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One in 5 older Indian adults had diabetes in 2019, says Lancet study: Should there be universal screening?
At least one in five people aged 45 and older had diabetes in India in 2019, according to a new paper published in 'The Lancet Global Health' journal. Significantly, two out of five people with diabetes (or 40 per cent of those diagnosed) were unaware of their condition.
However, 46 per cent of the people identified regained control of their blood sugar levels, 59 per cent achieved blood pressure control and six per cent took a lipid-lowering medication to reduce the risk of cardiovascular disease. 'Moving forward with the epidemiological transition and economic development, we anticipate that this trend will continue,' Dr T V Sekher, Professor at International Institute for Population Sciences, Mumbai, and one of the principal authors of the study, told The Indian Express. 'Only about half of these people are aware of their condition and even fewer achieve targets for glycaemic control, blood pressure control and use of lipid-lowering medications. Our findings emphasise the urgent need to scale up policies to better prevent, detect, manage and control diabetes among middle-aged and older adults in India,' he said.
The Lancet paper is based on the findings from the Longitudinal Aging Study in India (LASI) that surveyed nearly 60,000 adults in India aged 45 years and older between 2017 and 2019 to estimate the prevalence, awareness, treatment and control of diabetes. 'LASI is a nationally as well as state level representative survey and includes all health conditions of individuals. We were able to analyse them along with diabetes (like BMI, hypertension and so on). It has also analysed the difference between the self-reported and measured diabetes prevalence,' Dr Sekher said.
What are findings?
As per the findings, an estimated 20 million Indians have undiagnosed diabetes. Overall, eight per cent of the elderly (60-plus) subjects have been found to be undiagnosed. The prevalence of untreated diabetes among older adults (aged 45 and above) is five per cent and that of under-treated diabetes is 47 per cent. About 36 per cent are adequately treated.
The study also found that rates of diabetes were similar among men and women (19.6 per cent of men vs 20.1 per cent of women). Urban diabetes prevalence (30 per cent) was approximately twice as high as rural prevalence (15 per cent). 'Around 60 per cent of individuals are aware of their diabetes. So there is a need for better awareness campaigns and universal screening for diabetes. The silver lining is that among those who are aware about their diabetes, LASI found that 94 per cent are undergoing treatment. This is the most important finding. Once people are aware, then treatment coverage is good,' Dr Sekher explained.
What about state wise prevalence?
The study also provides updated evidence on the patterns of diabetes within India. States in southern India tend to have a higher rate of diabetes after adjusting for age, while others in central and northeastern India have a lower rate. The states with the highest age-adjusted diabetes rates among adults aged 45 and above were Chandigarh (36.9 per cent), Kerala (36.0 per cent) and Puducherry (36 per cent). The states with the largest number of adults having diabetes were Tamil Nadu (6.1 million people), Maharashtra (5.8 million people) and Uttar Pradesh (4.7 million people).
LASI used the blood samples for testing their HbA1c (an integrated measure of diabetes over the previous 90 days) in a laboratory (ICMR- NITVAR, Pune). This is a more accurate and appropriate method for testing diabetes compared to field-level testing of random glucose levels (most other large surveys used this method in India).
Anuradha Mascarenhas is a journalist with The Indian Express and is based in Pune. A senior editor, Anuradha writes on health, research developments in the field of science and environment and takes keen interest in covering women's issues. With a career spanning over 25 years, Anuradha has also led teams and often coordinated the edition.
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