The burden of prediabetes in India

National Urban Diabetes Survey indicated that 14% of the Indian population is prediabetic. Out of the global population of pre-diabetic patients, which stands at 88 million, a staggering 77 million reside in India. Let us have a look at the big picture…

Last Updated on July 17, 2023 by Shabnam Sengupta

Prediabetes refers to a condition where blood glucose levels are higher than normal but not yet at the level of type 2 diabetes. It serves as a warning sign, indicating an increased risk of developing full-blown diabetes in the future. Depending on specific diagnostic criteria, prediabetes is also known as impaired glucose tolerance (IGT) or impaired fasting glucose (IFG).

In prediabetes, the body’s ability to regulate blood sugar levels becomes impaired. This occurs when the body either fails to effectively utilise insulin or doesn’t produce enough insulin to maintain normal blood glucose levels. Insulin, a hormone produced by the pancreas, facilitates the transport of glucose from the bloodstream into cells for energy.

Prediabetes condition is largely asymptomatic as it often lacks noticeable symptoms. It is commonly diagnosed through routine blood tests that measure fasting blood glucose levels or glucose levels after consuming a specific amount of glucose during an oral glucose tolerance test.

If left untreated, prediabetes can progress to type 2 diabetes over time. Additionally, individuals with prediabetes face a higher risk of developing other health complications, such as cardiovascular disease.

Current state of prediabetes in India

A survey conducted by the National Institutes of Health highlighted an increase in prediabetes cases in urban regions of India from 3.3% (1972) to 19.0% (2015-2019). A similar rise has been noticed in the rural stats from 2.4% to 15%, respectively. The scenario of prediabetes in India was concerning due to several factors:

High Prevalence: India has been experiencing a rising prevalence of prediabetes. It is largely attributed to sedentary lifestyles, unhealthy diets, and a genetic predisposition towards insulin resistance. The combination of these factors, along with a large population, contributes to a significant number of individuals at risk.

Lifestyle Factors: Rapid urbanisation and changes in lifestyle have led to decreased physical activity levels and increased consumption of processed foods, high in unhealthy fats and sugars. These factors contribute to weight gain and the development of insulin resistance, a key underlying mechanism of prediabetes.

Lack of Awareness: Many individuals with prediabetes are unaware of their condition, as symptoms may not be apparent. This lack of awareness results in delayed diagnosis and intervention, allowing the condition to progress to full-blown diabetes.

Limited Healthcare Resources: India’s healthcare system faces challenges in terms of accessibility, affordability, and quality of care, particularly in rural areas. Limited resources, including healthcare infrastructure, personnel, and diagnostic facilities, can impede early detection and management of prediabetes.

What do experts have to say about prediabetes in India?

Dr Anoop

As per Dr Anoop Misra, Chairman, Fortis-CDOC, the rise of prediabetes in rural rather than urban areas is a worrying trend. “A good aspect is that we could get patients’ glucose levels to normal with the correct diet and exercise. To achieve this, sometimes medicines are used,” Dr Misra said.

Dr Rajiv Kovil, Diabetologist, Chairperson at Zandra Healthcare, Co-founder of Rang De Neela initiative, and Secretary at United Diabetes Forum, said, “The conversion from prediabetes to diabetes over a 10-year period is 58.9%, which is one of the highest globally. Hence, primordial prevention is essential in India to prevent the further rise of these Non-communicable diseases (NCDs).”

Dr Rajiv Kovil

He further added, “According to the National Urban Diabetes Survey, the estimated prevalence of prediabetes is 14% in India. Diabetes prevalence is close to 8-9%, which converts to 1/4th of our population with some form of dysglycemia. Asian Indians have one of the highest incidence rates of diabetes with rapid conversion from normoglycemia to dysglycemia. To slow down the diabetes epidemic in this population, public health interventions should focus on addressing risk factors that can be changed.” 

Lifestyle modifications to avoid or delay prediabetes

It’s important to note that not everyone with prediabetes will progress to type 2 diabetes. By adopting a healthy lifestyle, many individuals with prediabetes can successfully prevent or delay the onset of diabetes. They can also improve their overall health. This includes:

Healthy Diet: Adopting a balanced diet with the consumption of certain foods. These include foods high in fibre, whole grains, fruits, vegetables, lean proteins, and healthy fats. The consumption of these foods is important while limiting the intake of refined sugars, saturated fats, and processed foods.

Regular Physical Activity: Engaging in regular exercise, such as brisk walking, swimming, or cycling. Individuals should engage in these activities for at least 150 minutes per week or as recommended by a healthcare professional.

Weight Management: Achieving and maintaining a healthy body weight by losing excess weight if overweight or obese. Even a modest weight loss of around 5-10% of body weight can significantly reduce the risk of developing diabetes.

Avoiding Tobacco and Excessive Alcohol: Limiting or avoiding tobacco use and excessive alcohol consumption. These factors can increase the risk of developing diabetes and other health problems.

Regular Check-ups: Undergoing regular medical check-ups to monitor blood glucose levels and overall health status, as well as to discuss any concerns or questions with a healthcare professional.

Addressing the scenario of prediabetes in India requires a comprehensive approach involving public health awareness campaigns, promoting healthy lifestyles, improving access to quality healthcare, and implementing preventive measures at both the individual and population levels.

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