Mumbai: Uma Suresh, 56, has been suffering from diabetes for more than 15 years. Despite a close watch, she has begun showing signs of complications: blurry vision, shaky nerves and being prone to falls.
“The wounds take a long time to heal,” she says, fearful of losing a limb as her elder brother, who lost a leg, did. He died a few years ago.
With an estimated 40 million diabetics in India and 36 million people showing pre-diabetic conditions, complications from the disease loom large—and costs are escalating.
Many doctors say the anecdotal growth of diabetes-related complications shows that India has not been able to control the disease, despite increased awareness. And with certain complications, such as kidney failure, medical experts fear that existing infrastructure in India will not be able to handle the surge in patients.
A 2005 study by the Novo Nordisk Education Foundation, a non-profit set up by the pharmaceutical company, gauging the economic burden of diabetes in India, found that of the 44% diabetics who have been hospitalized, nearly three-quarters were admitted due to complications from diabetes. The study estimates that such complications account for 60% of diabetes-related health care costs and almost 80-90% of indirect costs, such as loss of personal and family income.
Anecdotally, doctors support the findings. Vijay Vishwanathan of the M.V. Hospital for Diabetes in Chennai says he is seeing an increase in patients losing limbs, eyes, kidneys, and ultimately, their lives to diabetes.
Doctors also say that complications in India are higher than those in the West because patients are only seeking care after the disease has progressed significantly. Diabetes is a chronic condition for which medication has to be taken every day and blood sugar levels monitored.
About one-third of diabetics who seek medical attention already have some complication. With the number of diabetics estimated to grow to 57 million by 2025, the incidence of complications could hit almost 20 million.
“Already, the number of amputations due to diabetes is three times higher in India than in the West. That is unacceptably high,” says Shashank Joshi, a diabetes specialist with Lilavati Hospital and Research Centre in Mumbai.
Every year, some 40,000 legs are amputated in India, of which almost 80% are due to complications of diabetes. The National Kidney Foundation (India) estimates that about 20-30% of diabetics will develop problems that could eventually need dialysis or a kidney transplant. With only about 400 dialysis units across India, the country is ill-equipped to handle the situation.
Diabetes is also the second most common cause of blindness in India, surpassed only by cataracts.
A few months ago, Eli Lilly and Co. (India) Pvt. Ltd launched a camp to check for complications across the country with an aim to minimize long-term complications. Of 17,000 patients screened, “we found that approximately 41% of them have complications,” says Vinod Matoo, medical director of Eli Lilly.