New Delhi: India accounted for the highest number of diabetics in 2022, with more than a fourth of 828 million globally, and nearly 62 percent of diabetics in the country were not receiving any treatment for the disease, a report by the NCD Risk Factor Collaboration (NCD-RisC) and the World Health Organization (WHO) has revealed.
The NCD-RisC is a network of over 1,500 health scientists providing data on major non-communicable diseases (NCDs) for all countries.
The report, published in The Lancet Thursday, said that in 2022, there were nearly 212 million (21.2 crore) people—who accounted for 23.7 percent of the population—living with diabetes in India. Of these, around 133 million (13.3 crore) were not on any treatment for the condition, or taking medications.
With nearly 30 percent of diabetics worldwide who were not receiving any treatment, India topped the global chart of diabetics in this aspect too.
In comparison, China—the only country comparable with India in terms of population—had far fewer (148 million or 14.8 crore) diabetics that year. Of these, around 78 million were living without treatment.
The findings are part of the first global analysis of trends in both diabetes rates and treatment across all countries.
They also show that in India in 1990, the rate of diabetes was 11.9 percent for women and 11.3 percent for men, which rose to 23.7 and 21.4 percent, respectively, in 2022.
The treatment coverage for diabetic women in 1990, on the other hand, was 21.6 percent, which rose to 27.8 percent in 2022. For men, the treatment coverage rose from 25.3 to 29.3 percent during the period.
Diabetes was defined as having a fasting plasma glucose (FPG) of seven millimoles per litre or higher and a glycated haemoglobin (HbA1c)—a form of haemoglobin chemically linked to sugar—of 6.5 percent or higher. These are two commonly used diagnostic options for diabetes in modern guidelines.
The analysis, however, was unable to differentiate between type 1 and type 2 diabetes in adults, even though previous evidence suggests that the vast majority of diabetes cases in adults are type 2.
The report also says that the total number of adults living with either type 1 or type 2 diabetes in the world has surpassed 800 million. This is over four times the total number in 1990.
Additionally, in 2022, around 445 million diabetics aged 30 and above did not receive treatment. This is three and a half times the number in 1990.
The researchers used data from 1,108 population-based studies—which included information on diabetes treatment and data on 141 million participants aged 18 and above whose fasting glucose and HbA1c levels had been measured—to arrive at the country-wise figures.
“Our study highlights widening global inequalities in diabetes, with treatment rates stagnating in many low- and middle-income countries where numbers of adults with diabetes are drastically increasing,” Majid Ezzati of Imperial College London and a senior author on the paper said in a statement.
This is especially concerning, he said, because in low-income countries, younger people tend to be diabetic. Also, in the absence of effective treatment, they are at risk of life-long complications such as amputation, heart disease, kidney damage or vision loss or, in some cases, premature death, he added.
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15.3% of Indians pre-diabetic
The latest figures revealed that in 2022, nearly 23.7 percent of the population in India was diabetic, a number much higher than 11.4, the value shown by last year’s ICMR-INDIAB (Indian Council of Medical Research-India Diabetes) survey. Conducted by the ICMR and Madras Diabetes Research Foundation (MDRF), the survey was published in The Lancet last year.
It also revealed that 15.3 percent of the Indian population was pre-diabetic.
Dr V. Mohan, chairman of the MDRF and member of the NCD-RisC, told ThePrint that while the latest report primarily used data from the INDIAB study, it also incorporated statistical information about fasting glucose and HbA1c levels.
These are different from oral glucose tolerance test (OGTT) results—a gold standard for detecting diabetes—which were used for gauging the number of diabetics in the ICMR-INDIAB survey.
“OGTT is a more accurate test to determine diabetes but since many countries do not use it, the global study had to use figures from a test used by all nations. This was to get standardised results,” Mohan said.
The new report underscores that the prevalence estimates are consistent with those of studies which are based on results of fasting glucose and HbA1c tests.
It says that the prevalence of diabetes in India estimated by analysing the results of both blood glucose and HbA1c tests is similar to the value shown by the ICMR-INDIAB survey, and is higher than the value obtained based on the assessment of glucose tests alone.
The latest report shows that while the number of diabetics in India is higher than South East Asian (SEA) nations such as Nepal, Bhutan and Bangladesh, it is less than that in other SEA countries such as Sri Lanka, Afghanistan and Pakistan.
Statistics of underweight and obese men, women
The report also said that while 61 million women or 14 percent (of the population of women in India) were underweight (a body mass index or BMI of less than 18.5 kg per metre square of height) in the country in 2022, the number and percentage of obese (those with BMI of over 25 kg per metre square of height) women stood at 44 million and 10 percent, respectively, that year.
Also, the country had 58 million men (12 percent) who were underweight and 26 million (5 percent) obese men in 2022.
In 2022, the number of thin girls in India was 35 million (20 percent of the population) and the number of thin boys 42 million (22 percent).
The WHO defines thinness as a BMI of less than 17 kilograms per metre square of height in adolescents and kids aged five to 14 years.
It also shows that 5.2 million (3 percent) girls and 7.3 million (4 percent) boys are obese.
“Given the disabling and potentially fatal consequences of diabetes, preventing diabetes through healthy diet and exercise is essential for better health throughout the world,” Dr Ranjit Mohan Anjana of the MDRF, one of the researchers involved in the new study, said in a statement.
She added that the findings highlight the need to see more ambitious policies, especially in lower-income regions of the world.
These policies must restrict unhealthy foods, make healthy foods affordable and improve opportunities to exercise through measures such as subsidies for healthy foods and free healthy school meals, she explained, adding that they must also promote safe places for walking and exercising, including free entrance to public parks and fitness centres.
(Edited by Radifah Kabir)
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