Image used for representation purposes. File

On World Diabetes Day (November 14), there was bitter news for the nations of the world. A paper published in a peer-reviewed journal, The Lancetbased on a global study, recorded more than 800 million adults living with diabetes, more than half do not receive treatment.

Not surprisingly, India had the highest number of diabetics in the world, but surprisingly enough, the number was almost 100 million more than the figures revealed as part of the Indian Council of Medical Research (ICMR)-INDIAB study of the year last. Splitting hairs over the figures, there are clear indications that the number of people with diabetes is increasing in India, and investment in diabetes prevention, treatment and prevention of complications is imperative.

The study, carried out by the NCD Risk Factor Collaboration (NCD-RisC), together with the World Health Organization (WHO), used data from more than 140 million people (18+ years) collected from more than 1,000 studies in different countries.

According to the study, the total number of adults living with type 1 or type 2 diabetes worldwide has exceeded 800 million – more than four times the total since 1990. Of these 800 million, more than a quarter (212 million) live in India, with another 148 million in China.

“Our study highlights growing global inequalities in diabetes, with treatment rates stagnating in many low- and middle-income countries, where the number of adults with diabetes is rising sharply. This is of particular concern because people with diabetes tend to be younger in low-income countries and, in the absence of effective treatment, are at risk of lifelong complications, including amputations, heart disease, kidney damage or loss sight or in some cases. cases, premature death,” said lead author Majid Ezzati, of Imperial College, London.

One reason for the huge numbers could be the use of either HbA1c or fasting glucose, whichever data was available in different countries, explained V. Mohan, president, Madras Diabetes Research Foundation. “The gold standard is the fasting blood glucose and the two-hour postprandial value after an oral glucose tolerance test (OGTT). This is what we used in the ICMR-INDIAB study. If only the OGTT values ​​were followed, then the number would be half of what was recorded,” said Dr. Mohan.

“Using HbA1c, they used a single cut-off point to determine diabetes – 6.5%. Even in those with normal glucose, a small percentage will spread into the 6.5% HbA1c value, depending on whether individuals are “rapid” or “normal” glycators. Glycation is influenced by many things, including anemia and aging. Of course, in a global study, there are limitations to using data that is already available. The reality is that we need to do something urgently to prevent diabetes and its complications,” he added.

“It is very clear that diabetes has been on the rise in India for two decades. In this context, we must undertake a war-like effort using the media to spread awareness about nutrition, physical activity and (and) adopting more legal provisions to regulate the carbohydrate (carbohydrate) and sugar content of food packed. We need to educate women because they are prone to obesity after pregnancy and are at increased risk in menopause. We must stop the rising trend of obesity through these efforts. A long-term vision for 10 years is required with a dedicated task force assigned to this task,” said Anoop Mishra, Chairman, Fortis CDOC Hospital for Diabetes and Allied Sciences.

“Our findings highlight the need to see more ambitious policies, particularly in lower-income regions of the world, that restrict unhealthy foods, make healthy foods affordable and improve opportunities to exercise through measures such as food subsidies healthy and free and healthy schools. meals, as well as promoting safe places to walk and exercise, including free entry to public parks and fitness centers,” Anjana Ranjit, president, Madras Diabetes Research Foundation, which was involved in the ICMR-INDIAB study, said.