Only half the Indian adults in the most productive age group (15-49 years) are aware that they ail from diabetes, and only one-fourth of those diagnosed and treated have their blood sugar under control. This was found in a large-scale population-based study carried out by the Public Health Foundation of India (PHFI), Harvard T.H. Chan School of Public Health, Madras Diabetes Research Foundation, Heidelberg Institute of Global Health, University of Birmingham and University of Gottingen.
Across the country, the study found that awareness, treatment and control levels were lowest in Daman and Diu (5.5%, 5.3% and 2.1% respectively), and highest in Meghalaya (69.6%, 60.9% and 53.7% respectively).
For the study, researchers used the National Health and Family Survey (NFHS-4, 2015-16) data of 7,29,829 individuals aged 15-49 years, which covered each district of 29 States and seven Union Territories of India.
Large-scale study
Diabetes was defined as blood glucose (BG) ≥ 200 mg/dL if not fasted and ≥ 126 mg/dL if fasted or reporting to have diabetes.
“The study is aimed at ascertaining and understanding where adults with diabetes in India are lost in the diabetes care cascade, which is vital for the design of targeted health interventions and to monitor progress in health system performance for managing diabetes over time,” said the study.
Dr. Ashish Awasthi, Assistant Professor, PHFI, one of the authors of the study, explained that, in India, diabetes is a growing challenge: “It is a major cause of cardiovascular deaths and renal dysfunction. Considering the co-existence of diabetes and hypertension with poor level of awareness, treatment and control, it is necessary to focus on primary prevention and screening efforts as a cost-effective strategy to reduce the impact of diabetes on population health in India.”
“This large population-based analysis of adults aged 15-49 years found substantial losses of patients at each step of the diabetes care cascade, with the highest proportion (47.5%) being lost to care at the awareness stage. This nationally representative study suggests about half of individuals (52.5%) are aware about their diabetic status, about 4 in 10 are reported currently taking medication and 1 in 4 had their diabetes under control,” noted the study.
Warning against neglect
Researchers also found that adults living in rural areas, men, and those who were poorer and less educated, were even less likely to receive the care they need.
While adults with undiagnosed diabetes make up the largest proportion of the State’s population in Goa and Andhra Pradesh, efforts at improving diabetes care should not neglect large States with low diabetes prevalence (for instance, Uttar Pradesh), which hosts some of the highest absolute numbers of adults of those who are unaware of their diabetes and remain untreated, warned the study.
