World Diabetes Day: Undiagnosed diabetes remains a Significant threat

India has screened close to 20 lakh individuals for diabetes, obesity, hypertension and oral, cervical and breast cancers in the current fiscal 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.

Till complications set in, since he/she stays asymptomatic one in two adults with diabetes worldwide is treatable and curable.

“Of the 129 lakh individuals screened at district hospitals and community health centers for NCDs last year, 10.68 lakh had undiagnosed diabetes along with 14.93 lakh had undiagnosed high blood pressure,” explained Dr Damodar Bachani, deputy commissioner, NCD, ministry of health and family welfare.

Undiagnosed disease was too high among the general public in villages (see box), in which the screening is carried out by ASHAs (accredited societal 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 guidance on nutrition, enhanced physical activity and reducing alcohol and tobacco can help India meet its target of reducing premature death in NCDs by one-third,” says Dr Bachani.

South Asians, such as Indians, typically develop, and are at a higher risk of type 2 diabetes in comparison to Caucasians the disease up to a decade before 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 many factors, such as high body fat; profound subcutaneous and visceral fat (adiposity) and reduced lean mass,” says Dr Anoop Misra, chairman, Fortis Centre for Diabetes, Obesity and Cholesterol, New Delhi.

There is no clear evidence to reveal genetic factors increases risk of diabetes in south Asians, but epigenetic factors — environmental influences on gene expression — might have a function, reported researchers at The Lancet. The analysis recommended south Asians be highly active to prevent diabetes and should lower weight.

Smokers are 30–40 percent more likely to develop type-2 diabetes than non-smokers. Smoking the threat is doubled by greater than 25 cigarettes.

A new study of over 1,100 patients over 10 centers — nine in India and one in Pakistan — more than five decades and published in Annals of Internal Medicine this season demonstrated low-cost software in the hands of a non-physician worker optimises treatment and reduces complications from diabetes patients by decreasing blood glucose-control and lowering blood pressure and ‘bad’ LDL cholesterol without added cost.

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