India has a bigger problem of diabetes and other metabolic non-communicable diseases (NCDs) like obesity and hypertension than previously estimated, suggests a recent study published in the medical journal Lancet.

The Indian Council of Medical Research–India Diabetes (ICMR-INDIAB) study, a cross-sectional population-based survey, assessed a representative sample of individuals aged 20 years and older drawn from urban and rural areas of 31 states, union territories, and the National Capital Territory of India.

Of the total of 1,13 043 individuals (79,506 from rural areas and 33,537 from urban areas) who participated in the ICMR-INDIAB study between Oct 18, 2008, and December 17, 2020, the overall weighted prevalence of diabetes was 11.4%, prediabetes 15.3%, hypertension 35.5%, generalised obesity 28·6%, abdominal obesity 39.5%, and dyslipidaemia 81.2%.

All metabolic NCDs except prediabetes were more frequent in urban than rural areas. In many states with a lower human development index, the ratio of diabetes to prediabetes was less than 1, the study found.

The new numbers of NCDs for India based on the study are people with diabetes (101.3 million), pre-diabetes (136 million), hypertension (315.5 million), generalised obesity (254.2 million), abdominal obesity (351.1 million), and hypercholesterolemia (213.3 million), Dr V Mohan, India Diabetes, a key author of the study, tweeted.   

“While the diabetes epidemic is stabilising in the more developed states of the country, it is still increasing in most other states. Thus, there are serious implications for the nation, warranting urgent state-specific policies and interventions to arrest the rapidly rising epidemic of metabolic NCDs in India”, the study said.

The researchers said the survey was conducted in multiple phases with a stratified multistage sampling design, using three-level stratification based on geography, population size, and socioeconomic status of each state. “Diabetes and prediabetes were diagnosed using the WHO criteria, hypertension using the Eighth Joint National Committee guidelines, obesity (generalised and abdominal) using the WHO Asia Pacific guidelines, and dyslipidaemia using the National Cholesterol Education Program—Adult Treatment Panel III guidelines”, they explained.

ICMR-INDIAB Collaborative Study Group consists of a team of 73 researchers. Indian Council of Medical Research and Department of Health Research, Ministry of Health and Family Welfare, Government of India funded the research.

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