No sugar coating

India’s position as the "diabetes capital of the world" has become a grim reality that is difficult to ignore. The latest report published by The Lancet on World Diabetes Day reveals a shocking picture: in 2022, India had the highest number of diabetics in the world, with an alarming 212 million adults affected. Even more troubling is that nearly 62% of these individuals—around 133 million—are living with untreated diabetes. This means that India also holds the record for the most untreated diabetes cases globally, an unenviable distinction that reflects a systemic healthcare failure.

The study, conducted by the NCD Risk Factor Collaboration and the WHO, shows a glaring contrast between the rapid growth in diabetes cases and the stagnation in treatment coverage, particularly in low- and middle-income countries like India. Despite decades of health campaigns, a negligible increase in treatment coverage has been observed—from 21.6% in 1990 to only 27.8% for women and from 25.3% to 29.3% for men. This gap has severe consequences, as untreated diabetes can lead to debilitating complications, including cardiovascular diseases, kidney failure, and vision impairment, burdening families and draining healthcare resources.

Why is diabetes, a manageable condition, left untreated for so many? The underlying reasons are manifold. India faces a mix of social, economic, and cultural challenges in tackling diabetes effectively. First, there’s a lack of early detection and awareness. Diabetes screening is still not a routine practice in many parts of the country, especially rural areas. Second, even when diagnosed, people often lack access to affordable treatment or fail to adhere to medication regimens due to cost or logistical barriers. Additionally, the healthcare infrastructure in rural and underserved areas remains inadequate, with few facilities capable of providing the long-term care essential for diabetes management.

Economic inequality exacerbates this issue. Low- and middle-income households are disproportionately affected, as the costs of treatment, regular monitoring, and medications are often beyond their reach. According to the study, India’s treatment gap is widening, and until we address these socio-economic disparities, the diabetes crisis will continue to grow.

Urgent, collective action is needed. First, health authorities must strengthen early diagnosis initiatives and raise public awareness of diabetes risks. Awareness campaigns must be extended beyond cities to reach rural communities, utilizing local health workers to disseminate information and screen at-risk individuals. Second, collaborative efforts between government agencies, healthcare providers, and community organizations are essential to provide cost-effective, continuous care. Subsidies for diabetes medications and free check-ups could also improve treatment rates and outcomes, ensuring equitable access to care.