The first ever pan-India Non-communicable diseases (NCD) study has confirmed that at least 101.3 million people in the country are directly affected by type 2 diabetes. Another 136 million people are estimated to be suffering from prediabetes.
The findings of the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study have confirmed that unless addressed on an urgent basis, diabetes and its comorbidities would create a major health and economic burden on the nation. The total number of people with diabetes in India was estimated to be around 77 million in a previous survey conducted in 2019. However, these latest findings published in Lancet on June 7, 2023, show that the number has soared by over 30 per cent, breaching the 100 million (10 crores) mark. The study was conducted in a phased manner from 2008 to 2020 by the ICMR and Madras Diabetes Research Foundation (MDRF), covering the entire country.
Prevalence of diabetes and its comorbidities
As many as 1,13,043 individuals over the age of 20 (79,506 from rural areas and 33,537 from urban areas) from a total of 31 states, union territories and the National Capital Territory participated in the study. The national prevalence of diabetes was found to be 11.4 per cent, with Goa having the maximum prevalence rate (26.4 per cent) and Uttar Pradesh (UP) having the minimum (4.8 per cent). Prediabetes emerged as a major concern with a national prevalence rate of 15.3 per cent, with Sikkim having the highest prevalence rate (31.3 per cent) and Mizoram having the lowest (6.8 per cent).
The study also states that a sort of stabilisation may be occurring in diabetes prevalence in the more developed states. However, the overall prevalence is on the rise in less developed states, pointing to the need for immediate intervention from policymakers.
“The study should be a wake-up call for everyone, as the prevalence rate of diabetes could considerably increase, albeit in a slow and steady manner,” says Dr RM Anjana, managing director, Dr Mohan’s Diabetes Specialities Centre (DMDSC) and president, MDRF. She is also the lead author of the study.
Impact of COVID on diabetes prevalence
Dr Anjana also pointed out that the pandemic has had an indirect impact on the prevalence of diabetes in recent years.
“COVID brought a change in our lifestyle altogether. We were confined to our homes because of the lockdown, resulting in physical inactivity trickling into most of our lifestyles,” she adds. This also led to an increase in stress levels, one of the main risk factors of diabetes.
She also points out that the use of steroids for treating COVID also led to diabetes in some people.
“The overall impact of the pandemic on diabetes is still being studied,” she says.
Prediabetes: A major concern in rural India
The study also confirms that prediabetes is emerging as a concern in rural India. Despite having a low prevalence of diabetes, states like UP and Rajasthan have recorded higher rates of prediabetes prevalence of 18 and 16.1 per cent respectively, which could lead to a diabetes surge in the near future.
In an email interaction with Happiest Health in April 2023, Dr V Mohan, chairman, DMDSC and MDRF, pointed out that type 2 diabetes is a growing concern in both urban and rural areas of India.
“While typically considered a problem of the urban affluent, recent studies have shown that diabetes has become increasingly prevalent in rural populations as well. According to research (2019) conducted by the ICMR and National Institute of Nutrition (NIN), nearly half of the individuals affected with diabetes them live in rural areas,” Dr Mohan had told Happiest Health while commenting on how diabetes was bridging the rural-urban divide in his e-mail. He is also one of the authors of the ICMR-INDIAB study.
Dr RM Anjana also attributes the steady increase of pre-diabetes and diabetes among the less developed states and rural areas across the country to the inclusion of ultra-processed food in the daily diet and an overall decline in physical exertion, possibly due to the mechanisation of agricultural activities.
Diabetic comorbidities are on the rise
The study also states that as of 2021, 315.5 million people have high blood pressure, in addition to the 213.3 million diagnosed with high cholesterol levels. Kerala has the highest prevalence of high cholesterol (50.3 per cent) against the national prevalence rate of 24 per cent. Obesity, one of the most dangerous risk factors for diabetes, is also on the rise, with 254.2 million people diagnosed with general obesity and 351.5 million with abdominal obesity.
Diabetes and cardiovascular conditions
Dr Mohan pointed out in his official statement that the findings will be disseminated to the respective states to chart out proper plans for preventing a further increase and bringing the high prevalence rate of NCDs under control.
According to Dr RS Dhaliwal, scientist & head, non-communicable disease division, ICMR, the findings of the study confirm that a substantial proportion of the country’s population is at risk of cardiovascular conditions that necessitate immediate medical intervention.
Takeaways
- India is likely to encounter a health crisis due to the high prevalence of diabetes and other non-communicable diseases.
- The first pan-India study on NCDs has confirmed that at least 237 million people in the country are directly affected by type 2 diabetes and prediabetes.
- Both diabetes and prediabetes are on the rise in rural parts of the country.
- Experts say that the findings will be disseminated to the respective states to chart out proper plans for preventing further increase and bringing the high prevalence rate under control.
