By Dr Richa Chaturvedi
Diabetes cases are expected to double by 2040. What is the main cause of this?
The current exponential rise of diabetes in India can be attributed primarily to lifestyle changes. Rapid changes in dietary patterns, physical inactivity and increased body weight, particularly abdominal fat accumulation, are some of the primary causes of increased prevalence. Approximately half of all people with diabetes are asymptomatic. As a result, if we only rely on symptoms for detection and prevention, we will miss half of the people who already have diabetes.
What will be the burden on healthcare with this number?
Diabetes is one of the largest global health emergencies of this century, particularly in developing economies such as India, owing primarily to the rising prevalence of overweight/ obesity and unhealthy lifestyles. Due to these complications, there is a significant spike in premature morbidity and mortality among individuals with diabetes, leading to reduced life expectancy and other financial costs of diabetes resulting in profound economic burden on the Indian health care system. Diabetes treatment and its associated complications impose a massive economic burden on both the household and national levels.
How will India be affected?
India has the second highest number of people with diabetes after China. Diabetes is primarily a lifestyle disease that has increased alarmingly across all age groups in India, with prevalence exceeding 10% among the younger population. Diabetes significantly raises the risk of a variety of cardiovascular problems, including coronary artery disease with chest pain (angina), heart attack, stroke and artery narrowing (atherosclerosis).
Is lifestyle mainly to blame or are Indians genetically predisposed to diabetes?
Indians have a higher genetic risk of diabetes. According to many researchers, our ethnicity appears to play a role in the current diabetes epidemic. Several of the risk factors for diabetes are potentially modifiable.
Our way of life has changed dramatically, as have our dietary preferences. Our traditional diet was high in fiber and consisted of unrefined wheat, rice, or millet. We replaced them with refined versions of the same. We are eating more fat, sugar and calories and are becoming less physically active. Mental stress and obesity are also on the rise. All of these factors contribute to poor insulin sensitivity and diabetes manifestation.
Which age group in India is showing maximum rise in cases?
According to the findings of a large-scale survey conducted across India, more than 36% of those with diabetes in 2020 were over the age of 60. Notably, nearly 4% of respondents between the ages of 20 and 29 reported having diabetes that year. This was a concerning trend that was associated with an unhealthy lifestyle.
Do we have enough doctors to deal with these cases?
The health workforce in India is in short supply and is unevenly distributed. In India, the distribution of qualified health workforce is concentrated in urban areas and hospitals that need to be present in rural areas also.
Dr Richa Chaturvedi is an endocrinologist at Indraprastha Apollo Hospitals, New Delhi