India’s diabetes epidemic just got more grim; Lancet report reveals why

The high rates of diabetes in rural India, coupled with a lack of infrastructure, could accelerate the ongoing obesity and prediabetes epidemic, a recent Lancet study has found. The high prevalence of obesity and prediabetes across the country, even in regions where the prevalence of diabetes is currently low, suggests that the epidemic will continue to accelerate.

“The diabetes epidemic is in transition in India, with some of the states having already peaked while others are still in the early take-off stage,” noted the study conducted by the Indian Council of Medical Research–India Diabetes (ICMR-INDIAB).

Over 11 per cent of Indians are diabetic, and 35.5 per cent suffer from hypertension, a recent Lancet study has found. While the prevalence of generalised obesity is 28.6 per cent, abdominal obesity is at 39·5 per cent, said the findings of the study released on June 8, 2023.

Also read: Health inequities to be blamed for premature deaths among people with disabilities: WHO

As many as 113,043 people —79,506 from rural areas and 33,537 from urban areas — participated in the study between October 18, 2008, and December 17, 2020. The prevalence of prediabetes was 15.3 per cent, and dyslipidemia 81.2 per cent, read the findings of the survey.

The ratio of diabetes to prediabetes was 1:2 or less in Arunachal Pradesh, Bihar, Madhya Pradesh, Meghalaya, Chhattisgarh, Rajasthan, Sikkim, and Uttar Pradesh, which are states lower on the Human Development Index.

“In these states, the ratio of diabetes to prediabetes was 1:2. Unless there is an intervention, about 60 per cent of people with prediabetes will turn into diabetes patients. This is why in our study said the prevalence of diabetes will increase in the years to come as the current rate of prediabetes is double in states that are low on HDI,” Dr Anjana Ranjit Mohan, from the Madras Diabetes Research Foundation in Chennai told Down To Earth.

The ratio was 1:1 or more in Chandigarh, Goa, Delhi, Kerala, Mizoram, Puducherry, Punjab, and Tamil Nadu, all states with a high human development index.

As different states in India are at different stages in the trajectory of the diabetes pandemic, state-specific strategies are the need of the hour, the study noted. States with a high prevalence of diabetes will need to put in place systems to ensure optimal risk factor control to effectively prevent long-term complications, the study added.

An underlying potential factor highlighted by the researchers is that Asians tend to develop diabetes at lower levels of obesity and progress faster from prediabetes to diabetes compared with white Caucasians, the researchers said.

Also read: Type 1 diabetes leading cause of diabetes deaths in those below 25, easily preventable: Study

All metabolic non-communicable diseases were observed at a higher rate in urban areas, except for prediabetes which recorded a higher presence among people in rural India. In these areas, there is a lack of infrastructure to care for an increasing number of people with diabetes and the consequent complications, which could be a potential escalating factor of the ongoing epidemic of diabetes, the paper published in the journal Lancet Diabetes and Endocrinology warned.

“Prevention, early diagnosis, and prompt treatment of hyperglycemia, hypertension, and dyslipidemia are the cornerstones of preventing morbidity and mortality due to cardiovascular disease and other chronic complications of diabetes,” the study authored by researchers at the Madras Diabetes Research Foundation.

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