Healthy Life Styles is the Key to Check Diabetes
November 14th, birthday of Frederick
Banting, who, along with Charles Best, discovered insulin, is celebrated as
World Diabetes Day. National Diabetes Month, observed each year in November, is
a time for communities across the country – and the world – to renew and
reinforce their fight against diabetes and encourage action to change the life
style to reduce its impact.
As diabetes is a chronic disease and
needs lifelong treatment, it becomes an economic burden on patients and family.
The most important aspect of diabetes is occurrence of complications that
increases the cost of management. Heart disease in diabetes is 21.4%,
neuropathy 17.5%, peripheral vascular disease leading to ulcers 6.3%-30%,
Retinopathy (eye) 19.0%, and Micro albumina (kidney) 26.3%.
Diabetes is part of a larger global
epidemic of non- communicable diseases. This disease affects 6.6% (285 million
people) of the world's population in the 20-79 years age group. According
to the International Diabetic Federation (IDF), this number is expected to grow
to 380 million by 2025. The IDF findings reveal that in 2007, countries
with the largest numbers of people with diabetes are India (40.9 million),
followed by China (39.8 million), the United States (19.2 million), Russia (9.6
million) and Germany (7.4 million).
India is home to 40.9 million people
with diabetes – nearly 15% of the global diabetes burden and is projected
to increase to 70 million by 2025. Impaired Glucose
Tolerance (IGT) is also a serious problem in India. Type-2 diabetes is more
common and results from a genetic predisposition and from lifestyle factors
characterised by a high calorie intake and little exercise. The age of onset in
India has been shifting towards younger people. Among Indians in their late
teens, ‘adult-onset’ diabetes already manifests itself more often than
‘juvenile onset’ diabetes does. The reasons are the same as those behind the
diabetes epidemic worldwide. One set of factors is urbanisation, a rise in
living standards and the spread of calorie-rich, fatty, fast foods cheaply
available in cities to rich and poor alike. Another is the increased
sedentariness that has resulted from the replacement of manual labour by
service jobs and from the advent of video games, television and computers that
keep people seated lethargically watching screens for hours every day.
Although poor Indians are currently at
lower risk than affluent Indians, the rapid spread of fast food exposes even
urban Indian slum dwellers to the risk of diabetes. In India, diabetes is no
longer a disease of the affluent or a rich man's disease. It is becoming a
problem even among the middle income and poorer sections of the society.
Excessive insulin resistance has been observed in Asian Indians as a
predominant mechanism leading to Type 2 diabetes.
This alarming scenario led the Government to start the National Diabetes
Control Programme on pilot basis during the seventh five year plan in 1987 in
some districts of Tamil Nadu, Jammu & Kashmir and Karnataka, but due to
paucity of Funds in subsequent years this programme could not be expanded
further in remaining states. However to contain the increasing burden of
Non-Communicable Diseases, Ministry of Health and Family Welfare, launched the
National Programme on Prevention and Control of Diabetes, Cardiovascular
diseases and Stroke (NPDCS) on 8th January 2008. The Government of India
launched the National Programme for Prevention and Control of Cancer, Diabetes,
Cardiovascular Diseases and Stroke (NPCDCS) in 2010 by merging the National
Cancer Control Programme and the National Programme for Prevention and Control
of Diabetes, Cardiovascular Diseases and Stroke. The programme is under
implementation in 100 districts and will be expanded to cover all districts of
the country in a phased manner during 12th Five Year Plan. The
integration of services at district level and beyond, equitable with universal
coverage under the umbrella of National Health Mission is envisaged under the
programme.
In the 12th five year
plan, NPCDCs is being implemented in the 35 States/UTs from 2013-14. NPCDCs has
now been brought under the umbrella of NHM in PIP mode. Interventions upto
District level and below have been integrated under the Mission and Funds provided
through NCD Flexi pool. While State NCD Cells are functional in 21 states,
District NCD Cells are functional in 96 districts. An average of 6.15%
was found suspected to be Diabetic (above 140mg/dl, random) and an average of
5.12% was found to be either pre hypertensive or hypertensive. 29000
Glucometers, 5.8 crore Glucostrips and 6.67 Lancets have been supplied to 21
States for Diabetes screening under NPCDCS, Urban Health Check-up (four cities)
and Pilot Phase of School Health Programme (four Districts).As on 31st March
2014 5,5,39,571 persons have been screened for Diabetes and Hypertension under
various health facilities, schools, urban slums and work places..
The commitment to strengthen health system stewardship for improved monitoring
of NCDs, related risk factors and comorbidities in India was reiterated during
GoI-WHO ‘Call for Action on NCD’s at New Delhi in 2011.The development of the
National NCD Monitoring Framework and targets was based on consultative process
with the relevant stakeholders.
With the successful implementation of
the programme, it is expected to achieve behaviour change in the community to
adopt healthy life styles including dietary patterns, enhanced physical
activity and reduced intake of tobacco and alcohol resulting in overall
reduction in the risk factors of common NCDs in the community.
To conclude, considering the
ever-increasing burden of diabetes, health system has to be strengthened with
standard care at all levels. The Government has taken certain initiatives at
national level which is appreciable but there is a need to implement them at
grass route level in focussed manner before it takes the shape of pandemic in
India. Awareness about the causes and easy way of preventions are the key to
success.
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