Diabetes Surge in Older Indian Adults

Context

Diabetes has emerged as a major health challenge in India, especially among older adults. A notable study published in The Lancet Global Health found that in 2019, one in five Indian adults aged 45 and above were living with diabetes. This prevalence highlights the urgent need to rethink preventive strategies, including the adoption of universal screening methods.

Diabetes Among Older Indians Adult

• Prevalence rate: About 19.8% of adults aged 45 years and older (approx. 50.4 million people) had diabetes in 2019.
• Urban vs. Rural Divide: Urban prevalence (around 30%) is nearly double that of rural areas (15%).
• State-wise Variation: Southern states such as Kerala and regions like Chandigarh reported prevalence rates over 36%.
• Gender Parity: The difference between men (19.6%) and women (20.1%) was negligible.
• Obesity Link: Diabetes was more common among overweight (24.7%) and obese (34.6%) individuals.
• Awareness Gap: Alarmingly, 40% of people with diabetes were unaware of their condition, and only 46% of those aware achieved glycemic control.
• Untreated or Under-treated: Around 5% had untreated diabetes and 47% were under-treated, with only 36% adequately treated.

Why Is Screening Important?

• Early Detection: Many older adults remain undiagnosed, missing crucial windows for effective management and preventing complications.
• High-Risk Demographics: India’s ageing population, increasing urbanisation, and genetic predisposition make it a high-risk group for diabetes.
• Cost and Burden: Undiagnosed diabetes leads to increased healthcare costs due to late-stage complications like cardiovascular disease, kidney failure, and vision loss.
• Treatment Outcomes: Universal screening could facilitate timely intervention, improve glycemic and blood pressure control, and reduce long-term morbidity.
• Global Targets: WHO recommends that at least 80% of people with diabetes be diagnosed and achieve glycemic and blood pressure control, which can only be achieved through widespread screening.

Challenges to Universal Screening

• Resource Allocation: Implementing nationwide universal screening, especially in rural and remote areas, requires substantial financial and logistical investment.
• Public Awareness: Low awareness about diabetes means some individuals may not participate in screening programmes.
• Follow-Up and Management: Screening alone isn’t enough—adequate follow-up, counseling, and subsidised medication are equally vital.

Expert Recommendations and Global Guidelines

• Indian experts and national guidelines increasingly recommend universal screening for diabetes among older adults, mirroring global best practices.
• Universal screening is especially advocated for other high-risk groups, e.g., gestational diabetes in pregnant women, with proven improved maternal and neonatal outcomes.
• The ideal approach is an integrated system combining screening, diagnosis, lifestyle counseling, and medical management.

Conclusion

With one in five older Indian adults living with diabetes and a significant proportion unaware or inadequately treated, universal screening should be strongly considered. State-led and national initiatives, paired with robust follow-up care and public awareness campaigns, are crucial to curb the rising tide of diabetes among India’s ageing population. Such measures could transform the health map of India, reducing long-term complications and healthcare costs, and improving the quality of life for millions.

Source: The Indian Express

UPSC Prelims Practice Question

Q. Consider the following statements regarding the surge of diabetes among older adults in India:

1. According to recent studies, nearly one in five Indian adults aged 45 years and above had diabetes in 2019.
2. The prevalence of diabetes in urban areas is significantly higher than in rural areas among older Indian adults.
3. Universal screening for diabetes among older adults is currently recommended by the Indian Council of Medical Research (ICMR).

Which of the above statements is/are correct?

A) 1 and 2 only
B) 2 and 3 only
C) 1 and 3 only
D) 1, 2 and 3

Answer: A)

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