, particularly in India, which now has the highest number of people with diabetes

Rise in the Cases of Diabetes 

• Diabetes Cases Soar Worldwide: The global number of people with diabetes has skyrocketed in recent decades. From approximately 200 million in 1990, the number has quadrupled to over 800 million in 2022. 
• Diabetes Among Adults: The global prevalence of diabetes in adults has also doubled, rising from 7 percent to 14 percent between 1990 and 2022, as reported in a study published in The Lancet on 13 November 2023.
• India Leads in Diabetes Cases: India now holds the highest number of people with diabetes globally, with 212 million individuals affected. This is significantly higher than China, which has 148 million people living with diabetes. 
• Untreated Diabetes: Additionally, India leads the world in the number of people over the age of 30 with untreated diabetes, at 133 million, compared to China’s 78 million.

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Methodology Behind the Rising Numbers

• One key reason for the steep rise in diabetes cases globally is the updated methodology used for pooling and analysing diabetes data.
• The new approach includes people who are either on medication for diabetes, have a fasting plasma glucose level of 7.0 mmol/L or more, or have an HbA1c level of 6.5% or more. 
• This broader definition of diabetes captures a larger population than earlier studies, which typically relied on a single biomarker, such as elevated fasting plasma glucose, to diagnose diabetes.
• While the exact numbers are still debated, the upward trend in diabetes prevalence is indisputable.

Key Risk Factors Contributing to the Diabetes Epidemic

• Diet and Lifestyle: 
  • Unhealthy diets, rich in calories, carbohydrates, and saturated fats, combined with sedentary lifestyles, are major contributors to the rise in diabetes. 
  • These factors are controllable, and improving diet and exercise habits could reduce the global diabetes burden.
• Role of Tobacco: 
  • A 2023 WHO report found that smoking increases the risk of diabetes by 30-40% compared to non-smokers. 
  • Nicotine impairs insulin production, induces insulin resistance, and disrupts glucose regulation, exacerbating diabetes risk. 
  • Avoiding tobacco not only reduces diabetes risk but also lowers the chances of cardiovascular diseases and mortality in diabetic individuals.

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India’s Challenge: Scaling Up Diabetes Diagnosis

• With 133 million people in India still undiagnosed, the country faces an urgent need to scale up efforts in diabetes diagnosis. 
• This is particularly critical as India strives to meet the WHO’s 2030 target for diabetes care, which calls for 80 percent of people with diabetes to be diagnosed and 80 percent of diagnosed individuals to have good control of their blood sugar levels.

Conclusion

The global rise in diabetes, with India at the forefront, is driven by unhealthy diets, sedentary lifestyles, and tobacco use. While progress has been made in diabetes diagnosis, urgent action is needed in India to scale up diagnosis and treatment, reduce undiagnosed cases, and meet global health targets to alleviate the long-term societal burden.