India must prioritise its fight against diabetes
Surveillance, policy support and early management can help lower risks
Non-communicable diseases (NCDS) such as heart diseases, stroke and diabetes have increased in India over the past 25 years and cause more disease and death than infections, maternal and newborn deaths during delivery, and malnutrition put together, according to the first comprehensive analysis of disease trends in India published in The Lancet in September. Unhealthy lifestyles, bad diets and sedentary behaviour, are the leading causes that strike Indians at least two decades before they do Caucasians, increasing their dependence on medicines.
The number of people with diabetes in India has gone up from 26 million in 1990 to 65 million in 2016. The age-standardised disability-adjusted life years (DALY) rate, a measure of overall disease burden expressed in the number of years lost to bad health, disability or early death, for diabetes increased by 39.6% from 1990 to 2016. Both diabetes prevalence and DALYS increased in every state, with the prevalence being highest in Tamil Nadu, Kerala and Delhi, followed by Punjab, Goa and Karnataka.
Being overweight is the biggest risk factor. For every 100 overweight adults in India, there were 38 adults with diabetes, compared with the global average of 19 for every 100 in 2016. With the number of overweight people aged 20 and above more than doubling over the past 25 years, from 9% in 1990 to 20.4% in 2016, diabetes prevalence will shoot up dramatically unless policy support to promote prevention and early management is given the priority. Improving surveillance systems to monitor trends for policy interventions to strengthen primary health centres and training general physicians for early diagnosis will improve disease management to lower diabetes-related complications, such as blindness and neuropathies. Multi-sectoral collaborations, such as policies to reduce dietary fat, sugar and salt, to controlling overlapping NCDS and risk factors will collectively lower the risks for diabetes, heart disease, stroke, and certain cancers.