62.4 million lives with diabetes in India, 77.2 million people with pre-diabetes

New figures for diabetes prevalence in India indicate that the epidemic is progressing rapidly across the nation, reaching a total of 62.4 million persons with diabetes in 2011.

Phase one results of the Indian Council of Medical Research – India Diabetes (ICMR-INDIAB) Study have provided data from three States and one Union Territory, representing nearly 18.1 per cent of the nation's population.

When extrapolated from these four units, the conclusion is 62.4 million people live with diabetes in India, and 77.2 million people are on the threshold, with pre-diabetes.

These results have been published in an article authored by R.M. Anjana et al, published in the current issue of Diabetologia.

“This is the first truly national diabetes study done in India in the last 40 years after the last ICMR Study in the early 1970s,” explained V. Mohan, who heads Madras Diabetes Research Foundation, the national co-ordinator for the study.

‘Authentic new data'

The first phase of the ICMR-INDIAB study covered Tamil Nadu, Maharashtra, Jharkhand and Chandigarh, with a sample size of 16,000 persons.

“The results are amazing and provide evidence for increase in prevalence of diabetes not only in urban areas but also in rural areas. The study also provides authentic new data on the total number of people with diabetes in India,” Dr. Mohan added.

The study began in late 2008 and was completed by 2010. It factored in anthropometric parameters like body weight, BMI (body mass index), height and waist circumference, and also tested fasting blood sugar, followed by blood sugar after a glucose load (known diabetics exempted), and cholesterol for all participants.

Questions were also asked about food habits, physical activity, and smoking, alcohol usage, among others.

The prevalence of diabetes in Tamil Nadu was 10.4 per cent, in Maharashtra it was 8.4 per cent, in Jharkhand, 5.3 per cent, and in terms of percentage, highest in Chandigarh at 13.6.

The prevalence of pre-diabetes (impaired fasting glucose and/or impaired glucose tolerance) was 8.3 per cent, 12.8 per cent, 8.1 per cent, and 14.6 per cent, respectively.

Projections to be revised

Projections made in the past about the total number of diabetics in the country for the future may need to be revised. For instance, in May 2004, in Diabetes Care, volume 27, Sarah Wild et al proposed that India would have 79.4 million people with diabetes in 2030.

Nineteen years ahead of that deadline, India has 62.4 million, and a further 77.2 million (potential diabetics) in the pre-diabetes stage.

“According to the Diabetes Atlas of 2009, there were 50.8 million people with diabetes in India. In just two years, this figure has gone up by 12 million. Obviously, diabetes in India is progressing exponentially. Also, we see that it has shifted to the 25-34 years age group,” Dr. Mohan explained.

“The epidemic is likely to stabilise in the population at about 20-25 per cent or so. The numbers of pre-diabetics will drop. We also expect that by then, the epidemic will shift to the economically disadvantaged groups, going by the experience of nations in the West,” Dr. Mohan added. Also, he explained that there was a huge window of opportunity for prevention, considering the number of modifiable risk factors among the pre-diabetes group.

The three-phased study, when concluded, hopes to have done similar analyses for all the States and union territories in India.