A 68-year old Mrs. S. developed high fever and had to be hospitalised since her blood sugars were very high. With no personal income or medical insurance, she had to depend on her son for paying hospital expenses for which he was not too willing.

Mr. S, 58, a watchman in a company, developed fever and infection in the foot. He had very high blood sugars and was hospitalised. Despite all efforts, his left leg had to be amputated and he had to use his entire savings which he had kept aside for his daughter’s wedding. This was a sad story of a man who lost his leg and his personal savings because he had diabetes, of which he was unaware. Innumerable are such pathetic cases.

Diabetes is one of the major health and development challenges of the 21st century. In India, it is estimated that around 62 million people have diabetes. One in two people with diabetes doesn’t know he/she has it. But diabetes and its complications are largely preventable, and proven, affordable interventions available. Everyone is concerned and everyone has a role to play in helping to turn the tide of diabetes to protect our future.

What can be done?

There are two major components of the burden of diabetes in India — genetic and environmental factors. Environmental factors such as physical inactivity and unhealthy diet pattern play an important role. There is an immediate need to seek the involvement of several stakeholders in prevention and control of diabetes.

To start with, the media plays a major role in not only creating awareness of the risk factors but also making policymakers and others focus on various avenues leading to a better living environment. The existing knowledge of prevention of diabetes can be disseminated to all with the help of the Ministry of Information and Broadcasting, NGOs and healthcare centres in both the private and public sectors.

Next, to put the knowledge into practice, it is necessary to create a conducive environment for the public to increase their physical activity. This needs earmarked funding for construction of parks, safe footpaths and cycle pathways.

In order to ensure healthy eating habits, retail shops, fast food outlets and chain restaurants should be encouraged to provide alternative healthy food choices. An additional tax could be levied on junk food. Regulation of pricing policy for fruits and vegetables is necessary.

The government should encourage small entrepreneurs to manufacture nutritious and palatable snacks for people belonging to different economic strata at an affordable cost. Agricultural research is also required for producing low glycemic cereals and grain. More operational research is necessary to develop strategies to reduce the burden of diabetes and its risk factors. Allocation of funds for such projects has to be given high priority by the funding agencies.

In order to help people with pre-existing diabetes, insurance companies should introduce policies which will cover both outpatient and hospitalisation costs.

This will help a large number of people in India with diabetes to have good control of their blood sugar levels and thus prevent dreadful complications.

Although various stakeholders are required to build the web of partnership for diabetes prevention, the most essential is individual commitment to a better living.

(The writer is Head and Chief Diabetologist, MV Hospital for Diabetes, and Prof. M Viswanathan Diabetes Research Centre, Chennai. Email: drvijay@mvdiabetes.com)