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One in six people with diabetes in the world is from India. The numbers place the country among the top 10 countries for people with diabetes, coming in at number two with an estimated 77 million diabetics. China leads the list with over 116 million diabetics.

On International Diabetes Day, the International Diabetes Foundation Diabetes Atlas makes it clear India needs to pause and re-evaluate its strategy to combat diabetes.

The ninth edition of the IDF Diabetes Atlas offers projections that continue to put India at the second slot right up to 2045. And the numbers are staggering — just over 134 million Indians will be diabetics in the next 25 years.

India is on the top of the table of a clutch of countries in from southeast Asia — Bangladesh, Sri Lanka, Nepal and Mauritius. Bangladesh, which is second on the list of top five countries with diabetes (20-79 years), however, has only 8.4 million diabetics.

The IDF has stressed the urgency to develop and implement multi-sectoral strategies to combat the growing epidemic. “Diabetes, being a lifestyle disorder with multidimensional causative factors, definitely needs a multidimensional approach,” said A. Ramachandran, chairman, Dr.A. Ramachandran’s Diabetes Hospitals, Chennai, and member of the Diabetes Atlas Committee.

“Once diabetes is diagnosed, currently, there is only fragmented care especially because our health delivery system is modelled for acute care rather than for chronic care.”

Dr. Ramachandran highlights the very high cost of treating diabetes. “In the future the costs will soar, and we will not be able to afford them.”

The IDF estimates that 10% of global health expenditure is being spent on diabetes. The way ahead, all experts concurred, was a focus on prevention. India needs a more effective national diabetes prevention programme which will require cooperation from several quarters, including medical education, health awareness in schools, and urban planning, he explains.

V. Mohan from Dr. Mohan’s Diabetes Specialities Centre, also underlined that prevention was key to the problem. “In addition to people with diabetes, the country also has a huge burden of pre-diabetics. If we target them with information on the right lifestyle options to help keep blood sugar, lipids and blood pressure under control, we can prevent at least a third of people from developing diabetes.”

The country should also be ready to offer treatment options, at least basic care for all who are living with diabetes, and provide for the treatment of various complications, and that is likely to be a massive challenge in future, he adds.

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