Diabetes is often considered a disease of the rich. A recent study by Indian Council of Medical Research-INdia DIABetes (ICMR-INDIAB) may have to some extent reiterated that presumption, linking GDP growth to the prevalence rate of diabetes.

However, the study has raised many surprises that are disquieting. For instance, the alarming increase in the prevalence of diabetes among the urban poor in seven of India’s affluent States and Union Territories, including Chandigarh, Tamil Nadu and Maharashtra. And over 50 per cent of those who participated in the study were unaware of their condition, which indicates low awareness about the disease.

The ICMR-INDIAB study also reveals that the disease prevalance in urban India is twice that of rural India. And in most States, the rate of pre-diabetes (the stage before onset of diabetes) exceeded the rate of diabetes, a forewarning of the impeding pressure on healthcare facilities and infrastructure.

Is the epidemic likely to level off in the near future? The conversion rates of diabetes from the pre-diabetes stage to the diabetes stage is the highest among Indians compared to any other ethnic group in the world. This means that the epidemic of diabetes is far from being under control; we may well see a huge increases in diabetes prevalence rates in India in the years to come.

The other worrying aspect that the ICMR-INDIAB study revealed is that in both urban and rural areas, for men and women alike, the take-off point for diabetes was seen to be in the age group of 25-34 years. This is a very worrisome trend as it takes only 10-15 years for diabetes-related complications to emerge, and this is likely to render millions of young Indians in the prime of their youth with complications affecting their kidney, heart and feet, leading to blindness, renal failure, heart attack and amputations.

Luckily, despite the increase in susceptibility to diabetes among Indians, much can be done to prevent diabetes. More than 60 per cent of diabetes incidence is traceable to environmental factors, and rest to hereditary or genetic factors. Through unique prevention programmes in India, diabetologists have shown that diabetes is preventable.

Up to 32 per cent of people with pre-diabetes can prevent the onset of diabetes by making simple lifestyle changes, such as exercising daily (even just walking) for at least 30 minutes a day; reducing consumption of refined carbohydrates like white rice and wheat; increasing the intake of vegetables, especially green leafy vegetables and fruits; reducing weight; and reducing stress through yoga, pranayama and meditation.

Diabetes can do to India what HIV has done to many countries in Africa, in terms of adversely impacting the country's young and economically active population. Unless we act fast, diabetes has the capacity to affect the individual, the community, the society and the whole country, with serious socio-economic consequences. Prevention of diabetes is not just necessary, but imperative.

The writer is Vice-President, Madras Diabetes Research Foundation, the research arm of Dr Mohan’s Diabetes Specialities Centre. She is the Co-Primary Investigator of the ICMR-INDIAB study and the author of the report.

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