India has screened close to 20 lakh people for diabetes, hypertension and oral, breast and cervical cancers in the current financial year under the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS). These diseases account for 55% of premature deaths in India.
One in two adults with diabetes worldwide is undiagnosed and untreated because he/she stays asymptomatic till complications set in.
“Of the 129 lakh people screened at district hospitals and community health centres for NCDs last year, 10.68 lakh had undiagnosed diabetes and 14.93 lakh had undiagnosed high blood pressure,” said Dr Damodar Bachani, deputy commissioner, NCD, ministry of health and family welfare.
Undiagnosed disease was also high among the general public in villages (see box), where the screening is done by ASHAs (accredited social health activists) and ANMs (auxiliary nurse midwife) using hand-held testing machines and equipment that can be easily carried to camps or door-to-door.
“Targeted screening, diagnosis and management, along with lifestyles advice on nutrition, enhanced physical activity and reducing tobacco and alcohol will help India meet its target of reducing premature death from NCDs by one-third,” says Dr Bachani.
South Asians, including Indians, are at a higher risk of type 2 diabetes compared with Caucasians, and typically develop the disease up to a decade earlier and at a lower weight.
“South Asians are more insulin resistant and experience β-cell (cells in the pancreas that produce, store and release insulin) degeneration at a younger age because of several factors, including higher body fat; deep subcutaneous and visceral fat (adiposity) and lower lean mass,” says Dr Anoop Misra, chairman, Fortis Centre for Diabetes, Obesity and Cholesterol, New Delhi.
There is no clear evidence to show genetic factors raises risk of diabetes in south Asians, but epigenetic factors – environmental influences on gene expression --- may have a role, reported researchers in The Lancet. The study recommended south Asians should lower weight and be highly active to prevent diabetes.
Smokers are 30–40% more likely to develop type-2 diabetes than non-smokers. Smoking more than 25 cigarettes doubles the risk.
Only 31.1% of people with diabetes in urban areas and 30.8% in rural areas have well-controlled diabetes, reported researchers in the journal, Diabetes Technology and Therapeutics.
A new study of more than 1,100 patients across 10 centres – nine in India and one in Pakistan – over five years and published in Annals of Internal Medicine this year showed low-cost software in the hands of a non-physician worker optimises treatment and lowers complications in diabetes patients by doubling blood glucose-control and lowering blood pressure and ‘bad’ LDL cholesterol without added cost.
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