Download PDF
CC BY-NC-ND 4.0 · Journal of Social Health and Diabetes 2016; 04(02): 077-084
DOI: 10.4103/2321-0656.188000
Review Article
NovoNordisk Education Foundation

Diabetes in India: Measuring the dynamics of a public health catastrophe

Pranav Kumar Patnaik
Joint Director NCD, Ministry of Health & Family Welfare, Odisha, India
,
Kamlesh K. Jain
1   Associate Professor, Pt. JNM Medical College, Raipur & State Nodal Officer, Directorate of Health Services, Chhattisgarh, India
,
P. Chandra
2   Deputy Director NPCDCS & State Nodal Officer, Directorate of Health Services, Madhya Pradesh, India
,
Jaya Pathak
3   Associate Professor of Medicine, SSG Medical College, Baroda, Gujarat, India
,
K. V. Raman
4   Director of Health & Family Welfare Services, Government of Puducherry, Puducherry, India
,
Asha Shah
5   Professor & HOD of Medicine, PG Director, B.J. Medical College, Ahmedabad, Gujarat, India
› Author Affiliations
Further Information

Publication History

Publication Date:
23 November 2018 (online)

Also available at
   Permissions and Reprints

Abstract

Diabetes has emerged as a major concern in the Indian health-care setting but has been underrecognized as a significant challenge in the context of public health policy due to the necessity to handle acute health conditions. Trends obtained from national and regional surveys over time strongly point to the increasing diabetes burden. In addition, people with undiagnosed and prediabetes can aggravate the burden in the near future. Long-term concerns arise from the rapid transformations such as urbanization, rural–urban migration, and lifestyle changes happening across different populations of India. Attempts at creating a rational diabetes prevention and management policy are severely hindered by a lack of comprehensive, standardized data on diabetes prevalence, and trends in the evolution of the epidemic. The impact of diabetes is multifaceted, ranging from the clinical impact of higher secondary complications to personal, psychosocial, and financial effects on the individual which create a cycle of negative outcomes. Given the chronic nature of diabetes, the impact is likely to remain as a self-perpetuating burden on the health-care system. The magnitude, spread, and impact of the diabetes epidemic are substantial, and it has transitioned to being a pandemic with potentially catastrophic implications for the Indian Public Health System. It is therefore essential to create public health policy specific to diabetes care that is effective in reducing the multidimensional impact of diabetes catastrophe and prevent further multiplication of this pandemic.

Diabetes mellitus - epidemic - prevalence - public health
 

  • References

  • 1 International Diabetes Federation. Diabetes Atlas. 7th ed.. Odisha: International Diabetes Federation; 2015
    Google Scholar
  • 2 Mohan V, Sandeep S, Deepa R, Shah B, Varghese C. Epidemiology of type 2 diabetes: Indian scenario. Indian J Med Res 2007; 125: 217-230
    PubMedGoogle Scholar
  • 3 Ramachandran A, Snehalatha C, Kapur A, Vijay V, Mohan V, Das AK. et al. High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey. Diabetologia 2001; 44: 1094-1101
    CrossrefPubMedGoogle Scholar
  • 4 Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R. et al. Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: Phase I results of the Indian Council of Medical Research-INdia DIABetes (ICMR-INDIAB) study. Diabetologia 2011; 54: 3022-3027
    CrossrefPubMedGoogle Scholar
  • 5 Raman Kutty V, Joseph A, Soman CR. High prevalence of type 2 diabetes in an urban settlement in Kerala, India. Ethn Health 1999; 4: 231-239
    CrossrefPubMedGoogle Scholar
  • 6 Zargar AH, Khan AK, Masoodi SR, Laway BA, Wani AI, Bashir MI. et al. Prevalence of type 2 diabetes mellitus and impaired glucose tolerance in the Kashmir Valley of the Indian subcontinent. Diabetes Res Clin Pract 2000; 47: 135-146
    CrossrefPubMedGoogle Scholar
  • 7 Agrawal RP, Singh G, Nayak KC, Kochar KD, Sharma RC, Beniwal R. et al. Prevalence of diabetes in camel-milk consuming ‘RAICA’ rural community of North-West Rajasthan. Int J Diabetes Dev Ctries 2004; 24: 109-114
    Google Scholar
  • 8 Deo SS, Zantye A, Mokal R, Mithbawkar S, Rane S, Thakur K. To identify the risk factors for high prevalence of diabetes and impaired glucose tolerance in Indian rural population. Int J Diabetes Dev Ctries 2006; 26: 19-23
    CrossrefGoogle Scholar
  • 9 Ramachandran A, Mary S, Sathish CK, Selvam S, Catherin Seeli A, Muruganandam M. et al. Population based study of quality of diabetes care in Southern India. J Assoc Physicians India 2008; 56: 513-516
    PubMedGoogle Scholar
  • 10 Zargar AH, Wani AA, Laway BA, Masoodi SR, Wani AI, Bashir MI. et al. Prevalence of diabetes mellitus and other abnormalities of glucose tolerance in young adults aged 20-40 years in North India (Kashmir Valley). Diabetes Res Clin Pract 2008; 82: 276-281
    CrossrefPubMedGoogle Scholar
  • 11 Vijayakumar G, Arun R, Kutty VR. High prevalence of type 2 diabetes mellitus and other metabolic disorders in rural Central Kerala. J Assoc Physicians India 2009; 57: 563-567
    PubMedGoogle Scholar
  • 12 Mohan V, Mathur P, Deepa R, Deepa M, Shukla DK, Menon GR. et al. Urban rural differences in prevalence of self-reported diabetes in India – the WHO-ICMR Indian NCD risk factor surveillance. Diabetes Res Clin Pract 2008; 80: 159-168
    CrossrefPubMedGoogle Scholar
  • 13 Mohan V, Deepa M, Deepa R, Shanthirani CS, Farooq S, Ganesan A. et al. Secular trends in the prevalence of diabetes and impaired glucose tolerance in urban South India – the Chennai Urban Rural Epidemiology Study (CURES-17). Diabetologia 2006; 49: 1175-1178
    CrossrefPubMedGoogle Scholar
  • 14 Pagidipati NJ, Huffman MD, Jeemon P, Gupta R, Negi P, Jaison TM. et al. Association between gender, process of care measures, and outcomes in ACS in India: Results from the detection and management of coronary heart disease (DEMAT) registry. PLoS One 2013; 8: e62061
    CrossrefPubMedGoogle Scholar
  • 15 Rajapurkar MM, John GT, Kirpalani AL, Abraham G, Agarwal SK, Almeida AF. et al. What do we know about chronic kidney disease in India:First report of the Indian CKD registry. BMC Nephrol 2012; 13: 10
    CrossrefPubMedGoogle Scholar
  • 16 Carstensen B, Borch-Johnsen K. Register-based studies of diabetes. Scand J Public Health 2011; 39 (Suppl. 07) 175-179
    CrossrefPubMedGoogle Scholar
  • 17 Mohan V, Shah S, Saboo B. Current glycemic status and diabetes related complications among type 2 diabetes patients in India: Data from the A1chieve study. J Assoc Physicians India 2013; 61 (Suppl. 01) 12-15
    PubMedGoogle Scholar
  • 18 Nathan DM, Davidson MB, DeFronzo RA, Heine RJ, Henry RR, Pratley R. et al. Impaired fasting glucose and impaired glucose tolerance: Implications for care. Diabetes Care 2007; 30: 753-759
    CrossrefPubMedGoogle Scholar
  • 19 Raghupathy P, Antonisamy B, Fall CH, Geethanjali FS, Leary SD, Saperia J. et al. High prevalence of glucose intolerance even among young adults in south India. Diabetes Res Clin Pract 2007; 77: 269-279
    CrossrefPubMedGoogle Scholar
  • 20 Chow CK, Raju PK, Raju R, Reddy KS, Cardona M, Celermajer DS. et al. The prevalence and management of diabetes in rural India. Diabetes Care 2006; 29: 1717-1718
    PubMedGoogle Scholar
  • 21 Sadikot SM, Nigam A, Das S, Bajaj S, Zargar AH, Prasannakumar KM. et al. The burden of diabetes and impaired fasting glucose in India using the ADA 1997 criteria: Prevalence of diabetes in India study (PODIS). Diabetes Res Clin Pract 2004; 66: 293-300
    CrossrefPubMedGoogle Scholar
  • 22 Yadav K, Krishnan A. Changing patterns of diet, physical activity and obesity among urban, rural and slum populations in North India. Obes Rev 2008; 9: 400-408
    CrossrefPubMedGoogle Scholar
  • 23 Rao CR, Kamath VG, Shetty A, Kamath A. A cross-sectional analysis of obesity among a rural population in coastal Southern Karnataka, India. Australas Med J 2011; 4: 53-57
    PubMedGoogle Scholar
  • 24 Bhagyalaxmi A, Atul T, Shikha J. Prevalence of risk factors of non-communicable diseases in a District of Gujarat, India. J Health Popul Nutr 2013; 31: 78-85
    CrossrefPubMedGoogle Scholar
  • 25 Ebrahim S, Kinra S, Bowen L, Andersen E, Ben-Shlomo Y, Lyngdoh T. et al. The effect of rural-to-urban migration on obesity and diabetes in India: A cross-sectional study. PLoS Med 2010; 7: e1000268
    CrossrefPubMedGoogle Scholar
  • 26 Khan FS, Lotia-Farrukh I, Khan AJ, Siddiqui ST, Sajun SZ, Malik AA. et al. The burden of non-communicable disease in transition communities in an Asian megacity: Baseline findings from a cohort study in Karachi, Pakistan. PLoS One 2013; 8: e56008
    CrossrefPubMedGoogle Scholar
  • 27 Joshi SR, Saboo B, Vadivale M, Dani SI, Mithal A, Kaul U. et al. Prevalence of diagnosed and undiagnosed diabetes and hypertension in India – results from the Screening India's Twin Epidemic (SITE) study. Diabetes Technol Ther 2012; 14: 8-15
    CrossrefPubMedGoogle Scholar
  • 28 Moses CR, Seshiah V, Sahay BK, Kumar A, Asirvatham AJ, Balaji V. et al. Baseline results indicate poor glycemic control and delay in initiation and optimization of insulin therapy: Results from the improving management practices and clinical outcomes in type 2 diabetes study. Indian J Endocrinol Metab 2012; 16 (Suppl. 02) S432-S433
    PubMedGoogle Scholar
  • 29 Boutayeb A. The double burden of communicable and non-communicable diseases in developing countries. Trans R Soc Trop Med Hyg 2006; 100: 191-199
    CrossrefPubMedGoogle Scholar
  • 30 Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA. et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): Prospective observational study. BMJ 2000; 321: 405-412
    CrossrefPubMedGoogle Scholar
  • 31 Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M. et al. Management of hyperglycemia in type 2 diabetes: A patient-centered approach: Position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2012; 35: 1364-1379
    CrossrefPubMedGoogle Scholar
  • 32 Grover S, Avasthi A, Bhansali A, Chakrabarti S, Kulhara P. Cost of ambulatory care of diabetes mellitus: A study from North India. Postgrad Med J 2005; 81: 391-395
    CrossrefPubMedGoogle Scholar
  • 33 Kumar A, Nagpal J, Bhartia A. Direct cost of ambulatory care of type 2 diabetes in the middle and high income group populace of Delhi: The DEDICOM survey. J Assoc Physicians India 2008; 56: 667-674
    PubMedGoogle Scholar
  • 34 Kumpatla S, Kothandan H, Tharkar S, Viswanathan V. The costs of treating long-term diabetic complications in a developing country: A study from India. J Assoc Physicians India 2013; 61: 102-109
    PubMedGoogle Scholar
  • 35 Cavanagh P, Attinger C, Abbas Z, Bal A, Rojas N, Xu ZR. Cost of treating diabetic foot ulcers in five different countries. Diabetes Metab Res Rev 2012; 28 (Suppl. 01) 107-111
    CrossrefPubMedGoogle Scholar
  • 36 Xu K, Evans DB, Kawabata K, Zeramdini R, Klavus J, Murray CJ. Household catastrophic health expenditure: A multicountry analysis. Lancet 2003; 362: 111-117
    CrossrefPubMedGoogle Scholar
  • 37 Ramachandran A, Ramachandran S, Snehalatha C, Augustine C, Murugesan N, Viswanathan V. et al. Increasing expenditure on health care incurred by diabetic subjects in a developing country: A study from India. Diabetes Care 2007; 30: 252-256
    CrossrefPubMedGoogle Scholar
  • 38 Available from: http://www.who.int/mediacentre/factsheets/fs236/en/ [Last accessed on 2014 Jun 05].
  • 39 Peyrot M, Rubin RR, Lauritzen T, Snoek FJ, Matthews DR, Skovlund SE. Psychosocial problems and barriers to improved diabetes management: Results of the Cross-National Diabetes Attitudes, Wishes and Needs (DAWN) Study. Diabet Med 2005; 22: 1379-1385
    CrossrefPubMedGoogle Scholar
  • 40 Poongothai S, Anjana RM, Pradeepa R, Ganesan A, Unnikrishnan R, Rema M. et al. Association of depression with complications of type 2 diabetes – the Chennai Urban Rural Epidemiology Study (CURES- 102). J Assoc Physicians India 2011; 59: 644-648
    PubMedGoogle Scholar
  • 41 Mendenhall E, Shivashankar R, Tandon N, Ali MK, Narayan KM, Prabhakaran D. Stress and diabetes in socioeconomic context: A qualitative study of urban Indians. Soc Sci Med 2012; 75: 2522-2529
    CrossrefPubMedGoogle Scholar
  • 42 Mendenhall E, Narayanan G, Prabhakaran D. Depression and diabetes in India: Perspectives and recommendations. Diabet Med 2012; 29: e308-e311
    CrossrefPubMedGoogle Scholar
  • 43 Nicolucci A, Kovacs Burns K, Holt RI, Comaschi M, Hermanns N, Ishii H. et al. Diabetes attitudes, wishes and needs second study (DAWN2™): Cross-national benchmarking of diabetes-related psychosocial outcomes for people with diabetes. Diabet Med 2013; 30: 767-777
    CrossrefPubMedGoogle Scholar
  • 44 Bajaj S, Jawad F, Islam N, Mahtab H, Bhattarai J, Shrestha D. et al. South Asian women with diabetes: Psychosocial challenges and management: Consensus statement. Indian J Endocrinol Metab 2013; 17: 548-562
    CrossrefPubMedGoogle Scholar
  • 45 Deepa M, Pradeepa R, Anjana R, Mohan V. Noncommunicable diseases risk factor surveillance: Experience and challenge from India. Indian J Community Med 2011; 36 (Suppl. 01) S50-S56
    CrossrefPubMedGoogle Scholar
  • 46 Corsi DJ, Subramanian SV. Association between socioeconomic status and self-reported diabetes in India: A cross-sectional multilevel analysis. BMJ Open 2012; 2: e000895
    CrossrefPubMedGoogle Scholar
  • 47 Rose G. Sick individuals and sick populations 1985. Bull World Health Organ 2001; 79: 990-996
    PubMedGoogle Scholar
  • 48 Sathish T, Williams ED, Pasricha N, Absetz P, Lorgelly P, Wolfe R. et al. Cluster randomised controlled trial of a peer-led lifestyle intervention program: Study protocol for the Kerala diabetes prevention program. BMC Public Health 2013; 13: 1035
    CrossrefPubMedGoogle Scholar
  • 49 Basu S, Vellakkal S, Agrawal S, Stuckler D, Popkin B, Ebrahim S. Averting obesity and type 2 diabetes in India through sugar-sweetened beverage taxation: An economic-epidemiologic modeling study. PLoS Med 2014; 11: e1001582
    CrossrefPubMedGoogle Scholar
  • 50 Abdullah B, Wolbring G. Analysis of newspaper coverage of active aging through the lens of the 2002 World Health Organization Active Ageing Report: A Policy Framework and the 2010 Toronto Charter for Physical Activity: A Global Call for Action. Int J Environ Res Public Health 2013; 10: 6799-6819
    CrossrefPubMedGoogle Scholar
  • 51 Chauhan LS, Tonsing J. Revised national TB control programme in India. Tuberculosis (Edinb) 2005; 85: 271-276
    CrossrefPubMedGoogle Scholar
  • 52 John TJ, Vashishtha VM. Eradicating poliomyelitis: India's journey from hyperendemic to polio-free status. Indian J Med Res 2013; 137: 881-894
    PubMedGoogle Scholar
  • 53 Nalamana Tamizhagam. National Rural Health Mission. State Health Society. Tamil Nadu. Government of Tamil Nadu's Diabetes and Hypertension Prevention Initiative. Available from: http://www.nrhmtn.gov.in/ntn.html [Last accessed on 2014 Jun 05].
  • 54 National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS). Operational Guidelines. Directorate General of Health Services, Ministry of Health and Family Welfare Government of India.. Available from: http://www.health.bih.nic.in/Docs/Guidelines/Guidelines.NPCDCS.pdf [Last accessed on 2014 Jun 05].
    Google Scholar