Editorial: Silent killer

India now has over 101 million people living with diabetes, accounting for 11.4% of the population

War on calories is what India needs to do to shed the dubious image of being the diabetes capital of the world. The rising prevalence of diabetes and other non-communicable diseases is driven by a combination of factors – rapid urbanisation, sedentary lifestyles, unhealthy diets and tobacco use. Obesity and overweight are the most important risk factors responsible for diabetes and the disease burden can be prevented or delayed by lifestyle changes including adopting a healthy diet and doing regular physical activity. A study by the Indian Council of Medical Research has revealed that the rate of increase in the prevalence of diabetes in the country is much higher than what was estimated. India now has over 101 million people living with diabetes, accounting for 11.4% of the population, compared with 70 million people in 2019, as per a study published in the Lancet Diabetes & Endocrinology journal. The study also showed that 136 million Indians are pre-diabetic, 213 million people live with high cholesterol, 185 million suffer from high LDL cholesterol or bad cholesterol, while 254 million live with generalised obesity. The extensive study is based on a survey of 1.13 lakh people aged 20 years and older across the urban and rural areas of the country between 2008 and 2020. These warning signals have serious implications for the nation, warranting urgent state-specific policies and interventions to arrest the rapidly rising epidemic of metabolic non-communicable diseases (NCDs) in India. Diabetes is primarily a lifestyle condition that has increased alarmingly across all age groups in India.

Lack of insulin, or the inability of cells to respond to it, leads to high levels of blood glucose — hyperglycaemia — which is the clinical indicator of diabetes. Insulin deficit, if left unchecked over the long term, can cause damage to many of the body’s organs, leading to life-threatening health complications. The countries with the largest numbers of adults with diabetes in the age bracket 20–79 years are China, India and the United States, and are anticipated to remain so in 2030. Worryingly, in India, a large number of children are also impacted by diabetes. Children are developing obesity and metabolic syndrome early because of the change in diets to more processed and fast foods. It is vital to keep diabetes in check as it can prove to be debilitating or even fatal if not treated or controlled with medicine and lifestyle changes. The World Health Organisation (WHO) says that diabetes is a major cause of blindness, kidney failure, heart attack and stroke. However, diabetes can be reversed through a healthy diet and physical activity in 60% of the cases. Simple lifestyle changes with medication and regular blood sugar monitoring are essential in most of the patients. With the rising trajectory of diabetes in India, there is a need for more effective health policy interventions.

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