Is India World's New Diabetes Capital? Five Reasons Why It's True

One in six people with diabetes in the world are from India. The numbers place the country among the top 10 countries for people with diabetes, coming in at number two with an estimated 77 million diabetics. Although China overtook India as the ‘Diabetes Capital of the World’, there are two startling statistics about India’s relationship with diabetes which are worrisome: 57% of adults with type 2 diabetes don’t know they have it, and over the past three decades, the number of type 1 diabetes patients in India has increased by 150%.

The combination of diabetes and obesity will result in “diabesity” which is probably going to be the biggest epidemic in human history. This is because, diabetes continues to be the biggest silent killer and the most significantly underappreciated public health concern, while the majority of us worry about COVID-19, cancer malignancies, respiratory ailments, and other conditions.

Why The Rising Numbers Should Concern Us All

Currently, around 80 million people in India have diabetes, which is 17% of the world's diabetic population. According to the International Diabetes Federation, the number is expected to rise to 135 million by 2045.

The prevalence of Diabetes is rising across all countries, especially India. It is likely due to a combination of factors, which include:

• 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 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.

• Decrease in traditional diets: At the same time, the increased ‘westernization’, especially in the metros and the larger cities, has led to a drastic change in our dietary patterns. Indian diets have always been carbohydrate-heavy and now the reliance on refined sugars, processed food in the form of quick bites fuss-free cooking and trans fatty acids are creating havoc.

• 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 high-calorie/high-fat and high-sugar diets, thus become major contributing factors.

• Rapid urbanization: Currently, India is undergoing a rapid epidemiological transition with increased urbanization. With the increasing availability of machines to do our work, there’s also a substantial drop in day-to-day activities. The current urbanization rate is 35% compared to 15% in the 1950’s and urbanization is associated with stress which has major implications on the present and future disease patterns in India with particular reference to diabetes and coronary artery disease.

The American Diabetes Association (ADA) guidelines suggest that self-management and education are crucial aspects of diabetes care. Diabetes self-management can reduce blood sugar levels, mortality risk, and healthcare costs, as well as weight in people with excess weight. Awareness and prevention are the game changers. Regular blood tests at least once a year and monitoring the risk factors can help bring down the number of undiagnosed diabetic cases.

Considering that Indians appear to be generally more insulin resistant; it would be prudent to advise a healthy lifestyle across the different geographic regions and age groups, continue traditional diets rich in fibre and possibly adopt stress reduction measures by yoga or other measures. Such an effort is urgently needed to tackle the explosion of diabetes and lower the burden due to the disease in India.

Authored by Dr Apurrva Sawant, Preventive Healthcare Expert, Doctor and Founder of Careport