What's New

Defusing the ticking time bomb called diabetes

Relevance

• GS Paper 2 Health, Government Policies & Interventions.
• Tags:#Diabetes, #Type-2 diabetes, #Type-1 diabetes.

Why in the news?

In June 2023, a study conducted by the Madras Diabetes Research Foundation in collaboration with the Indian Council of Medical Research and the Union Health Ministry revealed that 11.4% of India’s population or 10.13 crore people are living with diabetes and 15.3% of the population or an additional 13.6 crore people are pre-diabetic. It also found that 28.6% of the population would be considered to be obese as per the BMI measure.

Diabetes

• Diabetes is a chronic (long-lasting) health condition that affects how our body turns food into energy.
• Diabetes is a metabolic disorder in which the body has high sugar levels for prolonged periods of time.
• The lack of insulin causes a form of diabetes.
• Type-I Diabetes: It is a medical condition that is caused due to insufficient production and secretion of insulin from the pancreas. Type 1 diabetes is thought to be caused by an autoimmune reaction (the body attacks itself by mistake). This reaction stops your body from making insulin. Approximately 5-10% of the people who have diabetes have type 1
• Type-2 diabetes: With type 2 diabetes, your body doesn’t use insulin well and can’t keep blood sugar at normal levels. About 90-95% of people with diabetes have type 2.
• Gestational Diabetes: This type occurs in women during pregnancy when the body sometimes becomes less sensitive to insulin. Gestational diabetes does not occur in all women and usually resolves after giving birth.

Prevalence of diabetes in India

• People living with Diabetes in India: There are an estimated 77 million people with diabetes in India, which means one in every 10 adults in India has diabetes. Half of those who have high blood sugar levels are unaware. Even among those who have been diagnosed with diabetes, only half of them have their blood sugar level under control.
• Rapid increase in younger population: According ICMR report, the prevalence of diabetes in India has increased by 64 percent over the quarter-century. prevalence among the younger population has also increased above 10%.
• Children impacting more: Worryingly, in India, a large number of children are also impacted by diabetes. Children are developing obesity and metabolic syndrome early because of the change in diets to more processed and fast foods.
• Projected Estimation: About 98 million Indians could have diabetes by 2030, these projections come from the International Diabetes Federation and the Global Burden of Disease project.
• Children impacting more: Worryingly, in India, a large number of children are also impacted by diabetes. Children are developing obesity and metabolic syndrome early because of the change in diets to more processed and fast foods.

Reasons for Indians more prone to diabetes

• Lifestyle changes: The current exponential rise of diabetes in India is mainly attributed to lifestyle changes. The rapid change in dietary patterns, physical inactivity, and increased body weight, especially the accumulation of abdominal fat, are some of the primary reasons for increased prevalence.
• Ethnically more prone: Ethnically, Indians seem to be more prone to diabetes as compared to the Caucasians, although the precise mechanisms are not well known.
• we Indians have a greater degree of insulin resistance which means our cells do not respond to the hormone insulin. And when compared to Europeans, our blood insulin levels also tend to rise higher and more persistently when we eat carbohydrates.
• Greater genetic predisposition: The epidemic increase in diabetes in India along with various studies on migrant and native Indians clearly indicate that Indians have an increased predilection to diabetes which could well be due to a greater genetic predisposition to diabetes in Indians.
• Decrease in traditional diets: Increased ‘westernization’, especially in the metros and the larger cities, has led to a drastic change in our dietary patterns which are carbohydrate-heavy and now the reliance on refined sugars, processed food in the form of quick bites and fuss-free cooking and trans fatty acids are creating havoc.
• Mechanization of day-to-day work: With the increasing availability of machines to do our work, there’s also a substantial drop in day-to-day activities.
• Consumption of high calorie food and lack of physical activities: Obesity, especially central obesity and increased visceral fat due to physical inactivity, and consumption of a high-calorie/high-fat and high sugar diets, thus become major contributing factors.
• Rapid urbanization: The current urbanization rate is 35% compared to 15% in the 1950’s and this could have major implications on the present and future disease patterns in India with particular reference to diabetes and coronary artery disease.
• Rural-urban migration: The rural migration to urban areas and associated stress plays a significant role in lifestyle change.

Related Initiatives

• National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS)

In order to prevent and control major NCDs, this initiative was launched by India in 2010 with focus on strengthening infrastructure, human resource development, health promotion, early diagnosis, management and referral.

• World Diabetes Day

It is observed on 14th November every year. The 2022 campaign focus on access to diabetes education.

• Global Diabetes Compact

WHO launched a Global Diabetes compact to better fight the disease while marking the centenary of the discovery of insulin.

Mandatory provisions

• The only way the government can safeguard people from the manipulative strategies of the food industry is through a legal framework or even an ordinance (Article 123 of the Constitution) with the objective of reducing/halting the consumption of ultra-processed foods.
• It could also include defining ‘healthy food’, a warning label on unhealthy food, and restrictions on the promotion and marketing tactics of unhealthy food and beverages.
• The people must be informed of the risk of consuming such food. In this process, there is no reason to partner with the food industry that is responsible for ill health.

International Example

• The governments of South Africa, Norway, and Mexico have recently taken similar actions.
• Such a law will be a clear demonstration of the will of the government. The Infant Milk Substitutes, Feeding Bottles, and Infant Foods Act flattened the growth of commercial baby food.
• The proposed new law could do the same to unhealthy foods and beverages. This is an idea whose time has come.

Source: The Hindu

Mains Question

Diabetes is increasing alarmingly across all age groups in India. Discuss the reasons and suggest measures to manage the epidemic of diabetes if it is not curable?