India logged 31 million new diabetes patients in 2019-21: study

A study covering all States shows the country has added substantially to its burden of non-communicable diseases; experts call for region-specific policies and interventions

The prevalence of diabetes in India stands at 11.4%, while 35.5% of Indians suffer from hypertension, additionally abdominal obesity stands at 40% across the population and female abdominal obesity is 50%. | Photo Credit: The Hindu

Thirty-one million Indians became diabetic between 2019-2021, according to a paper touted as “one of the first comprehensive studies covering all States of India” to assess the non-communicable diseases (NCD) burden in the country.

The highest prevalence of diabetes was found in Goa (26.4%), Puducherry and Kerala (nearly 25%) and the study warns that the figures are likely to shoot up in rural areas in the next five years even though the prevalence is relatively low there.

According to the World Health Organisation, diabetes is a major cause of blindness, kidney failure, heart attacks, stroke, and lower-limb amputation.

The prevalence of diabetes in India stands at 11.4%, while 35.5% of Indians suffer from hypertension, additionally abdominal obesity stands at 40% across the population and female abdominal obesity is 50%.

In the past four years, India has added substantially to its burden of diabetics, pre-diabetics, hypertensive and persons with generalised and abdominal obesity which predisposes them to non-communicable diseases and life-altering medical conditions including strokes.

But what does this study mean to the common man and how does it impact the quality of life and life expectancy?

Dr V. Mohan, a senior author of the study, speaking to The Hindu said that what is happening in India today is that there is availability of surplus food, exacerbated by a culture of overexposure to fast food, lack of sleep, reduce exercise and stress.

“These factors together are driving up the number of NCD patients. The solution isn’t with the government alone — individuals must take responsibility for eating healthy, cutting down on high-carbohydrate foods, fats, sugar, and salt content, sleeping on time and exercising. A little discipline will go a long way in keeping us disease-free and healthy,’’ he said.

The findings of the study, conducted by the Madras Diabetes Research Foundation in collaboration with the Indian Council of Medical Research (ICMR) and the Union Health Ministry, were published in the journal, The Lancet Diabetes & Endocrinology, earlier this week.

The study, titled ‘Metabolic non-communicable disease health report of India: the ICMR-INDIAB national cross-sectional study (ICMR-INDIAB-17)’, found that prevalence of generalised obesity and abdominal obesity in India stood at 28.6 and 39.5%, respectively and it showed that 24% of Indians suffer from hypercholesterolemia — a condition in which fat collects in arteries and puts individuals at a greater risk of heart attack and strokes — while 15.3% of people have pre-diabetes.

Takeaways

But what does this study mean to the common man and how does it impact the quality of life and life expectancy?

Dr. Rajiv Bahl, director-general ICMR, says that the study has shown that diabetes and pre-diabetes are prevalent in India. “The reason why we did it is to understand how to prevent the trend and how to bring about changes in society which will have a lesser burden of these non-communicable diseases. NCDs eventually result in high risk of cardiovascular disease, hypertension and others. The answer to that is in wellness, in having a lifestyle that encompasses a healthy diet and more physical activity,’’ he said.

The study notes a national prevalence of 11.4% diabetes, 15.3% pre-diabetes, 35.5% hypertension, 28.6% generalised obesity, 39.5% abdominal obesity and 24% hypercholesterolemia in India. The highest prevalence of the NCD was found in Goa, Sikkim, Punjab, Puducherry (both generalised and abdominal obesity) and Kerala, respectively.

Urban vs rural

Non-communicable diseases (NCDs)	National prevalence	Estimated number of people in India, in millions (Burden)	State with highest prevalence	State with lowest prevalence
Diabetes	11.4%	101.3	Goa (26.4%)	Uttar Pradesh (4.8%)
Pre-diabetes	15.3%	136.0	Sikkim (31.3%)	Mizoram (6.8%)
Hypertension	35.5%	315.5	Punjab (51.8%)	Meghalaya (24.3%)
Generalized Obesity	28.6%	254.2	Puducherry (53.3%)	Jharkhand (11.6%)
Abdominal Obesity	39.5%	351.1	Puducherry (61.2%)	Jharkhand (18.4%)
Hypercholesterolemia	24.0%	213.3	Kerala (50.3%)	Jharkhand (4.6%)
High LDL cholesterol	20.9%	185.7	Kerala (52.1%)	Jharkhand (3.2%)

Urban vs rural difference: Urban regions had higher rates of all metabolic NCDs than rural areas, with the exception of pre-diabetes.

New National estimates for diabetes and other NCD’s: Our study estimates that in 2021, in India there are 101 million people with diabetes and 136 million people with prediabetes, 315 million people had high blood pressure, 254 million had generalized obesity, and 351 million had abdominal obesity. Additionally, 213 million people had hypercholesterolaemia and 185 million had high LDL cholesterol.

As per the study in 2021, there were 101 million people in India with diabetes and 136 million with pre-diabetes, while 315 million people had high blood pressure, 254 million had generalised obesity, and 351 million had abdominal obesity. Additionally, 213 million people in the country had hypercholesterolaemia.

The results are based on surveying 1,13,043 people (33,537 urban and 79,506 rural residents), in 31 States and Union Territories in the country, between 2008 and 2020.

The prevalence of diabetes and other metabolic NCDs in India is considerably higher than previously estimated. While the diabetes epidemic is stabilising in the more developed States of the country, it is still increasing in most other States. Thus, there are serious implications for the nation, warranting urgent State-specific policies and interventions to arrest the rapidly rising epidemic of metabolic NCDs in India, said, Dr. R.M. Anjana, lead researcher associated with the project.

NCDs have been one of the major concerns of the Health Ministry and according to the study report ‘India: Health of the Nation’s States — The India State-Level Disease Burden Initiative’ released in 2017 by Indian Council of Medical Research (ICMR), it is estimated that the proportion of deaths due to NCDs in India has increased from 37.9% in 1990 to 61.8% in 2016.

The four major NCDs are cardiovascular diseases (CVDs), cancers, chronic respiratory diseases (CRDs) and diabetes, which share four behavioural risk factors — unhealthy diet, lack of physical activity, and use of tobacco and alcohol.

“A population-based initiative for prevention, control, and screening for common NCDs — i.e. diabetes, hypertension, and common cancers — has been rolled out in the country under National Health Mission and as a part of ‘Comprehensive Primary Health Care’. Under the initiative, persons more than 30 years of age are targeted for their screening for the common NCDs, in which there is focus on screening of breast cancer and cervical cancer among women. Screening of these common NCDs is an integral part of service delivery under Ayushman Bharat— Health and Wellness Centres,’’ said the Health Ministry.

It added that the Central government provides technical and financial support to the States/UTs under the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), (launched in 2010) as part of National Health Mission (NHM), based on the proposals received from the States/UTs and subject to the resource envelope.

The programme focusses on strengthening infrastructure, human resource development, health-promotion & awareness-generation for prevention, early diagnosis, management, and ensuring referrals to appropriate healthcare facilities for treatment of NCDs.