Rapid economic transition behind surge in diabetes cases, says study

New Delhi: The growing prevalence of obesity heightening the risk of type 2 diabetes in Indians, can be attributed to rapid economic transition, movement from rural to urban areas coupled with consequent changes in diet and physical activity patterns, a study published in Lancet revealed.

Major lifestyle changes associated with economic transition, industrialization, urbanization and globalization have been key determinants in the increasing burden of non-communicable diseases mainly diabetes. The paper, Epidemiology and determinants of type 2 diabetes in South Asia, focused specifically on Bangladesh, Bhutan, India, Nepal, Pakistan, and Sri Lanka indicating that in recent decades, type 2 diabetes, a condition in which, the body either doesn’t produce enough insulin, or it resists insulin, has rapidly developed into a major public health problem in South Asia.

“South Asia especially India is facing an unprecedented health challenge associated with rapid economic transition, a massive exodus from traditional rural to more urban settings, and consequent changes in diet and physical activity patterns. A heightened predisposition to non-communicable diseases is an unfortunate consequence of these changes, with increased prevalence of overweight and obesity leading to increased risk of type 2 diabetes,” said Anoop Misra, one of the authors of the study. According to the paper, coincident with the epidemiological transition in south Asia, there has been a massive increase in rural-to-urban migration and a 10 times increase in the prevalence of diabetes in urban India over the past 40 years. Also, by 2045 an estimated 134 million Indians will have type 2 diabetes, up from a 2017 estimate of about 72 million, the study said.

The paper also pointed out that examples of dietary change include the consumption of highly processed rice-based and wheat-based cereal diets in India, providing up to 60–70% of total energy, commonly with a high intake of sugar, with a high glycemic response (the effect that food or meal has on blood sugar levels after consumption). While a fondness for sugar and associated consumption of sweets is commonplace across South Asia, rice-based patterns in the south and wheat-based patterns in northwest in India are common.

“In last few decades, there has been a decline in nutrition quality, reduced physical activity, and increased sedentary behaviour are reflected in the increasing prevalence of type 2 diabetes and related risk factors in the region including India. Because of the presence of multiple risk factors and a body composition conducive to the development of type 2 diabetes South Asians should be aggressively targeted for prevention,” said Misra.

The International Diabetes Federation 2017 estimates the prevalence of diabetes in adults in the region range from 4.0% in Nepal to 8.8% in India. India represents 49% of the world’s diabetes burden, with an estimated 72 million cases in 2017. Diabetes prevalence has increased by 64% across India over the quarter-century, according to a November 2017 report the Indian Council for Medical Research, Institute for Health Metrics and Evaluation, both research institutes, and the Public Health Foundation of India, an advocacy.