India is now in the midst of a diabetes epidemic, with an adult prevalence rate of nine per cent and almost 69 million people living with diabetes. In another 15 years, the figure is expected to rise to 101 million. In all this, more than 90 percent of cases are lifestyle-induced.
Individuals with diabetes do not have any symptoms for long periods of time and may have complications at the time of diagnosis. Common examples such as retinopathy (blindness), nephropathy (kidney disease), neuropathy (nerve damage) and diabetic foot (gangrene and amputations in extreme cases) affect a large proportion of individuals with diabetes. Approximately a third of those with diabetes are known to develop retinopathy. Diabetes is also known to increase the risk of cardiovascular diseases (heart attack and stroke); nearly half of those with diabetes die of heart attack.
A bad lifestyle is what propels this epidemic while an inadequate response from the health system results in debilitating complications. The staggering increase in cases of diabetics and prediabetics has been attributed to lifestyle changes as a result of rapid and unplanned urbanisation, an ageing population, a sedentary lifestyle and increasing consumption of unhealthy food, especially modern processed foods. Lack of opportunistic screening delays diagnosis while poor access to care and medicines, information asymmetry between doctors and patients, and a paucity of well-trained human resource, impede evidence-based management of diabetes.
Health promotion strategies
Prevention remains central in halting the current pace of the diabetes epidemic. Our focus should be on both individual and policy-level interventions. Health promotion strategies should be aimed at maintaining normal body weight by improving physical activity and following a balanced and healthy diet. Evidence from the [INTERNATIONAL] Diabetes Prevention Program (DPP) shows that small reductions in weight by the moderate-intensity activity of at least 150 minutes per week and reduced fat consumption on most days prevented progression to diabetes by 58 percent among those with prediabetes.