Diabetes Scenario In A Backward Rural District Population Of India And Need For Restructuring Of Health Care Delivery Services
Suman Kanungo, Tanmay Mahapatra, Kalyan Bhowmik, Sanchita Mahapatra, Jayanta Saha, Debottam Pal and Kamalesh Sarkar* National Institute of Cholera and Enteric Diseases, Kolkata - 700010, West Bengal, India Corresponding Author: Kamalesh Sarkar Scientist F, National Institute of Cholera and Enteric Diseases and Officer-in-Charge National Nutrition Monitoring Bureau West Bengal Unit. P-33, CIT Road Scheme-XM, Beliaghata, Kolkata, India Tel: +91-33-23631222 E-mail: [email protected] Citation: Kanungo S, Mahapatra T, Bhowmik K, Mahapatra S, Saha J, et al. (2016) Diabetes Scenario in a Backward Rural District Population of India and Need for Restructuring of Health Care Delivery Services. Epidemiol 6:224.doi:10.4172/2161-1165.1000224 Copyright: © 2016 Kanungo S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Epidemiology: Open Access Abstract Background: Poor healthcare infrastructure and utilization complicated Indian diabetic epidemic especially in backward areas where many cases remain uncontrolled or even undiagnosed till complications develop. Dearth of information from eastern India regarding the burden and correlates of such uncontrolled and undiagnosed diabetes and consequent healthcare-seeking thus called for a detailed investigation in a poor-resource setting. Methods: A community-based cross-sectional study was conducted in Malda, an under-developed district in eastern India. Between October 2013 and July 2014, 18028 consenting adults were randomly recruited, interviewed and tested for capillary blood sugar (fasting/post-prandia Continue reading >>
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Over 60% Urban Indian Women At Risk Of Diabetes: Survey
Over 60% urban Indian women at risk of diabetes: Survey Share @Whatsapp Share @Facebook Share @twitter Share @Email Share @google+ Share @reddit Over 60 per cent of urban Indian women do not follow a regular exercise regime, putting them at increased risk of diabetes, show results of a new survey. Released on the occasion of World Diabetes Day on Tuesday, the survey conducted by diabetes care company Novo Nordisk India also showed that 73 per cent of urban women in the country are unaware of gestational diabetes and its related health risks for the next generation. For the survey conducted in partnership with market research firm Kantar IMRB, over 1,000 women, belonging to the age group of 18-65 years were interviewed to draw insights on the level of awareness on risks emerging from diabetes. The survey was conducted across 14 cities in the country -- Delhi, Mumbai, Bangalore, Kolkata, Hyderabad, Chennai, Ahmedabad, Bhubaneswar, Lucknow, Ludhiana, Indore, Guwahati, Kochi and Vijaywada. The findings showed that 78 per cent women interviewed were aware of diabetes as a serious health concern and more than 70 per cent women believed that a healthy lifestyle will help prevent diabetes and its associated complications. "While it is encouraging to note that 78 per cent of the respondents were aware about diabetes and its complications, it is alarming to note that women are not taking concrete actions to address this challenge," Melvin D'souza, Managing Director, Novo Nordisk India, said in a statement. According to a study published in the journal Lancet, lack of physical activity is linked to an increased risk of diabetes, heart disease, and some cancers and is associated with more than five million deaths per year. With 72.9 million people currently living with diabetes, I Continue reading >>
The Burden Of Diabetes In India
India, the second most populous country of the world, has been severely affected by the global diabetes epidemic. As per the International Diabetes Federation (2013), approximately 50% of all people with diabetes live in just three countries: China (98.4 million), India (65.1 million) and the USA (24.4 million)[1]. There is clear evidence to show that diabetes prevalence is rapidly increasing, especially in urban India. The conventional risk factors of urbanization, unhealthy eating habits and physical inactivity, coupled with inherent genetic attributes and differences in body composition are propelling the increase in cases of diabetes. Accordingly, diabetes related complications are also on the rise and contribute significantly to overall morbidity and mortality. The low levels of education and poor awareness of the disease in the country are enhancing its impact on health of the population. While communicable diseases are slowly getting controlled in low and middle income countries (LMIC), such as India, there is a significant increase in the burden of non communicable diseases, including but not restricted to diabetes. Going by the model of four phases of health transition, India is currently in the age of man-made and degenerative diseases. This age is characterised by a life expectancy close to 50-60 years and unhealthy lifestyles which promote diseases like cardiovascular disease and hypertension. Prevalence/ incidence While comprehensive data are not available, smaller studies have been performed in various states of India to study the prevalence of diabetes. Based on these studies, the highest prevalence reported is from Ernakulum in Kerala (19.5%) and the lowest from Kashmir valley (6.1%). Most other areas have prevalence above 10%. While most prevalence stud Continue reading >>
Govt Survey: Over 20 Per Cent Indians Suffer From Diabetes, Hypertension
A government health survey conducted across 26 states and Union Territories has found that more than a fifth of India’s 125-crore population suffers from diabetes and hypertension. According to the National Family Health Survey-4, whose results were released on Tuesday, the overall incidence of diabetes was 20.3 per cent and that of hypertension 22.2 per cent. While there would be some commonality in the data — some people suffer from both — the actual numbers exceed the estimations. This is the first time the government has conducted a survey to find out the incidence of diabetes and hypertension. An earlier attempt to do so under the National programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Disease and Stroke did not quite take off, and the initial data had suggested a far lower incidence — about 6 per cent for diabetes and 8 per cent for hypertension. However, as a senior health ministry official said, the sample size in NFHS is too small to be representative of the entire country. NFHS-4, conducted in 2015-16, recorded data from 6 lakh households, covering 7 lakh women and 1.3 lakh men. Some of the states where the incidence of diabetes was found to be higher than the national average include Goa (33.7 per cent), West Bengal (28.2 per cent), Assam (34.6 per cent) and Odisha (27.2 per cent). States with a higher incidence of hypertension include Punjab (35 per cent), Sikkim (44.8 per cent) and Maharashtra (26 per cent). The data shows that like in previous editions of the survey, deliveries by caesarean section are disproportionately high in private hospitals as compared to government ones, taking the overall incidence of such deliveries way above the 25 per cent that WHO says is the expected rate in any population. The percentage of c Continue reading >>
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Overview Of Diabetes Burden
Diabetes is one of the largest global health challenges of this century. The number of people living with both type 1 and type 2 diabetes is increasing day by day causing severe economic burden to the patients and to the society at large. Among the two types, Type 2 diabetes, being common and more prevalent contributes significantly to the increasing trend. The International Diabetes Federation has estimated that globally there are 415 million people with diabetes in 2015 and is predicted to increase to 642 million by 2040.1 It is alarming to note that more than 47% of the world’s population is still undiagnosed for diabetes with the prevalence still bound to increase further. Furthermore, 318 million people are estimated to have impaired glucose tolerance and 20.9 million live births are affected by some form of hyperglycaemia in pregnancy, of which 85.1% are due to gestational diabetes. People with type 2 diabetes are increasing in every country, but more than 80% live in low and middle –income countries such as India, Bangladesh, Bhutan, Pakistan, Sri Lanka, Philippines and Indonesia. Among the top 10 countries in the world, India stands second with 69.2 million people with diabetes and another 36.5 million with prediabetes which is a high-risk condition for diabetes and cardio-vascular disease.1 This increasing incidence is mainly attributed to lifestyle changes; eating unhealthy food and being physically inactive. The South Asian and Pacific region is facing a high risk with prevalence of diabetes. There are reported differences in the characteristics of diabetes in Asian populations2. A recently reported Indian Council of Medical Research - INdia DIABetes (ICMR-INDIAB) study conducted in four different zones of rural and urban India showed that the prevalence Continue reading >>
The Current State Of Diabetes Mellitus In India
Diabetes is fast gaining the status of a potential epidemic in India with more than 62 million diabetic individuals currently diagnosed with the disease.1,2 In 2000, India (31.7 million) topped the world with the highest number of people with diabetes mellitus followed by China (20.8 million) with the United States (17.7 million) in second and third place respectively. According to Wild et al.3 the prevalence of diabetes is predicted to double globally from 171 million in 2000 to 366 million in 2030 with a maximum increase in India. It is predicted that by 2030 diabetes mellitus may afflict up to 79.4 million individuals in India, while China (42.3 million) and the United States (30.3 million) will also see significant increases in those affected by the disease.3,4 India currently faces an uncertain future in relation to the potential burden that diabetes may impose upon the country. Many influences affect the prevalence of disease throughout a country, and identification of those factors is necessary to facilitate change when facing health challenges. So what are the factors currently affecting diabetes in India that are making this problem so extreme? The aetiology of diabetes in India is multifactorial and includes genetic factors coupled with environmental influences such as obesity associated with rising living standards, steady urban migration, and lifestyle changes. Yet despite the incidence of diabetes within India, there are no nationwide and few multi-centric studies conducted on the prevalence of diabetes and its complications. The studies that have been undertaken are also prone to potential error as the heterogeneity of the Indian population with respect to culture, ethnicity, socio- economic conditions, mean that the extrapolation of regional results may g Continue reading >>
Survey On Diabetic Patients In The Country
Press Information Bureau Government of India Ministry of Health and Family Welfare Diabetes is one of the common Non-Communicable Diseases. Indian Council of Medical Research (ICMR) has informed that according to the International Diabetes Federation (IDF) Diabetes Atlas, 7th Edition, the prevalence of diabetes in India is 69.2 million in 2015. Indian Council of Medical Research (ICMR) has undertaken a study on diabetes viz. ICMR India Diabetes (ICMR-INDAB) Study on the prevalence of diabetes. It is an ongoing study and current results available from 15 States/UTs indicate overall prevalence of Diabetes which varies from 4% to 13%. While Health is a State Subject, the Central Government supplements the efforts of State/UT Governments to create awareness and provide health care facilities. Government of India is implementing National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) for interventions up to District level under the National Health Mission. It has focus on awareness generation for behaviour and life-style changes, screening and early diagnosis of persons with high level of risk factors and their treatment and referral (if required) to higher facilities for appropriate management for Non- communicable Diseases including Diabetes. Under NPCDCS, diagnosis and treatment facilities for Diabetes are provided through different levels of healthcare by setting up NCD Clinics in District Hospitals and Community Health Centres (CHCs). Endocrinology is one of the major focus area for new AIIMS and many other institutions upgraded under Pradhan Mantri Swasthya Suraksha Yojna. Free or subsidised treatment of Diabetes is also available at many Central and State Government Health Care Facilities. The Government of India, Continue reading >>
Prevalence And Risk Factors Of Diabetes In A Large Community-based Study In North India: Results From A Steps Survey In Punjab, India
Abstract India is the diabetes capital with home to 69.1 million people with DM, the second highest number of cases after China. Recent epidemiological evidence indicates a rising DM epidemic across all classes, both affluent and the poor in India. This article reports on the prevalence of diabetes and pre-diabetes in the North Indian state of Punjab as part of a large household NCD Risk Factor Survey. A household NCD STEPS survey was done in the state of Punjab, India in a multistage stratified sample of 5127 individuals. All the subjects were administered the WHO STEPS questionnaire, anthropometric and blood pressure measurements. Every alternate respondent in the sample (n = 2499) was assayed for blood parameters. Overall prevalence of DM among the study participants was found out to be 8.3% (95% CI 7.3–9.4%) whereas prevalence of prediabetes was 6.3% (5.4–7.3%). Age group (45–69 years), marital status, hypertension, obesity and family history of DM were found to be the risk factors significantly associated with DM. Out of all persons with DM, only 18% were known case of DM or on treatment, among whom only about one-third had controlled blood glucose status. The study reported high prevalence of diabetes, especially of undiagnosed cases amongst the adult population, most of whom have uncontrolled blood sugar levels. This indicates the need for systematic screening and awareness program to identify the undiagnosed cases in the community and offer early treatment and regular follow up. Background According to International Diabetes Federation estimates, around 415 million people had DM in 2015 and this number is expected to rise to 642 million by 2040 [1]. Around 75% of subjects with DM live in low- and middle-income countries (LMICs). In financial terms, the glo Continue reading >>
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Rajasthan Ranks Lowest In Diabetes Prevalence: Survey
Rajasthan ranks lowest in diabetes prevalence: Survey At a time when diabetes is fast gaining the status of a potential epidemic in India, Rajasthan has the lowest number of people affected by the disease. This striking fact surfaced in the National Family Health Survey-2015-16 report which union ministry of health tabled in a reply to a question asked in Lok Sabha recently. As per the report, 5.8 per cent women and 8.8 per cent men in the age group of 15-59 years on an average out of the surveyed in India were found suffering from diabetes measuring above 140 Mg/dl. The percentage of people suffering from high blood pressure in Rajasthan is much lower than the national average and at the bottom when compared to rest 35 states and union territories. The survey finds that only 3.5 percent women and 5.7 percent men were found diabetic in 2015-16 in Rajasthan which is the lowest in the country. It also indicates that men are more prone to diabetes than women. On the other hand, Kerala and Goa were top two in the country with the highest share of population with 8.7 per cent(women)-13.1 percent(men) and 8.9 percent (women) and 12.3 percent(men) ratio respectively. These were followed by Andhra Pradesh at 8.2 percent population ratio in women and West Bengal with 11.4 percent in men categories. Apart from Rajasthan, Haryana, Jharkhand and Maharashtra have secured bottom position with fewer diabetic patients. The survey indicates that Haryana with 4.8 percent patients in males is followed by Jharkhand at 4.9 percent. In females, Maharashtra keeps second place from bottom with 5.9 percent which is followed by Haryana at 6.1. The findings of the survey as far as Rajasthan is concerned is shocking and hard to be digested by endocrinologists. Apart from Rajasthan, Haryana, Jhark Continue reading >>
Prevalence Of Diagnosed Diabetes And Associated Risk Factors: Evidence From The Large-scale Surveys In India
Context: India has observed the most devastating increases in the burden of diabetes in the contemporary era. However, so far, the comparable prevalence of diabetes is only available for limited geography. Aims: The present paper provides comparable estimates of diabetes prevalence in states and districts of India and examines the associated risk factors with newly diagnosed and self-reported diabetes. Setting and Design: The study uses clinical, anthropometric, and biochemical data from District Level Household and Facility Survey (2012–2013) and Annual Health Survey (2014). Subjects and Methods: The paper analyses the information on glucose level of the blood sample and defines diabetes as per the World Health Organization (1999) criteria. It applies multinomial logistic regression to identify the risk factors of diabetes. Results: The study estimates 7% adults with diabetes in India, with a higher level in urban (9.8%) than in the rural area (5.7%), a higher proportion of males (7.1%) than females (6.8%). Widowed, older persons, and persons with high blood pressure have very high risk of both diagnosed and self-reported diabetes. Comparing to Hindus, Muslims and Christians have higher, and Sikhs have less risk of diabetes. Further, corresponding to general caste, scheduled castes, and other backward classes have a high risk of newly diagnosed but the lower risk of self-reported diabetes. Conclusions: The list of districts and states with alarming diabetes prevalence is the valuable information for further programs and research. A significant population with undiagnosed diabetes reflects an urgent need to strengthen the diagnostics at the local level and for those who need them most. Table 2: Sample size distribution by key background variables, District Level House Continue reading >>
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Current Scenario Of Diabetes In India
Abstract India, a country experiencing rapid socioeconomic progress and urbanization, carries a considerable share of the global diabetes burden. Studies in different parts of India have demonstrated an escalating prevalence of diabetes not only in urban populations, but also in rural populations as a result of the urbanization of lifestyle parameters. The prevalence of prediabetes is also high. Recent studies have shown a rapid conversion of impaired glucose tolerance to diabetes in the southern states of India, where the prevalence of diabetes among adults has reached approximately 20% in urban populations and approximately 10% in rural populations. Because of the considerable disparity in the availability and affordability of diabetes care, as well as low awareness of the disease, the glycemic outcome in treated patients is far from ideal. Lower age at onset and a lack of good glycemic control are likely to increase the occurrence of vascular complications. The economic burden of treating diabetes and its complications is considerable. It is appropriate that the Indian Government has initiated a national program for the management and prevention of diabetes and related metabolic disorders. Lifestyle modification is an effective tool for the primary prevention of diabetes in Asian Indians. The primary prevention of diabetes is urgently needed in India to curb the rising burden of diabetes. Continue reading >>
High Rates Of Diabetes, Hypertension In India, Even In The Young
High Rates of Diabetes, Hypertension in India, Even in the Young High prevalence rates of diabetes, and especially hypertension, are being reported across India, where even among young adults, hypertension is common, according to the first nationally representative sample of 1.3 million adults. As India is home to more than one sixth of the world's population, "understanding how diabetes and hypertension prevalence varies within a country as large as India is essential for targeting of prevention, screening, and treatment services," Pascal Geldsetzer, MBChB, Harvard TH Chan School of Public Health, Boston, Massachusetts, and colleagues write in their article, published online January 29 in JAMA Internal Medicine. "An important finding of our study...is the unexpectedly high prevalence of hypertension among young adults in India, which if ineffectively treated will likely result in longer lifetime exposure to this risk factor and thus higher cardiovascular disease rates in the future," they stress. More Than 1 in 10 Young Adults Have Hypertension Researchers used the District-Level Household Survey-4 and the second update of the Annual Health Survey, both of which were carried out between 2012 and 2014. For each, blood glucose and blood pressure were measured in adult men and women. "Diabetes was defined as having a high plasma glucose reading ( 126 mg/dL [7.0 mmol/L] if patients reported having fasted or 200 mg/dL [11.1 mmol/L] if patients reported not fasting," study authors explain. Hypertension was defined as a systolic blood pressure 140 mm Hg or diastolic blood pressure 90 mm Hg. Among women, the crude prevalence rate of diabetes was 7.3%, and among men was 7.8%, the investigators report. Age-standardized rates of diabetes in India were slightly lower, at 6.1% for Continue reading >>
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Icmr Survey On Diabetic Patients In India Reveals Variations In Prevalence
ICMR survey on diabetic patients in India reveals variations in prevalence ICMR survey on diabetic patients in India reveals variations in prevalence The Indian Council of Medical Research (ICMR) in the latest survey focused on diabetes across various states in India has revealed the variation of prevalence from 4 percent to 13 percent New Delhi: Diabetes is one of the common Non-Communicable Diseases. Indian Council of Medical Research (ICMR) has informed that according to the International Diabetes Federation (IDF) Diabetes Atlas, 7th Edition, the prevalence of diabetes in India is 69.2 million in 2015. ICMR has undertaken a study on diabetes viz. ICMR India Diabetes (ICMR-INDAB) Study on the prevalence of diabetes. It is an ongoing study and current results available from 15 States/UTs indicate overall prevalence of Diabetes which varies from 4 percent to 13 percent, stated the Minister of State (Health and Family Welfare), Mr Faggan Singh Kulaste stated in a written reply in the Parliament on February 07, 2017. While Health is a State Subject, the Central Government supplements the efforts of State/UT Governments to create awareness and provide health care facilities. Government of India is implementing National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) for interventions up to District level under the National Health Mission. It has focus on awareness generation for behaviour and life-style changes, screening and early diagnosis of persons with high level of risk factors and their treatment and referral (if required) to higher facilities for appropriate management for Non- communicable Diseases including Diabetes. Under NPCDCS, diagnosis and treatment facilities for Diabetes are provided through different Continue reading >>
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Diabetes Care In India - Sciencedirect
Volume 81, Issue 6 , NovemberDecember 2015, Pages 830-838 Diabetes has become a major health care problem in India with an estimated 66.8 million people suffering from the condition, representing the largest number of any country in the world. The rising burden of diabetes has greatly affected the health care sector and economy in India. The goal of health care experts in India is to transform India into a diabetes care capital in the world. An expert detailed review of the medical literature with an Asian Indian context was performed. Recent epidemiologic studies from India point to a great burden from diabetes. Diabetes control in India is far from ideal with a mean hemoglobin A1c of 9.0%at least 2.0% higher than suggested by international bodies. Nearly half of people with diabetes remain undetected, accounting for complications at the time of diagnosis. Screening can differentiate an asymptomatic individual at high risk from one at low risk for diabetes. Despite the large number of people with diabetes in India, awareness is low and needs to be addressed. Other challenges include balancing the need for glycemic control with risk reduction due to overly tight control, especially in high-risk groups and taking into account health care professional expertise, attitudes, and perceptions. Pharmacologic care should be individualized with early consideration of combination therapy. Regular exercise, yoga, mindful eating, and stress management form a cornerstone in the management of diabetes. Considering the high cost incurred at various steps of screening, diagnosis, monitoring, and management, it is important to realize the cost-effective measures of diabetes care that are necessary to implement. Result-oriented organized programs involving patient education, as well as Continue reading >>
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It City 4th In Diabetes Prevalence: Survey
IT city 4th in diabetes prevalence: Survey IT city 4th in diabetes prevalence: Survey Indias IT capital ranks fourth in diabetes prevalence, reveals a survey conducted across eight major cities of the country. BENGALURU: India's IT capital ranks fourth in diabetes prevalence, reveals a survey conducted across eight major cities of the country. Data analysis of more than 6.3 million samples by SRL Diagnostics over the past three-and-a-half years has found that 20.74% of Bengaluru's tested population suffered from diabetes. Mumbai topped the list with 23.74%, followed by Kolkata (22.07%) and Delhi (21.86%). "If the number of diabetic patients continues to rise at this pace, India may soon grab the tag of diabetic capital of the world from China. It's a terrible prospect because the most-affected will be the working population. As per International Diabetes Federation, there are over 69 million people in India suffering from diabetes, which kills about 3.5 lakh people every year," said Dr BR Das, advisor and mentor -R&D and Molecular Pathology , SRL Diagnostics. Across cities, adults across genders in the age groups of 46-60 and 61-85 showed the highest diabetes prevalence, 26.71% and 27.01% respectively. Get latest news & live updates on the go on your pc with News App . Download The Times of India news app for your device. Read more City news in English and other languages. Continue reading >>
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