Stronger action needed to stem the rising tide of diabetes

Dr Nachiket Sule, CNS Correspondent, India
Hemant (name changed) was diagnosed with diabetes in his early forties. Although, he had very few symptoms, the denial that it was diabetes was quite strong. Coming from an urban set-up he was able to diagnose the condition early on and triage it from other doctors as well. However, he admits that he was reluctant to take medicines for the rest of his life and neither did he want to live with restrictions that diabetes brings with it.

As per the 2015 IDF Diabetes Atlas, India has almost 70 million (7 crores) people with diabetes. The percentage of people with pre-diabetes risk conditions is also on the rise. Also the estimated burden of prediabetes in India is around 80 million (8 crores). The cost of treating diabetes in a country like India is quite high, and majorly entails out-of-pocket expenditures for those living with it.

Hemant too found it financially difficult to manage his ongoing treatment. Initially he even changed quite a few doctors. However, now he has accepted his condition and is on regular treatment. Proper counselling from one of his doctors helped him understand the dos and don’ts of diabetes. He now exercises regularly, follows healthy dietary habits and goes for routine blood sugar check-ups to keep his diabetes under control.

However, this might not be true for a large number of people living with diabetes in India, especially in rural India. The awareness levels about diabetes remain relatively poor and limitations to access to proper treatment escalate the problem. In my numerous interactions with people with diabetes from rural India, it was evident that many of them either did not not have access to treatment, or left treatment in between because of travel and cost related issues. Thus, they become prone to develop complications in the future. Complications in diabetes are numerous which develop gradually over a period of time. Hence, if the initial symptoms of diabetes are not taken care of they may lead to serious, even life threatening situations. 

The Government of India has initiated the National Programme for Prevention and Control of Cancer, Diabetes, CVD and Stroke (NPCDCS) from 2010 onwards. This programme has created NCD cells in many of the states in India and NCD clinics at the district hospitals and Community Health Centres (sub-district level). However, the capacity of each state to implement such programmes varies, with severe shortfalls of human resources in most of the states. According to Dr Ehsan Latif, Senior Advisor on Non-Communicable Diseases at the International Union Against Tuberculosis and Lung Disease (The Union), all the countries need to look at their own capacities to develop national plans for NCD care and control. Priorities must be aligned to develop cost-effective action plans. India needs to re think whether the current program should be restructured for universal coverage and implementation.

Dr Nachiket Sule, Citizen News Service - CNS
July 13, 2017 

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