Diabetes in India

Type 2 diabetes is one of the world's biggest health threats and India is the capital of it. This year's study by the Indian Council of Medical Research (ICMR) showed that over 100 million people are suffering from this lifestyle disorder in India, and another 136 million are prediabetic.

The aetiology of Diabetes in India is multifactorial and includes genetic factors coupled with environmental influences such as obesity associated with rising living standards, steady urban migration,and lifestyle changes.

Obesity is one of the major risk for diabetes, yet there has been little research focusing on this risk factor across India. Despite having lower overweight and obesity rates, India has a higher prevelance of diabetes compared to western countries suggeting that diabetes may occur at a much lower body mass index( BMI ) in Indians compared with Europeans. Therefore, relatively lean Indian adults with a lower BMI may be at a equal risk as those who are obese. Futhermore indians are genetically predisposed to the development of coronary artery diesease due to dyslipidaemia and low levels of high density lipoproteins ,these determinants make Indians more prone to development of the complications of diabetes at an early age (20-40). This indicates that diabetes must be carefully screened and monitored regardless of patient age within India.

Early screening and detection of pre-diabetes (especially in pregnant women, children and adults with (Bmi>=25) may yield positive health outcomes in society. To reduce the disease burden that diabetes creates in India, appropriate government interventions and combined efforts from all the stakeholders of the society are required.

Government policies may help in creating guidelines on diabetes management, funding community programmes for public awareness about the diabetes risk reduction, availability of medicines and diagnostic services to all sections of community. Efforts by various governments and agencies around the world to intervene in diabetes management have resulted in positive health outcomes for their communities. In the United States there are number of public and private funded programmes to prevent and manage diabetes that have been successful. Similarly, the Australian government runs programmes such as the “National Health Priority Areas initiative” that is dedicated to provide focussed and continuum of care and attention on chronic disease like diabetes.The United Kingdom government places special emphasis on diabetes care in patients, with the National Health Service conducting various patient education programs and trials to improve quality of life of patients such as the “Dose Adjustment for Normal Eating” (DAFNE) study and “Diabetes Education & Self-Management for Ongoing & Newly Diagnosed” (DESMOND) study to provide patient education. Similarly, a government initiative in the United Arab Emirates has set up an expert panel to form guidelines for diabetes management and public awareness programmes.This has resulted in positive health effects which may arrest rising trend in diabetes cases in that country. In India, similar efforts and services are required at ‘grass roots’ level to contain the new-age diabetes pandemic.

Conclusions

Diabetes mellitus is reaching potentially epidemic proportions in India. The level of morbidity and mortality due to diabetes and its potential complications are enormous, and pose significant healthcare burdens on both families and society. Worryingly, diabetes is now being shown to be associated with a spectrum of complications and to be occurring at a relatively younger age within the country. In India, the steady migration of people from rural to urban areas, the economic boom, and corresponding change in life-style are all affecting the level of diabetes. Yet despite the increase in diabetes there remains a paucity of studies investigating the precise status of the disease because of the geographical, socio-economic, and ethnic nature of such a large and diverse country. Given the disease is now highly visible across all sections of society within India, there is now the demand for urgent research and intervention - at regional and national levels - to try to mitigate the potentially catastrophic increase in diabetes that is predicted for the upcoming years.