Diabetes, a chronic metabolic disease characterized by elevated blood sugar, is one of the most prevalent health issues today. A new study published in The Lancet has found that more than 800 million adults across the globe have diabetes, almost double the number previously estimated.
The Global Prevalence of Diabetes
In 2022, about 828 million people aged 18 and older were found to be diabetic, the Lancet study found. Among those above the age of 30, 59%, or 445 million, did not receive any treatment. This is concerning, given that untreated diabetes can lead to severe health complications, including damage to the heart, blood vessels, nerves, and other organs.
In their research, the NCD Risk Factor Collaboration and World Health Organization (WHO), provides the first global analysis of diabetes rates and treatment estimates for all countries. The findings show that the diabetes rate around the globe has doubled since 1990, from about 7% to 14%. A significant factor driving this rise is the increased incidence of diabetes in low- and middle-income countries. However, the treatment rates have been stagnant, leading to a wide treatment gap between countries of high and low income economies.
In regions, like sub Saharan Africa, the treatment coverage is abysmal with only 5-10% of diabetes patients receiving care, putting millions of people at a high risk of developing complications.
Diabetes in India: A National Crisis
Out of the total 828 million diabetes cases, 212 million are from India making it home to a quarter of the global diabetic population. The Lancet study published highlights India as the number one nation with the highest diagnosed populations with diabetes, followed by China, United States, Pakistan and Indonesia.
While the country suffers from acute levels of diabetes cases, the prevalence numbers seem to have been inflated due to the use of different diagnostic benchmarks. President of Madras Diabetes Research Foundation, Dr R.M Anjana says that adding the HbA1c test (which measures average blood sugar over three months) may have led to the higher numbers, as it can be influenced by factors such as anemia and certain medications, which are more common in India. Without the HbA1c inclusion, a ICMR-INDIAB study recorded 131 million diabetes cases in India in 2022, with a prevalence rate of 14.4% for women and 12.2% for men.
Even with the adjusted figures, what India is facing is an epidemic. The estimated number of diabetics in India has increased proportionally over the years, driven largely by lifestyle factors such as obesity, poor diet, and lack of exercise.
The Diagnosis and Treatment Gap
The major concern is the treatment gap. Although diabetes has increasingly been reported in India, the proportion of patients actually receiving appropriate treatment is astonishingly low. Around 64 million men and 69 million women with untreated diabetes in India were found to be at high risk of developing severe complications such as heart disease, kidney damage, and even premature death.
Dr Anjana has emphasized that policymakers need to consider comprehensive reforms, particularly in lower-income regions of India. One of the strategies she said is to limit the intake of unhealthy foods, making healthy food options more affordable, and promoting physical activity through initiatives such as free access to public parks and fitness centers.
Mental Health Impact of Diabetes
As with other diseases, diabetes has its share of complications, with the worst of them being psychological in nature. According to the International Diabetes Federation (IDF), 86% of Indians living with diabetes experience anxiety, depression, and other mental health conditions. The fear of developing complications, coupled with the burden of daily management, contributes significantly to the mental toll on diabetic patients.
The gender divide is also evident, with 90% of women living with diabetes reporting mental health conditions, compared to 84% of men. Additionally, as many as 85% of diabetics complain of “diabetes burnout,” a condition where patients feel overwhelmed by the constant need to manage their blood sugar levels.
The Role of Obesity and Lifestyle Factors
Obesity is a major predisposing risk factor for diabetes, not only in India but across the globe. In India, lifestyle changes like excessive intake of junk foods and lack of physical activity are the reasons for the exponential increase in the number of diabetic patients. Dr. Anjana suggests that ambitious public health policies aimed at restricting unhealthy foods and promoting exercise are crucial to reversing this trend.
Moreover, the alarming rise in type 2 diabetes, particularly in younger populations, highlights the urgent need for preventive measures.
Dr. C.S. Yajnik, a leading diabetologist, emphasizes the need for targeted interventions to address the rising burden of diabetes, especially in urban and semi-urban areas.
Ongoing Research
Recent studies have focused on genetic factors and molecular pathways that may lead to the development of type 2 diabetes. For example, researchers at The Jackson Laboratory in the United States have identified genes and stress responses that may influence the susceptibility to diabetes. Targeting these genes could open new avenues for preventing and treating the disease.
Additionally, scientists have developed innovative blood tests that can help identify children at risk of developing obesity-related diseases, including type 2 diabetes. Early intervention in children could significantly reduce the burden of diabetes in future generations.
