DATA DEPENDENT: Diabetes in India reflects global trends

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Non-communicable diseases are trending upwards across the globe. With more countries moving into the middle income bracket, NCDs reflect the increased affluence. On top of that, cultural changes, specifically with regards to eating habits, have introduced not-so-healthy aspects of Western diets. Taken together, NCDs represent a major public health threat all over the world.

In 2014, 1.9 billion adults were considered overweight, a key driver of NCDs. 422 million people were clinically diagnosed with diabetes worldwide. That same year, the disease caused 4.9 million deaths around the world. The damage was not limited to loss of life. Blindness, kidney failure, lower limb amputation and just a few examples of possible complications. That’s without even counting the economic and financial costs.

According to World Health Organization estimates, the South Asian region — consisting of India, Pakistan, Bangladesh, and Sri Lanka — accounted for 78 million cases of diabetes in 2015. In India, NCDs accounted for 60% of all deaths and 44% of disability adjusted life years lost in 2011. 68 million people in India are reported to suffer from Type 2 Diabetes and that number isn’t going down. Experts expect that number to balloon to 140 million by 2040. Disturbingly, almost half of those cases will remain undiagnosed.

It’s been a gradual process, spanning four decades. A study in 1972 estimated the urban prevalence of diabetes at 2.3% and rural prevalence at 1.5%. Twenty years later, a smaller study focusing on the South Indian city of Chennai indicated that those rates increased to 8.2% and 2.4% respectively. By 2001, a national urban diabetes study showed that the NCD had expanded to 12.1% among India’s city-dweller. The upward trend’s slope among urban populations increased significantly by 2015. Diabetes prevalence in Chennai and New Delhi ballooned to 22.8% and 25.2% respectively.

A 2016 report documented 96 million people with diabetes in South East Asia region in 2014. The average prevalence of the disease registered at 8.6%. It is also a major cause of illness and mortality in India. Among 30-69 year-olds, diabetes accounted for 75,900 deaths among men and 51,700 among women. Elderly cases 70+ years of age accounted for 46,800 deaths among men and 45,600 deaths among women. In keeping with global trends, overweight individuals continue to increase, 19% among men and 23.9% among women.

Diabetes prevalence in India falls in line with global trends. It is only 0.1% higher than the global average and the exact average for the WHO South-East Asia region. It is also well within the higher and lower bands represented by the Eastern Mediterranean Region (13.7%) and the European Region (7.3%). However, the prevalence of the disease in the region is the highest among non-Eastern Mediterranean regions.

According to the WHO, the Indian government and health officials are addressing the problems and thankfully, the essential diabetes medicines of insulin, metformin, and sulphonylurea are all widely available. One point of worry is that primary care facilities lack basic technologies necessary for diagnosing diabetes. Specifically, oral glucose tolerance tests, HbA1c tests, dilated fungus examinations, foot vascular status, and urine strips for glucose and ketone measurement are not as prevalent as they should be.

IMAGE SOURCE: Creative Commons

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