On an average, nearly one in three adults in Kerala over 18 years of age suffer from hypertension and one in five from diabetes.
More alarmingly, only 13% of those diagnosed with hypertension and just 16% of those diagnosed with diabetes managed to achieve adequate control over blood pressure and blood sugar respectively, according to the data collected from representative sample of over 12,000 adults from all districts in Kerala.
Awareness about non-communicable diseases (NCDs), its treatment and control was alarmingly low even among the better educated. The study was done by the Achutha Menon Centre for Health Science Studies, the public health wing of the Sree Chitra Tirunal Institute for Medical Sciences and Technology, and the State Health Services as part of a project, “Prevention and Control of Non-Communicable Diseases in Kerala.”
This is the first time that such a large population of adults is being studied in Kerala for collecting baseline data on the current prevalence of risk factors as well as NCDs such as diabetes and hypertension.
The study followed the WHO-recommended methodology for NCD risk factor surveillance. Among adults in the age group of 45-69 years, over two-thirds of the population, 67.7%, are either diabetic or prediabetic. Prediabetes is a condition wherein the blood sugar levels are higher than normal, but not high enough to be classified as full-blown diabetes.
Individuals in the prediabetic stage are at high risk of developing diabetes and heart diseases.
There is clinical evidence that the conversion from prediabetes to diabetes happens much faster in Asian Indians than in any other ethnic population.
This disproportionately high burden of prediabetes or diabetes in Kerala called for urgent policy action to prevent or delay the onset of diabetes at the population level, researchers pointed out.
Intervention strategies
Context-specific, resource-sensitive and scalable intervention strategies need to be developed and implemented in Kerala to check the alarming increase in the incidence of NCDs, they said.
Individuals with diabetes often require multiple drugs to prevent life-threatening complications of NCDs, forcing them to incur high out-of-pocket expenditure.
The study argues for universal health care with provisions for appropriate management of NCDs at the primary care level. The new policy initiative of the government to convert primary health centres as family health centres with provisions for regular follow-up of lifestyle diseases is a step in the right direction.
The NCD project also aimed at implementing risk-reduction strategies in selected 350 schools and 200 panchayats in Kerala in the first year of the project. Sensitisation and training programmes were held for local body representatives and school teachers, while orientation sessions were held in 335 schools.
About 450 heath workers have been trained in communication NCD risk reduction strategies to the target population.
The study will be repeated in the next five years to assess the impact of the risk-reduction strategies.
