Professor, Health Communication
Indian Institute of Health and Family Welfare


November 14, which is popularly known for Children’s day, Cha Cha Nehru’s birthday, is known as World Diabetes Day. It is different story that despite 62 years of India’s independence, the infant mortality rate in the country is 57 according to National Family Health Survey III. This means that 57 children out of every 1000 live births die before they see their first birth day. As we are discussing, one child or other is dying in some part of country. Andhra Pradesh which boasts of development, is no exception in this aspect. Andhra Pradesh Infant Mortality Rate is 53. What a shame. Does the occasion necessitate celebrating Children’s day in the country.

The bad news is that India which has many dubious distinctions in the social indicators, has now emerged diabetes capital of the world .About 50.8 million people are now suffering from the looming epidemic of diabetes, followed by China with 43.2 million. There are 285 million diabetes cases worldwide, accounting for seven per cent of the world’s population.

According to the recent World Diabetes Congress of the International Diabetic Congress Federation held at Montreal recently, another eight million cases would be added to the existing diabetes cases in India by next year (2010) which works to seven per cent of  country’s adult population. The Congress noted that the by 2030, over 8.4  per cent of the country’s population will suffer from diabetes, due to the increasing life expectancy  and urbanization, the congress report added.

The table explains the India’s position visa vis other countries

Position Population suffering form diabetes in Millions

l. No. Name of the Country Rank Diabetes in Millions
1 India 1 50.8
2 China 2 43.2
3 US 3 26.8
4 Russia 4 9.6
5 Brazil 5 7.5
6 Germany 6 7.5
7 Pakistan (third Country in Asia) 7 7.1
8 Japan 8 7.1
9 Indonesia 9 7.0

What is baffling is that a developing country like India where communicable diseases like TB, Aids, Diarrhaea etc are rampant. Non communicable diseases like diabetes which was the domain of developed countries, thanks to rapid development of IT sector which is leading to sedentary life styles. If we look at the data that is available within India, surprisingly South India which is well developed compared to North dominates in diabetes cases as explained the table below.

Prevalence of DM in six cities (Population)

Name of the State Percentage
Delhi 11.6
Mumbai 9.3
Calcutta 11.7
Hyderabad 16.6
Bangalore 12.4
Chennai 13.5

Hyderabad is watch out. Hyderabad which is fast emerging IT hub in the country adding the country’s diabetic table. One thing is common that these cities, thanks to the globalization, coupled with the traditional values, life styles are fast changing. Sedentary life styles consumption of junk food among the youth and large quantities of rice in other population could be the plausible reasons for the increase in incidence of diabetes in  South India.

Researchers are scratching their heads as to why Hyderabad which is alike the neighbouring south India cities like Chennai and Bangalore in many aspects is leading in diabetic cases. Some researchers opined that like more  consumption of rice in the city could be the possible reason. Some others said that it because of the sedentary life styles because of the IT sector. But this reasons are also applicable to Bangalore and Chennai where the life styles are similar to the residents of Hyderabad. In fact Bangalore which witnessed IT boom more than one and half decade accounts for just 12.4 per cent.

Another interesting research finding which goes in favour of increase in diabetes in Hyderabad and other parts of Andhra Pradesh is that 40 per cent of marriages in Andhra Pradesh are consanguineous , marriage among close relatives.. Girls getting married to “ mena bhava or mena mama” is common in Andhra Pradesh for variety of reasons. Many Telugu films in the past promoted this concept which is carried forward by political icons like Chandra babu naidu. The chances of Diabetes, which is a  hereditary disease like many diseases, transferring to the next generation are very high if the family has history of diabetes. However, there is imperative need for conducting research to co relate the above causes to diabetes as no evidence is available now.

The World Diabetic Congress cautioning India’s policy makers “ Evidence suggest that in more affluent parts of  the country, the rural prevalence is higher than in less affluent rural areas, indicating that increasing economic growth will raise diabetes prevalence in India even more than these possibly conservative estimates have indicated”.

Development issue

“Diabetes has become a development issue and it threatens the health and economic prosperity of people in low and middle-income countries”, the IDF report said. It also predicted that diabetes would cost the world economy at least $376 billion in 2010, or 11.6 per cent of the total world health care expenditure. “By 2030, this number is projected to exceed $490 billion. More than 80 per cent of spending on diabetes is in the world’s riches countries and not in the poorer countries, where over 70 per cent of people with diabetes now live,“ it said.  According to the report, India currently spends $2.8 billion or one per cent of the global total expenditure. Diabetes will impose a huge economic burden on India and other countries, the report noted. Apart form losing billions in lost productivity, India will also be spending $2.8 billion annually on diabetes control measures by 2010.There are estimated to be 285 million diabetes cases worldwide, accounting for seven per cent of the world’s population. Diabetes, along with cardiovascular disease, cancer and chronic respiratory diseases, accounts for 60 percent of all deaths worldwide.

“Diabetes imposes a large economic burden on the individual, national healthcare system and economy. Healthcare expenditure on diabetes are expected to account for 11.6 per cent of the total healthcare expenditure in the world in 2010”, the report said. “Estimated global healthcare expenditures to treat and prevent diabetes and its complications are expected to total at least $376 billion in 2010”, the report stated. Diabetes often goes undiagnosed in many people because they have only minor symptoms especially in the initial stages.

Undiagnosed diabetes accounts for 50 per cent

According to experts undiagnosed diabetes represents about 50 per cent of the cases in the population. Since diabetes primarily affects the blood vessels, these people develop problems in the retina, kidneys, heart, brain and nerves in the feet. How can we prevent this situation? This is where primary prevention of diabetes and early secondary prevention strategies play a very important role.

It is very necessary for people with a family history of diabetes and other risk factors like being over weight and high blood pressure and cholesteroal levels to have regular blood sugar checks with a glucose tolerance test to detect the early stages of the disease. This helps in primary prevention of which helps to delay the onset of diabetes for several years with regular exercise and diet control. For people in who diabetes has already been detected, it is necessary to have good control of their diabetes with regular exercise, medication and diet control and also by controlling the other co-morbid conditions like hypertension and cholesterol.

Regular check-ups

Therefore people who have a risk of developing diabetes should undergo regular blood sugar checks. They can have random blood sugar check at diabetes camps conducted by various organizations. This will bring to light many of the undetected diabetes cases. Each time such a camp is held, at least 10 per cent of people tested will be found to have diabetes for the first time. It is very important for such people to keep their diabetes under control right from day one since it is possible that they have had diabetes for many months without their knowledge. They must consult a physician and get advice about medication, diet, lifestyle and blood sugar checks.

The major Symptoms of Diabetes are Excessive thirst, Excessive hunger, Excessive urination, Weight loss, Fatigue

Here are some tips to diabetic and diabetic patients

  1. For people with diabetes, you need to exercise daily or at least five times a week
  2. You should exercise for 45 to 55 minutes at a time
  3. Since the muscles that use glucose appropriately are the long, thin muscles, you need to develop these muscles
  4. This requires exercise that is low-resistance and high-frequency, such as walking
  5. With a daily low-resistance, high-frequency exercise / activity program lasting 45 to 55 minutes, the control of blood glucose for those with diabetes  improves and stabilizes even before weight loss is achieved
  6. Exercise has no long-term effect on glucose. Within 24 to 48 hours of cessation, the beneficial effects on diabetes and its control are lost.
  7. Therefore exercise is a life-long commitment
  8. Diet Control
  9. Limit your food portions at each meal or snack
  10. Divide your food into 3 evenly spaced meals with a small healthy snack between meals if needed
  11. Don’t skip meals
  12. Eat high fiber foods such as fruits, vegetables, grains and beans
  13. Limit the amount of fat, sugar and salt you add to your food
  14. Avoid roots and tubers e.g. potato, sweet potato, but carrot and radish can be consumed
  15. Avoid sugar, glucose, jams, honey, sweets, nuts, Horlicks, Bournvita, etc.
  16. Avoid fried foods
  17. Include salads but no salad dressing with more fats
  18. Include plenty of green leafy vegetables
  19. Quantity of oil should be restricted
  20. Dietary exchanges should be taken into consideration
  21. Include food rich in fiber
  22. Avoid fruits such as mango, banana, chickoo, custard apple etc

Top ten benefits of being active

  • Improve Blood Glucose Management
  • Lower Blood Pressure
  • Improve Blood Fats
  • Take less insulin or Diabetes Pills
  • Lose weight and keep it off
  • Lower risk for other health problems
  • Gain more energy and sleep better
  • Relieve stress
  • Build stronger bones and muscles
  • Be more flexible