India is sitting on a ticking diabetes bomb as a study shows that 35 -50% of people with the disease do not know they have it. This silent killer could severely damage the heart, blood vessels, eyes, kidneys and nerves over a period of time. Madras Diabetes Research Foundation (MDRF) chairman Dr V Mohan tells Kavita Bajeli-Datt that in five years India will be dubbed as the diabetes capital of the world.
Q. Is India sitting on a ticking diabetes bomb?
India is indeed burdened by diabetes. According to the 2019 International Diabetes Federation World Atlas, the number of people with diabetes was estimated to be 74 million. As per the ICMR-INDIAB study, which was published recently in the Lancet Diabetes & Endocrinology, India now has 101 million people with diabetes. Also, during the next few years, the number of people with diabetes in India could increase. In that sense, the situation worrying, but it is also an opportunity to prevent diabetes.
Q. How is undiagnosed diabetes posing a problem to the Indian population? What needs to be done?
The ICMR-INDIAB study shows that 35 -50% of people with diabetes in India do not know they have the disease. This is because diabetes is a silent disorder and very often does not show any symptoms. The most cost-effective way to tackle this is by conducting large-scale screening programmes for diabetes, especially among the high-risk groups. Those with a strong family history of diabetes, who have obesity, physical inactivity, etc. are more prone to diabetes and they should be screened at least yearly or once in two years. This way, undiagnosed diabetes can be detected early.
Q. MDRF collaborated on the ICMR-INDIAB study, which found that India faces a huge burden of non-communicable diseases. Any other findings?
Yes, we at the Madras Diabetes Research Foundation were the national coordinator for the study, which took 15 years to complete but screened the whole of India, state by state. We have now completed all the states in India with a true urban-rural representative sample of every state. What we found in the study is that not only was the prevalence of diabetes very high, but also hypertension (35.5%), abdominal obesity (39.5%) and hypercholesteremia (24%)
Q What urgent steps need to be taken both by individuals and the government to combat this huge problem?
The study showed that there is a huge burden of prediabetes in the country. If we can focus on people with prediabetes and introduce lifestyle changes in them like healthy eating (reducing carbohydrate intake, increasing protein intake and increasing green leafy vegetable intake), increasing physical activity, and also making stress reduction by doing yoga, meditation, pranayama, etc., prediabetes can be prevented from progressing to the stage of diabetes. In overweight individuals, even by reduction of body weight by 5-10 kg, prediabetes can be reversed to the stage of glucose tolerance. This is called ‘Remission of Diabetes’. However, these steps must be taken not by the individual alone. A multi-sectoral approach is needed if the problem of diabetes is to be tackled in India.
Q. In 5 years, what will be India’s position on diabetes and NCDs?
In my estimate, in five years, we will be the diabetes capital of the world. I am saying this firstly because India, with over 1.44 billion people, has already overtaken China as the most populous country in the world. Secondly, due to socioeconomic development, obesity is also increasing. It is, therefore, reasonable to assume that India will overtake China in the number of people with diabetes and other non-communicable diseases shortly. The Indian government is taking steps by setting up 150,000 health and wellness clinics in which control of diabetes and hypertension is top priority.