Basics & Context
- Study Source: Lancet Global Health, based on Longitudinal Aging Study in India (LASI), 2017–2019.
- Sample Size: ~60,000 adults aged 45 years and above, nationally and state-level representative.
- Focus: Prevalence, awareness, treatment, and control of diabetes in India’s ageing population.
- Significance: First large-scale nationally representative survey linking self-reported and measured diabetes prevalence in older adults.
Relevance : GS 2(Health , Governance)
Key Findings – Prevalence
- Overall Prevalence: ~20% of adults aged ≥45 years had diabetes in 2019.
- Gender Parity: Men – 19.6%; Women – 20.1% (negligible difference).
- Urban–Rural Gap: Urban – 30% prevalence; Rural – 15% (2x higher in urban).
- Regional Variation:
- Highest rates (age-adjusted): Chandigarh (36.9%), Puducherry (36%), Kerala (36%).
- Highest absolute numbers: Tamil Nadu (6.1M), Maharashtra (5.8M), Uttar Pradesh (4.7M).
- Southern States: Higher prevalence; Central & NE States: Lower prevalence.
Awareness & Diagnosis
- Undiagnosed Burden: ~20 million Indians aged ≥45 years had undiagnosed diabetes.
- Unaware Patients: 40% of diabetics did not know they had the disease.
- Elderly (60+) Undiagnosed: ~8%.
- Awareness Rate: ~60% of diabetics knew of their condition.
Treatment & Control
- Treatment Coverage: Once aware, 94% received treatment – a high compliance rate.
- Control Rates (among those diagnosed):
- Glycaemic control: 46%
- Blood pressure control: 59%
- Lipid-lowering medication use: Only 6% (low, despite cardiovascular risk).
- Treatment Status:
- Untreated diabetes: 5% of ≥45 population.
- Under-treated diabetes: 47% of diagnosed cases.
- Adequately treated diabetes: 36%.
Public Health Implications
- Epidemiological Transition: Rising prevalence linked to economic development, urbanisation, sedentary lifestyles, dietary changes.
- Screening Gap: High undiagnosed proportion → Need for universal screening in primary healthcare.
- Awareness-to-Treatment Conversion: Strong (94%) → Campaigns can have significant impact.
- Control Gaps: Even with treatment, less than half achieve optimal blood sugar control; lipid management grossly neglected.
Policy & Programmatic Takeaways
- Scale-up Priorities:
- Universal diabetes screening for ≥40 age group.
- Strengthen NPCDCS (National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases & Stroke).
- Integrate diabetes detection into Ayushman Bharat Health & Wellness Centres.
- Regional Targeting: Focus on high-prevalence southern & UT regions with preventive interventions.
- Comorbidity Approach: Combine diabetes care with hypertension & dyslipidaemia management to reduce CVD risk.
- Health Education: Community-level lifestyle modification awareness – diet, exercise, weight control.
Strategic Outlook
- LASI Wave 2: Will follow up same cohort for better longitudinal insights into detection, treatment, and control trends.
- Global Context: India is part of the global surge in type-2 diabetes prevalence; WHO and IDF project further increases without intervention.
- Silver Lining: High treatment compliance post-awareness suggests that the key bottleneck is early detection, not willingness to seek care.
