Call for policy, action in diabetes prevention, management

Will take heavy toll on India’s healthcare system if left uncontrolled: Global Burden of Disease Study

The recently-released Global Burden of Disease Study 2016 has shown that the prevalence of diabetes has increased more rapidly in the less-developed States of the country. The report has also highlighted the need for policy and health system action commensurate with the disease burden in each State to ensure more effective prevention and management of diabetes.

The study, authored by Nikhil Tandon et al, goes on to warn: “If uncontrolled, diabetes and its complications are likely to take a heavy toll on India’s healthcare system in the coming decades.” The total number of people with diabetes grew from 26 million in 1990 to 65 million in 2016. The prevalence of diabetes in India was 5.5 % in 1990, but it has increased to 7.7 % in 2016.

‘Potentially explosive’

Terming the increase “a potentially-explosive public health situation”, it calls for effective policy implementation. When combined with appropriate allocation of financial and human resources, and a robust disease monitoring system, this would help in prevention, treatment and reduction of diabetes deaths and, in turn, curb the growing disease burden.

The highest prevalence is in the States of Tamil Nadu and Kerala, followed by Delhi, Punjab, Goa, Karnataka, Madhya Pradesh and Tripura.

The increase in loss of health from diabetes since 1990 is the highest among all major non communicable diseases, says V. Mohan, one of the collaborators for the report. “This is enough to compel us to take immediate action in terms of awareness and prevention,” he adds.

Diabetes contributed to 3% of all deaths in India, with an increase in death rates due to diabetes from 1990 to 2016. This highlights the low likelihood of meeting national and global targets for reducing deaths due to diabetes by 2025 and 2030, respectively, the report states.

Among the risk factors contributing to diabetes in India in 2016, high BMI had the highest impact, while the other factors were dietary risks, tobacco use, occupational exposure to secondhand smoke, low physical activity, and alcohol use. The prevalence of being overweight in persons aged 20 years or older had increased from 9% in 1990 to 20.4% in 2016. Interventions to prevent obesity, providing public facilities to increase physical activity, and taxing ‘sin foods’, would go a long way in reducing the numbers, epidemiologists say.

“The way forward would be providing awareness about diabetes,” says R.M. Anjana, another contributor to the report. “Once the community decides to do something, then it just takes off. If there is one thing everyone can do, and start from childhood, it is to make sure physical activity is a component of our life, so we can keep diabetes at bay.”