Indians getting diabetes at younger ages, experts say India not taking health seriously

An increasingly prevalent lifestyle disease, diabetes, seems to be affecting an alarmingly younger population, said medical experts on Thursday. Ahead of the World Health Day, for which the World Health Organisation has picked diabetes as the theme of the year, a gathering of government and private health experts sounded the alarm on the non communicable disease (NCD), stressing how the Indian population seemed particularly vulnerable.

WHO also called into question India's commitment to health, with Dr Hank Bekedam, WHO's representative to India saying that the country "has not taken health seriously" as it was in the bottom four in the world in terms of government expenditure on public health.

According to Dr Damodar Bachani, Deputy Commissioner, union health ministry, in 2013 63 million people were living with diabetes in India and by 2030 that is projected to go up to 101.2 million, based on data gathered by the International Diabetes Federation. WHO's own profile of India shows that from 2011 to 2014 deaths due to NCDs have gone up from 53% to 60% of all deaths in the country. Diabetes may count for only 2% of these deaths, making it seem innocuous in the face of cardiovascular disease (CVD) and respiratory conditions such as chronic obstructive pulmonary disease (COPD). However, the danger lies in how much it contributes to other possibly fatal conditions, such as diseased livers and pancreas, and CVD. For example, deaths are often recorded as cardio-respiratory arrest, i.e the heart and the lungs stop working, which fails to capture diabetes as an underlying factor. Hence, it is difficult at the moment to quantify just how much diabetes contributes to disease mortality.

Endocrinologist Dr Anoop Misra, chairman of Fortis Centre for Diabetes, Obesity and Cholesterol said that the leading cause for liver cirrhosis was now diabetes and obesity, alcohol coming in second.

He also pointed out how the Indian population is particularly at risk, with people developing type 2 diabetes at a lower BMI and at younger ages than European populations, calling into question lifestyle choices and the rapid urbanisation in Indian cities.

Dr Tanveer Kaur, from the Indian Council of Medical Research, backed this up with her findings from ICMR's hospital-based registry, which has seen a worrying rise of Type-2 diabetes, which is caused by external factors as compared to Type-1, whose causes are unknown. Type-1 has been known as juvenile diabetes, occurring in children and adolescents. However, according to ICMR's registry, the ratio among young patients in hospital based settings for Type-1 to Type-2 is approximately 90:10. Even this 10% is worrying, as Type-2 has traditionally been seen as a ageing populations disease.

At the moment 7.8% of the 18-plus Indian population, according to WHO, has raised blood glucose levels, and 60 million live with diabetes. Since there is a dearth of reliable data, experts go by a broad assumption; 50% of people live with undiagnosed diabetes, 50% of the diagnosed do not get proper treatment. The numbers, as Dr Nikhil Tandon, head of endocrinology, metabolism and diabetes at AIIMS was quick to point out, are worse for rural population, with perhaps 80% living with undiagnosed diabetes.

He probed further into the lack of reliable data, saying every study so far was wrong about its diabetes projections in India. Poor lifestyle conditions had already outstripped estimations, with things far worse than was previously thought.

New Delhi itself has a 23% prevalence of diabetes he said, adding that the processes of care, even in urban cities, were "atrocious".