Introduction
A study published in the Lancet Diabetes and Endocrinology journal has highlighted the need for various policies to keep a check on the non-communicable disease in India. According to the study, the prevalence of diabetes in India is 11.4 percent, while 35.5 and 15.3 percent of people suffer from hypertension and pre-diabetes. The largest epidemiological study on NCDs estimates that in 2021 there were 101 million people with diabetes in India, 136 million with pre-diabetes and 315 million had high blood pressure.
Dr Mohan Diabetes, Specialty Center
Dr Mohan Diabetes, Specialty Center in collaboration with the ICMR, are funded by the Union Health Ministry. The findings are based on a cross-sectional population-based survey which assess a sample of 1 lakh, 13 043 people aged over 20 across 31 states and union territories. The study found that Goa had the highest prevalence of diabetes and UP had the lowest, Sikkim and Mizoram had the highest and lowest burden of pre-diabetes.
Dr R M Anjana
Dr R M Anjana talked about obesity, hypertension and shared her insights and opinions on this matter. She said: “It gives me great pleasure to announce India’s metabolic Health Report card that has been published in Lancet, Diabetes, Endocrine just this morning.”
Introduction
For the past 15 years, the Indian Council of Medical Research (ICMR) and many other individuals have been working hard to produce the results of the diabetes early detection project. In this article, we will discuss the natural prevalence of diabetes in India, the methods used to diagnose diabetes, and the maps of urban and rural India.
Natural Prevalence of Diabetes in India
The natural prevalence of diabetes in India is 11.4 percent, with an urban prevalence of 16.4 and rural prevalence of 8.9. This has been determined through OGTT (Oral Glucose Tolerance Tests) which were conducted on 113,000 individuals from all corners of the country. Additionally, other methods of diagnosing diabetes such as A1C, HP1C, and a combination of OGTT and A1C have been used internationally. In India, the best method is OGTT, which is accepted by the RSSDI (Research Society for the Study of Diabetes in India) and other national guidelines. If the A1C criteria is used, the prevalence increases to 13, and if the combination criteria is used, the natural prevalence is 21.1.
Maps of Urban and Rural India
Maps of urban and rural India have been color coded to show the prevalence of diabetes. These maps show that the urban prevalence is higher than the rural prevalence.
Diabetes Prevalence in India
Diabetes prevalence in India is high, with up to 5% prevalence in urban areas and up to 7.2% in rural areas. In urban India, the prevalence of diabetes is high across the country. In rural areas, there is more heterogeneity, with higher prevalence in some parts of the South and North, and lower prevalence in the East and some natural parts of India.
When looking at the prevalence of diabetes on a state-level, the prevalence ranges from 4.8% in Uttar Pradesh to 26.4% in Goa.
Time Frame of Study
When conducting an epidemiological study, it is generally reported within five years. However, this study was conducted over a 15 year period. To ensure that all states were comparable, statisticians moved all states to one time point – 2021 – using the NFHS demographic as the base population. Adjusted and weighted prevalences were then added to this population.
Diabetes and Pre-Diabetes Prevalence in India
Diabetes prevalence in India is comparable across both urban and rural areas. Pre-diabetes prevalence is higher than diabetes prevalence, however there is almost no difference between urban and rural areas. This is of particular importance as individuals in the pre-diabetic state are likely to convert to diabetes within a five year period.
Consequences of Pre-Diabetes
The conversion of pre-diabetes to diabetes is a significant burden on India, particularly in rural areas. 70% of India’s population lives in rural areas, meaning even a small percentage increase in pre-diabetes can lead to a catastrophic number of people with diabetes.
Opposite Prevalence of Diabetes and Pre-Diabetes
Interestingly, the prevalence of diabetes and pre-diabetes is opposite. Where diabetes is high, pre-diabetes is low, and vice versa. This suggests that individuals who are likely to convert to diabetes have already done so, and those who are at risk are in areas where diabetes is low.
Prevalence of Diabetes in India
India is facing a growing epidemic of diabetes, with a prevalence of 5.7%. This is a major public health concern, as diabetes is a pre-runner to other serious health conditions. To better understand the prevalence of diabetes in India, it is important to look at the prevalence of pre-diabetes, obesity, hypertension, and high blood cholesterol.
Pre-Diabetes
Pre-diabetes is a condition in which blood sugar levels are higher than normal, but not high enough to be classified as diabetes. In India, the prevalence of pre-diabetes is estimated to be around 28.6%, with 40% prevalence in urban India and 23% in rural parts of the country.
Obesity
Obesity is a major risk factor for diabetes, and is a growing problem in India. The overall prevalence of obesity in India is 28.6%, with 40% prevalence in urban India and 23% in rural parts of the country. Even more concerning is the prevalence of abdominal obesity, which is even higher. In urban India, one in two people is obese, and in rural India, the prevalence of abdominal obesity is over 40%.
Hypertension and High Blood Cholesterol
Hypertension is another risk factor for diabetes, and in India the overall prevalence of hypertension is 35.5%, with 40.7% prevalence in urban India and 33% in rural parts of the country. High blood cholesterol is also a risk factor for diabetes, and the overall prevalence of hypocholesterolemia (high blood cholesterol) is 24%, with 27% in urban India and 22% in rural parts of the country.
Metabolic NCDs and Their Prevalence Across India
Diabetes
The International Diabetes Federation’s Atlas reported 74 million people with diabetes in 2021. However, the new numbers are a whopping 101.3 million people with diabetes in the country. Pre-diabetes is even higher, at 136 million people.
Hypertension
Hypertension is also a major concern, with over 300 million people having a 35% prevalence.
Obesity and Hypercholesterolemia
Obesity is reaching 250-300 million people, and hypercholesterolemia is at 200 million.
Government Intervention Needed
It is time for governments to take notice of the problem and do something about it. All interventions for metabolic NCDs are similar, and state-specific interventions are needed to prevent these numbers from further increasing and increasing the health burden of the country.
