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MUMBAI: While it is well known that India is the diabetes capital of the world, there seems to be poor awareness across the country about the need to control fluctuating blood sugar levels. The all India levels of HbA1c, a blood test to determine the average blood sugar control levels over a period of three months, stood at 8.5% in May 2019—around 3 % higher than normal sugar levels, a new national survey has revealed.

The picture gets more dismal at the city level—right from Mumbai to Kolkata and from Delhi to Chennai. Mumbai, the financial capital where people complain of high levels of stress and exhibit poor sleep patterns, has an average reading of 8.2% while the national capital of Delhi was worse at 8.8%. The survey, part of an ongoing year-long study by Novo Nordisk Education Foundation, looked at the readings of 1.8 lakh patients across 28 cities. Diabetes, which is a condition in which the body’s ability to process blood glucose is impaired, affects its metabolism and over the years affects major organs such as kidneys, eyes, the nervous system, among others.

The study also looked at how HbA1c levels changed over a year in 28 cities. Bengaluru has seen a rise in HbA1c levels from 8.3% in June 2018 to 8.4% in May 2019. During the same period, though, Chennai (8.4% to 8.2%) and Kolkata (8.4% to 8.1%) registered a fall. In Gurgaon, too, the levels fell from 8.6% to 8.5%. Smaller cities such as Khandwa showed 9% in June 2018 but fell to 8.2% in May 2019.

In Hyderabad, the levels have been more or less static (8.59% and 8.6%). “The number of patients with diabetes in India is now increasing in the low socio-economic strata. They are not well aware of the significance of the condition and how to control it. The result is a high average sugar levels and complications at an early age,’’ said Dr Anoop Misra. The survey is a part of pharmaceutical company Novo Nordisk India’s recent India Diabetes Care Index report that maps diabetes and care in the country. “The cost of diabetes care in India alone was estimated to be Rs 63,000 crore in 2017 with 72.9 million people in India being impacted by diabetes and 80% not getting recommended treatment,” said the report.

Dr Ambrish Mithal, who heads endocrinology at Medanta, the Medicity in Gurgaon, said the diabetes epidemic is still growing in India. “Till a few years back, diabetes is something that happened to people who were above 40, but now we increasingly see it in 20 year olds,” said the doctor. He said almost 60% of the patients undergoing bypass surgery in his hospital had diabetes as a underlying cause.

“In many metro cities, almost 40% of those over the age of 60 have diabetes. This is alarming,” he said. Endocrinologist Dr Shashank Joshi from Lilavati Hospital in Mumbai said, “The level of 7% is the magic number that endocrinologists seek for their diabetic patients. But it can be relaxed in certain cases. In older people, doctors would be satisfied with a score of 7.5% while 6.5% is satisfactory for pregnant women and youngsters.”

The key is to ke-ep sugar in check and work towards a lower count, he added. The India Diabetes Care Index report also said that uncontrolled diabetes causes more than three crore cases of diabetes-related complications of the heart, eye, kidney, nerve and limb. The company has started Impact India, a 1,000-day challenge to reduce India’s average HbA1c level by 1% by 2021. “Prevention should be the focus, but we have that in patients taking medicines, the burden on one’s own health, families, workplace is lower,” said Dr Mithal.

