Health care costs of diabetics are crippling a number of patients across this country of one billion, an international conference on diabetes and nutrition from a South-Asian perspective was told here recently.

"More than half of India's diabetics are too poor to afford the rapidly-escalating cost of insulin therapy. Even for those who can afford it, the supporting services are often unreliable," said N. Kochu Pillai, head of the endocrinology department at Delhi's premier referral and research facility, the All India Institute of Medical Sciences (AIIMS).

Epidemiological studies in India indicate that there has been an increase in diabetes patients from 8.2 per cent to 11.6 per cent in the urban areas and from 1.5 per cent to 2.75 per cent in the rural areas.

"In India, there is a paucity of information on the economic costs of diabetes," said Chandrakant S. Pandav of the AIIMS's centre for community medicine.

One study in the rural and urban Bangalore district showed that the annual economic burden of a diabetic patient is Rs 35,714. Of this, Rs 16,765 ($399) accounts for the direct cost. This includes routine treatment, monitoring and laboratory and hospital costs. Indirect costs arise from absenteeism, lowered productivity and disability benefits. Compared to this, the direct cost of diabetes care in some other countries is $330 in Argentina, $675 in France and $3,535 in Denmark, Pandav said.

Diabetes eats up five per cent of the income of high-end families, while caring for a single diabetic patient could require up to 25 per cent of the earnings of low-income families, studies presented here said.

Researchers from the U.S. pointed out that the economic burden of diabetes is "increasing as the epidemic grows".

"Burgeoning health care costs are directly-related to new cases and serious complications including blindness, end-stage kidney disease, amputations, neuropathy, cardiovascular disease and pregnancy complications. In the U. S., these costs approach $100 billion per year," James L. Emerson of the Juvenile Diabetes Foundation International told the meet.

Pandav said that the direct cost of diabetes management in South Asia is $5 billion, while indirect costs total $10 billion.

The "alarming increase" in India's diabetes rate has been caused by increased life expectancy, rapid urbanization and changing lifestyles - changes in diet, the lack of exercise among the burgeoning middle classes and the growth in population, said Indian Council of Medical Research (ICMR) deputy director general (nutrition) Rakesh Mittal.

Researchers postulate that fetal malnutrition and malnutrition during infancy increase the susceptibility to chronic diseases like diabetes in later life. India's National Diabetes Control Program was started in the second half of the eighties. This was launched as a pilot project in Jammu and Kashmir, Karnataka and Tamil Nadu.

(India Abroad News Service)