Health Sector – UHC, National Health Policy, Family Planning, Health Insurance, etc.

How should India tackle diabetes load?

Note4Students

From UPSC perspective, the following things are important :

Mains level: Health Issues; Challenges faced by society due to NCDs;

Why in the News?

On International Diabetes Day (November 14), the Lancet shared a global study showing over 800 million adults have diabetes, and more than half aren’t receiving proper treatment.

What is the controversy over the numbers and the difference in Testing Methodology?

  • The Lancet study reported that diabetes was significantly higher in number than the Indian Council of Medical Research (ICMR) estimates (just over 100 million). This stark contrast raises questions about the accuracy and methodology used in both studies.
  • The primary reason for the discrepancy lies in the methodologies used to measure blood sugar levels:
    • The Lancet study utilized various methods including fasting glucose and HbA1C (a three-month glycated hemoglobin average) from data across 200 countries.
    • The ICMR study relied on fasting and two-hour post-prandial blood sugar tests using an Oral Glucose Tolerance Test (OGTT), which is considered the gold standard in India.
  • Experts argue that using HbA1C can lead to inflated numbers due to its sensitivity to factors like age and anemia.
    • For instance, a person without diabetes might still show elevated HbA1C levels based on their physiological characteristics, which can skew prevalence estimates.

What are the issues raised in the Lancet study?

  • Global Inequalities in Treatment: The study highlighted significant disparities in diabetes treatment access, particularly in low- and middle-income countries where treatment rates are stagnating despite rising diabetes cases. This raises concerns about long-term health complications for untreated individuals.
  • Rising Rates of Diabetes: The findings underscore that diabetes rates have increased dramatically, especially Type 2 diabetes, which poses a growing public health challenge. This trend is alarming given that many affected individuals are younger and at risk for severe complications.
  • Complications and Healthcare Burden: With a large number of individuals requiring treatment, there is a looming healthcare crisis regarding complications such as kidney failure, heart disease, and vision loss, which could overwhelm healthcare systems.

What steps need to be taken? (Way forward)

  • Enhanced Awareness and Education: There is a pressing need for widespread education on diabetes prevention through nutrition and physical activity. Public health campaigns should focus on promoting healthy lifestyles to mitigate risk factors associated with diabetes.
  • Policy Changes: Governments must implement policies that restrict unhealthy food options while making healthy foods more affordable. This includes subsidies for nutritious foods and initiatives to create safe spaces for physical activity.
  • Targeted Interventions for Vulnerable Populations: Special attention should be directed towards vulnerable groups, particularly women who may be at higher risk post-pregnancy or during menopause. Tailored interventions can help address specific risk factors prevalent in these populations.
  • Investment in Healthcare Infrastructure: To effectively manage the rising burden of diabetes, there must be significant investment in healthcare infrastructure, especially in low- and middle-income countries where resources are limited.
  • Long-Term Strategic Planning: A comprehensive long-term strategy is essential to combat the growing diabetes epidemic, requiring collaboration between governments, healthcare providers, and communities to ensure sustainable health outcomes.

Mains PYQ:

Q Appropriate local community-level healthcare intervention is a prerequisite to achieve ‘Health for All’ in India. Explain. (UPSC IAS/2018)

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