Non-communicable diseases (NCDs) such as heart diseases, stroke and diabetes have increased in every state in India over the past 25 years and now cause more disease and death than infections, maternal and new-born deaths during delivery, and malnutrition put together, according to the first comprehensive analysis of disease trends in India published in The Lancet in September. Unhealthy lifestyles, which include being overweight, bad diets and sedentary behaviour, are the leading causes of these chronic diseases that strike Indians at least two decades before they do Caucasians, in the process, increasing their dependence on medicines and bringing down quality of life over their last three to four decades.

The number of people with diabetes in India has gone up from 26 million in 1990 to 65 million in 2016, with the prevalence of diabetes in adults aged 20 years or older rising from 5*5% to 7*7% in the same period. The jump in the rate of healthy years lost to diabetes since 1990 is the highest among major NCDs in India. The age-standardised disability-adjusted life years (DALY) rate, which is a measure of overall disease burden expressed in the number of years lost to bad health, disability or early death, for diabetes increased by 39*6% from 1990 to 2016. Both diabetes prevalence and DALYs increased in every state, with the prevalence being highest in Tamil Nadu, Kerala and Delhi, followed by Punjab, Goa and Karnataka. The relative rate of increase was highest in several less developed states, where the co-existence of diabetes with malnutrition and infectious diseases such as diarrhoea, lower respiratory tract infections and tuberculosis is leading to a double burden of disease.

Being overweight is the biggest risk factor. For every 100 overweight adults in India, there were 38 adults with diabetes, compared with the global average of 19 for every 100 in 2016. With the number of overweight people aged 20 and above more than doubling over the past 25 years, from 9% in 1990 to 20*4% in 2016, diabetes prevalence will shoot up dramatically in every state unless policy support to promote prevention and early management is given the priority usually reserved for communicable and childhood diseases. Improving surveillance systems to monitor changing trends across states for quick policy interventions and using innovations to strengthen primary health centres and training general physicians for early diagnosis will improve disease management to lower diabetes-related complications, such as blindness and neuropathies. Multi-sectoral collaborations, such as policies to reduce dietary fat, sugar and salt, to controlling overlapping NCDs and risk factors such as high sugar, hypertension, being overweight and high cholesterol, will collectively lower the risks for diabetes, heart disease, stroke, and certain cancers.

First Published: Nov 13, 2018 17:57 IST