| Upsc Relevance-Prelims-Non-Communicable Diseases (NCDs) – causes, prevention, national programmes. Mains – GS II & GS III GS II: Government policies & interventions in health. GS III: Science & tech in healthcare, socio-economic impact of NCDs, lifestyle diseases |
Why in News
A study published in The Lancet Global Health reveals that 20% of Indians aged 45 and above had diabetes in 2019, with 40% of them unaware of their condition. The findings, based on the Longitudinal Aging Study in India (LASI), highlight the dual challenge of high prevalence and low detection rates, especially among older adults.
Background
What is Diabetes?
Diabetes is a chronic condition where the body cannot produce or effectively use insulin, leading to high blood glucose levels. Over time, this can damage organs and cause complications like blindness, kidney failure, heart attacks, strokes, and amputations.
Types of Diabetes:
- Type 1 Diabetes:
- The immune system destroys insulin-producing cells, requiring daily insulin injections.
- Common in children and young adults, symptoms include excessive urination, thirst, hunger, weight loss, and fatigue.
- Type 2 Diabetes:
- The body becomes resistant to insulin, often due to obesity and inactivity.
- Symptoms are milder, leading to later diagnosis.
- Gestational Diabetes:
- High blood sugar during pregnancy, with risks for both mother and child. It usually resolves after childbirth but increases the risk of Type 2 diabetes later.
- India’s Diabetes Journey
- 1970s-80s: Diabetes largely urban and elite phenomenon.
- 1990s onwards: Rapid urbanisation, sedentary lifestyles, and dietary changes lead to spread in rural areas.
- Present: Known as the “Diabetes Capital of the World”, with ~77 million diabetics (IDF 2021).
- Global Picture
- According to WHO, 422 million people worldwide have diabetes, and 1.5 million deaths are directly attributed to it each year.
- The South-East Asia region is seeing one of the fastest increases in prevalence.
- Government Interventions
- National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) launched in 2010.
- Ayushman Bharat – Health & Wellness Centres (HWCs) for NCD screening.
- Integration of NCD prevention in school health programs and workplace wellness policies.
Key Findings of the Study
- Prevalence: 1 in 5 adults ≥45 years had diabetes; 8% of elderly (60+) undiagnosed.
- Awareness Gap: 20 million Indians have undiagnosed diabetes.
- Treatment Gaps: Only 46% achieve blood sugar control; 36% of untreated diabetics receive adequate treatment.
- Gender Disparity: Diabetes prevalence higher in men (19.6%) than women (21.0% — reversed trend after adjusting).
- Regional Variation:
- High rates: Chandigarh (36.9%), Puducherry (36%), Kerala (36%).
- Lower rates: Central & Northeast India.
- Risk Factors: Urbanisation, sedentary lifestyle, dietary transitions, and obesity rise.
Why This Matters
Public Health Dimension
- NCD Burden: Diabetes is a major contributor to cardiovascular diseases, kidney failure, and blindness.
- Undiagnosed Cases: Delay in diagnosis leads to irreversible organ damage.
- Healthcare Inequality: Disparities in screening, treatment, and awareness between rural and urban areas.
Economic Impact
- Productivity Loss: Long-term complications reduce workforce participation.
- Healthcare Costs: Escalating out-of-pocket expenditure on medicines and monitoring devices.
Social Implications
- Aging Population: India’s elderly population is projected to double by 2050, increasing diabetes-related morbidity.
- Intergenerational Effects: Household income strain impacts children’s education and nutrition.
Global & National Context
- Global Burden: India has the second-highest number of diabetics globally after China (IDF 2021).
- National Programs:
- NPCDCS – Focus on prevention, screening, treatment at district level.
- Ayushman Bharat HWCs – Universal screening for hypertension, diabetes, and common cancers.
- International Goals:
- WHO Global NCD Targets: Halt the rise of diabetes & obesity by 2025.
- SDG 3.4: Reduce premature mortality from NCDs by one-third by 2030.
Challenges in Diabetes Control in India
- Low Awareness: Many asymptomatic individuals remain undiagnosed.
- Fragmented Screening: Opportunistic rather than universal.
- Lifestyle Factors: Urban diets, reduced physical activity.
- Cultural Beliefs: Delay in seeking medical advice due to stigma or fatalism.
- Treatment Adherence: Poor due to cost, side effects, or lack of follow-up
Way Forward
Policy-Level
- Integrate annual diabetes screening into primary healthcare services.
- Subsidise essential medicines & diagnostics.
- Urban planning for walkable cities & active lifestyles.
Health System Strengthening
- Train ASHA workers & ANMs for community-level diabetes education.
- Scale up telemedicine for remote monitoring.
Public Awareness & Prevention
- National campaigns on diet, exercise, and early detection.
- Promote low-glycaemic, fibre-rich diets and regular exercise through schools and workplaces..
Conclusion
India’s diabetes crisis is a silent epidemic threatening health, productivity, and economic growth. The Lancet study’s findings emphasise that without integrated policy action, early detection, and lifestyle interventions, India risks facing an NCD tsunami in the coming decades.
Upsc Mains practice question
Q. “India’s battle against diabetes is as much a governance challenge as it is a medical one.” In the light of recent Lancet study findings on diabetes prevalence among older adults, critically analyse the socio-economic and public health implications, and suggest a multi-pronged strategy to address this growing epidemic. (250 words)
SOURCE-The Indian Express
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