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How crucial is India’s struggle against the dual challenge of obesity and diabetes

bynewsdesk
November 28, 2023

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With over 101 million people living with type 2 diabetes (T2D), India houses the second-highest diabetes population in the world. The numbers are expected to reach almost 124 million by 2045. There are serious implications for the nation, warranting urgent state-specific policies and interventions to arrest the rapidly rising epidemic of metabolic non-communicable diseases (NCDs) in India. 


Obesity is one of the major modifiable risk factors for diabetes. Over the years, the Indian population has transformed from underweight to overweight or obese. In its March 2023 World Obesity Atlas, the World Obesity Federation projected that adult obesity (BMI >30 kg/m2) in India will grow at a compound annual growth rate of 5.2% and obesity in children by 9.1% between 2020-2035. This is an alarming observation given that obesity is a complex chronic disease contributing to various non-communicable diseases (NCDs), including diabetes. 

The dual impact

In India, 1 in 10 adults live with T2D, and 4 in 10 adults live with overweight or obesity. It is noteworthy that 20.4% of the population living with T2D also live overweight. Moreover, nearly 67% of the population with T2D live with obesity. Further, people living with diabetes and obesity are susceptible to a host of medical conditions including increased risk of high blood pressure and high cholesterol, certain cancers, bone issues, and heart, kidney, and liver illnesses. The combination of obesity and T2D increases the risk of mortality by 7 times.

Moreover, excess body weight comes with complications like hypertension, T2D, cardiovascular (CV) issues, respiratory issues, certain cancers, infertility, and the like. It is thus important to change how obesity and CV issues are perceived in the country and make it a healthcare priority, while raising awareness around the prevalence of these comorbidities in people with type 2 diabetes.

Economic burden of diabetes and obesity 

As per IDF Atlas 2021, the average diabetes-related expenditure in India was to tune of USD 8 billion. Moreover, as per World Obesity Atlas 2023, India has one of the fastest-growing rates of obesity in the world that substantially impacts the nation’s economy in terms of healthcare costs and reduced productivity of human capital.3 The report further predicts the impact of being overweight on India’s GDP to amount to US$ 3,815 billion by 2025 (nearly 1.3%), and US$ 7,117 billion by 2035.3
At the individual level, 80-85% of healthcare costs in India are borne by individuals. While the rural and urban poor spend about 27%-34% of their household income on diabetes care, middle-income groups spend 5%-12.6% and high-income groups spend 4.8% to 16.9%. On average, diabetes alone exhausts a 5 to 25% share of the earnings of an Indian household. 
Further, research shows that in people with type 2 diabetes, compared to people with normal weight, there is an increase in direct costs as weight increases. By controlling diabetes well today, one can reduce risk of developing complications. Additionally, obesity is also a major contributor to the diabetes problem as it increases the disease burden (in terms of reduced productivity and the healthcare cost for treatment) of the country. Studies have found that the per capita cost of obesity in India was US$ 17 in 2019, which is nearly 0.8% of the country’s GDP.

Prevention and timely intervention

India houses a myriad of issues including severe lack of awareness about diseases, low access to quality healthcare, poor economic conditions, and non-adherence to medication. Therefore, managing obesity, diabetes, and its comorbidities effectively continues to be a challenge in India. There have been sweeping changes in T2D management principles lately.

Consensus Report guidelines by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) have stressed weight management as an important tenet of holistic T2D management. Recognizing the gravity of these intertwined challenges, the need for comprehensive prevention, early intervention and access to quality care becomes ever more apparent.

 

—The author, Vikrant Shrotriya, is Managing Director, Novo Nordisk India. The views expressed are personal.

(Edited by : C H Unnikrishnan)

Sources

1/ https://Google.com/

2/ https://www.cnbctv18.com/healthcare/obesity-and-diabetes-indias-struggle-against-the-dual-challenge-non-communicabale-diseases-18419221.htm

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