India has 74.2 million people with diabetes between the age of 20–79 years, according to the International Diabetes Federation (IDF) Atlas, 2021.

Key points of the report:

• Diabetes is one of the fastest growing global health emergencies of the 21st century. 

• In 2021, it is estimated that 537 million people have diabetes, and this number is projected to reach 643 million by 2030, and 783 million by 2045. 

• In addition, 541 million people are estimated to have impaired glucose tolerance in 2021.

• The countries with the largest numbers of adults with diabetes aged 20–79 years in 2021 are China, India and Pakistan.

• By country, India now has the highest estimated number of prevalent Type 1 diabetes cases in people under 20 years of age (229,400), followed by the USA (157,900) and Brazil 92,300.

• India accounts for one in 7 of all adults living with diabetes worldwide.

• Partly due to its large population, China has the highest annual number of deaths from diabetes, at approximately 1.4 million. 

• Due to its large population and high prevalence of diabetes, the US has the second highest number of deaths with 0.7 million. The next highest is India (0.6 million), followed by Pakistan (0.4 million) and Japan (0.2 million).

• The number of children and adolescents (up to 19 years old) living with diabetes increases annually. In 2021, over 1.2 million children and adolescents had Type 1 diabetes. 

• Direct health expenditures due to diabetes are already close to $1 trillion and will exceed this figure by 2030.

• Hyperglycaemia in pregnancy (HIP) affects approximately one in six pregnancies. 

• Another cause for alarm is the consistently high percentage (45 per cent) of people with undiagnosed diabetes, which is overwhelmingly Type 2. 

• This highlights the urgent need to improve the ability to diagnose people with diabetes, many of whom are unaware they have diabetes, and provide appropriate and timely care for all people with diabetes as early as possible.

Some facts on diabetes:

• Diabetes is a chronic disease, which occurs when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces. This leads to an increased concentration of glucose in the blood (hyperglycaemia).

• Type 1 diabetes (earlier known as insulin-dependent or childhood-onset diabetes) is characterised by a lack of insulin production. Type 1 diabetes is a chronic condition in which the pancreas produces little or no insulin by itself. 

• Type 2 diabetes (earlier known as non-insulin-dependent or adult-onset diabetes) is caused by the body's ineffective use of insulin. It often results from excess body weight and physical inactivity. Type 2 diabetes occurs when the body becomes resistant to insulin or doesn't make enough insulin.

• Gestational diabetes is hyperglycaemia that is first recognised during pregnancy. It can lead to serious health risks for both the mother and child.

• The rising prevalence of diabetes and other noncommunicable diseases is driven by a combination of factors — rapid urbanisation, sedentary lifestyles, unhealthy diets, tobacco use, and increasing life expectancy.

• Obesity and overweight are the most important risk factors responsible for diabetes. Much of the diabetes burden can be prevented or delayed by behavioural changes favouring a healthy diet and regular physical activity.

Steps taken by Indian govt to support diabetes patients

• The Department of Health & Family Welfare provides technical and financial support to states/UTs under the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), as part of National Health Mission (NHM). 

• The programme focusses on strengthening infrastructure, human resource development, health promotion & awareness generation for prevention of Non-Communicable Diseases (NCDs), early diagnosis, management and referral to an appropriate level of health care facility for treatment.

• A population-based initiative for prevention, control and screening for common NCDs has been rolled out in the country under NHM and also as a part of Comprehensive Primary Health Care. Under the initiative, persons more than 30 years of age are targeted for their screening. Screening of these common NCDs including diabetes is an integral part of service delivery under Ayushman Bharat – Health and Wellness Centres.

• Under the Free Drugs Service Initiative of NHM, financial support is provided to states/UTs for provision of free essential medicines including insulin for poor and needy people.

• Quality generic medicines, including insulin, are made available at affordable prices to all, under ‘Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP), in collaboration with state governments.

• The Department of Biotechnology under its ‘Chronic Disease Programme’ supports research in focused high disease burden areas including diabetes. 

• Diabetes and metabolic syndrome has remained the major thrust area and a number of projects have been supported to gain deeper insights into the molecular mechanisms, addressing associated morbidities and finding novel drug targets for Type 2 diabetes and diabetes related complications.

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