Lancet study: About a quarter of diabetics globally are Indians

• A quarter of adults living with diabetes globally are in India (212 million of the 828 million) according to a Lancet report, published on World Diabetes Day.

Highlights:

• On World Diabetes Day, a Lancet report reveals that India has the highest number of adults living with diabetes globally, accounting for 212 million of the world’s 828 million cases. Other countries with significant diabetic populations include:
  • China: 148 million, United States: 42 million, Pakistan: 36 million, Indonesia: 25 million, Brazil: 22 million.

Study Background:

• The report is based on the first global analysis of diabetes trends and treatment, conducted by the NCD Risk Factor Collaboration (NCD-RisC) and the WHO. Data from over 140 million adults across more than 1,000 studies were analyzed using:
  • Fasting Plasma Glucose (FPG): ≥ 7.0 mmol/L or 126 mg/dL
  • HbA1c Levels: ≥ 6.5%

Reasons for High Diabetes Rates in India

Diagnostic Criteria and Methodology:

• Dr. R.M. Anjana, president of the Madras Diabetes Research Foundation, notes that using HbA1c and fasting glucose levels as diagnostic benchmarks may have contributed to India’s high prevalence rate. Dr. C.S. Yajnik highlights that conditions like anemia and iron deficiency, common in India, can artificially elevate HbA1c levels, potentially leading to over-diagnosis.

Alternative Estimates:

• Using alternative testing methods, such as the Oral Glucose Tolerance Test (OGTT), the prevalence of diabetes in India was estimated at 14.4% in women and 12.2% in men, totaling 131 million cases in the ICMR-INDIAB study for 2022.

Risk Factors Contributing to High Diabetes Rates

• Obesity and Poor Diet:
• Obesity and unhealthy diets are major global risk factors for diabetes. Dr. Anjana recommends ambitious policies in India to address these factors, such as:
  • Restricting Unhealthy Foods: Especially in lower-income regions
  • Affordable Healthy Foods: Making nutritious options accessible, especially in schools
  • Promoting Physical Activity: Encouraging safe spaces for exercise and providing free access to public parks and fitness centers

Treatment Gaps and Health Implications

• Lack of Access to Medication:
  • Globally, 59% of adults over 30 with diabetes were untreated in 2022, a stark increase from 1990. In India, approximately 64 million men and 69 million women with diabetes went untreated last year.

Health Risks from Untreated Diabetes:

• Without effective treatment, people with diabetes face increased risks of severe health complications, including:
  • Amputation, Heart Disease, Kidney Damage, Vision Loss, Premature Death.

Prelims Takeaways

• NCD Risk Factor Collaboration (NCD-RisC)