No longer a lifestyle disease, diabetes strikes small towns too

The Government of India recently launched a campaign against non-communicable diseases, with a focus on diabetes. Prevention is key to the strategy that the Ministry of Health and Family Welfare has adopted, but for Tamil Nadu, this is a greater challenge as expert’s point that its incidence in the urban and rural areas is no more very widely divergent. 

According to an ongoing ICMR-IDIAB study among 14 states in the country, Tamil Nadu tops the list in prevalence of diabetes. While this is 13.8 per cent in the urban areas, rural Tamil Nadu has almost 9 per cent. Dr V Mohan, chairman, Dr Mohan’s Diabetes Specialties Centre, says, “The shocking part is that there is not much difference in the prevalence rates between urban and rural areas in Tamil Nadu, where there is growing urbanisation at almost 50 per cent now. The average is almost 10 per cent for the whole state. This means that of the estimated 35 million adults in the state, 3.5 million are diabetic. The number goes up multi-fold, when you take a highly urbanised centre like Chennai, where it is 24.5 per cent among those aged above 20 years. In the those who are 50 or above, 40 per cent is diabetic and 35 per cent is pre-diabetic.”

Dr R Shivaa Mohan, diabetologist, points out that the special area of focus in Tamil Nadu’s diabetes challenge is the growing pre-diabetes rate. He says, “The pre-diabetic population is likely to develop diabetes over a period of time. In fact, a study of the IT workforce in Chennai has shown that one in four was pre-diabetic. This calls for immediate intervention and if you catch it at the earliest, you can prevent it.” 

Dr Shivaa, who has looked at rural areas for online consultation and follow-ups, says rural Tamil Nadu has a higher number of women in the pre-diabetic group. 

While statistics paint an alarming picture, experts say there are a number of positive factors to fall back on: a robust health system in the state and improving awareness. Dr Vijay Viswanathan, head and chief diabetologist, MV Hospital for Diabetes, says, “Due to the Tamil Nadu Health System Project and the involvement of the private sector the awareness and detection rate of diabetes is much better. Facilities for blood glucose detection are available even in many of the PHCs in Tamil Nadu. Many medical colleges have a separate diabetology department. Insulin and other oral medications are available through the Tamil Nadu Medical Services Corporation.” 

He says the same outreach can be adopted in the rural areas. “Some of the latest insulin and oral medication can be made available in the rural parts. Blood sugar monitoring devices with blood glucose strips can be given to all patients taking insulin in government hospitals. Diabetic foot clinics can be started in all the Government Medical College Hospitals to prevent amputations. Regular screening for diabetes complications can be done in major taluk and district hospitals. It also calls for action from people: many turn up for testing only when they contract an infection related to diabetes,” he adds. 

Dr Mohan says the government should subsidise healthy food, like fruit and vegetables. “People would eat healthy if these foods were available at a lower price. The state could build more parks to encourage activities, like walking. Those in rural Tamil Nadu don’t have to make the same mistake as their urban counterparts. We are just 10 years behind Indians living in the West, who took to healthy eating habits and fitness almost three decades ago,” he says.