Rural diabetes care to get tech upgrade

Centre decision after pilot studies and findings

NEW DELHI: The Union health ministry is upgrading its tech support at the grassroots level for optimal blood glucose control and the early diagnosis of diabetes, which affected 65 million people in India in 2016 and which is spreading rapidly with a change in lifestyle making more people overweight, inactive and dependent on unhealthy food.

The decision was taken after pilot studies in Himachal Pradesh’s Solan district and findings from community health centres in Tripura and Mizoram, said Manoj Jhalani, additional secretary and mission director, National Health Mission, ministry of health and family wel- fare.

“The pilot studies in Solan and community health centres in Tripura and Mizoram have shown that using decision-support e-health records improves blood glucose control and lowers blood pressure and bad LDL cholesterol. Based on this evidence, we are integrating the software with the national Informational Technology application for the national programme for NCD [non-communicable diseases] prevention,” Jhalani said.

Union health minister JP Nadda described the prevention of diabetes and all NCDS as a national priority.

“Population-based screening for diabetes, hypertension, and oral, breast and cervical cancers is being done for all men and women 30 years and older in 170 districts under Ayushman Bharat’s comprehensive primary health care plan. With the upgradation of 15 million subcentres into health and wellness centres, screening will reach all districts over the next one year,” he said.

Diabetes prevalence in Indian adults who are 20 years and older is 7.7%, with every state registering an increase over the past 25 years, according to data from state-level disease burden initiative published in The Lancet in September. Tamil Nadu, Kerala and Delhi have the

highest prevalence, but the highest rates of increase were in less developed states.

“Diabetes in India subscribes to the ‘rule of halves’. Around half of all people with type-2 diabetes are undiagnosed, half of those diagnosed do not get treated, and half of those who are on medication have poor glycaemic control,” said Dr Nikhil Tandon, professor and head of endocrinology, All India Institute of Medical Sciences (AIIMS). This means only around 12.5% have a healthy glucose control, measured by Haemoglobin A1c (Hba1c is a test that represents blood glucose control over the preceding three months) reading of under 7%.

“The decision-support application will be highly useful in the field for multi-purpose workers as it will enhance capacity of front line staff by providing guidance on what should be done,” said Jhalani.

Diabetes can be managed if diagnosed and treated, but if left untreated, leads to irreversible complications. In 2016, diabetes contributed to 3.1% of the total deaths in India.

The study was carried out in partnership with the Centre for Chronic Disease Control, Public Health Foundation of India and Emory University, Atlanta, with software support from Tata Trusts and Dell EMC.