Socioeconomic and demographic trends in the prevalence of type 2 diabetes in India

Abstract

Noncommunicable diseases (NCDs), also known as chronic diseases, are not passed from person to person. They are of long duration and generally slow progression. The four main types of NCDs are cardiovascular diseases (such as heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma), and diabetes. The rapid demographic and epidemiologic transition that India is facing today is paralleled by a massive increase in NCD prevalence, of which diabetes remains the most dominant. Besides genetic and environmental factors, an increase in life expectancy, urbanization, influenced unhealthy lifestyle changes, affluence associated with dietary excess, and reduced physical activity appear to be major drivers for increased burden of diabetes in India. Inappropriate nutrition and physical inactivity lead to obesity, a positive predictor for diabetes. Moreover, early onset of diabetes accompanied by prevailing poverty, low awareness, and poor health consciousness across socioeconomic and demographic strata is reflected in the large burden of undiagnosed cases of diabetes. In addition, reversal of socioeconomic gradient of disease burden observed in India can have serious health and financial implications on individual and healthcare system, which, if left unaddressed, may result in an adverse impact on the nation's economy. Keeping in view, a major shift in India's burden of disease, there is an imperative need for robust, systematic measures for data reporting supported by effective public healthcare interventions to reduce the burden of diabetes. Comprehensive multisectoral actions prioritizing identification of risk factors, early diagnosis, and effective implementation of cost-effective interventions can curb the epidemic of diabetes. A multifaceted approach for implementation of evidence-based policy measures involving various departments of the government and nongovernmental agencies is required to address both preventive and curative aspects of diabetes management. Policies that ensure better surveillance and increase in access to affordable and essential medicines providing universal health coverage should be developed. Policymakers should take lead in the development or strengthening the existing policies and see that they are not only implemented but also evaluated for their effectiveness. A strong commitment from both public and private sectors toward implementation and intensification of population-based prevention strategies through proven programs and policies is required to address the growing burden of diabetes.