National programme on prevention and control of diabetes in India: Need to focus. Diabetes is part of a larger global epidemic of non- communicable diseases. It has become a major public health challenge globally. This disease affects 6. According to the International Diabetic Federation (IDF), this number is expected to grow to 3. The IDF published findings revealing that in 2.
India (4. 0. 9 million), followed by China (3. United States (1. Russia (9. 6 million) and Germany (7. India is home to 4. Projections show that this will increase to 7.
1 national programme for prevention and control of cancer, diabetes, cardiovascular diseases & stroke (npcdcs) operational guidelines directorate general of health. Companion to: Guidelines for the development of a national diabetes programme (WHO/DBO/DM/91.1). 标题: Implementing national diabetes programmes : report of a WHO. As “National Diabetes Control Programme” on a pilot basis during VII Five Year Plan in some districts of Tamil. Recent developments in diabetes control and. The diabetes prevention and control programme of the Islamic Republic of Iran 作者: Azizi, F. Gouya, M.M. Vazirian, P. Dolatshahi, P. National Health Programs 主题.
As India has a population of 1. India's future workforce is crucial. With the largest number of diabetic patients, India leads the world with earning the dubious distinction of being termed the “Diabetes Capital of the World”. The problem has been well documented in a battery of recent papers. Between 5% and 1. Projections show that in the next decade, India will lose US$2.
Diabetes, National Programme for Prevention and Control of Cardiovascular Diseases and Stroke A Guide for Health Workers Directorate General of Health Services. This alarming scenario led the Government of India to start the National Diabetes Control Programme on pilot basis during the. for_medical_officer.pdf. National Diabetes Programme. The Guide to National Diabetes Programmes presents a set of practical. prevent and control diabetes and related chronic.
Impaired Glucose Tolerance (IGT) is also a mounting problem in India. It has been noticed that with every diagnosed case of diabetes there is at least one undiagnosed case of glucose intolerance.
So the actual population at risk would be much greater than our current estimate. The prevalence of IGT is thought to be around 8. Around 3. 5% of IGT sufferers go on to develop type- 2 diabetes, so India is genuinely facing a healthcare crisis. Type- 2 diabetes is also known as non- insulin- dependent or adult- onset diabetes and this form of the disease is far more common than type- 1 (insulin dependent or juvenile- onset) diabetes. It results from a genetic predisposition and from lifestyle factors, especially those of the so- called Western lifestyle, characterised by a high calorie intake and little exercise.
Until recently, type- 2 diabetes — henceforth simply ‘diabetes’ — was viewed as a disease of overfed, sedentary people of European ancestry, but it is now exploding around the world owing to the spread of Western habits. The age of onset in India has been shifting towards ever- younger people. Among Indians in their late teens, ‘adult- onset’ diabetes already manifests itself more often than ‘juvenile onset’ diabetes does. In Britain, the prevalence of type 2 diabetes is 1.
Asian than European children. In India (2. 01. 0), a wide range of outcomes for different groups. European countries. Prevalence is only 0. Indians. It reaches 1.
Indians; and it peaks at 2. Ernakulam district of Kerala, one of India's most urbanised states. By contrast, surveys in 1. Indian cities that are today diabetes strongholds, yielded a prevalence of just 1% or less.
Only in the 1. 98. During 1. 97. 1–2. However, studies show that diabetes has risen rapidly in rural areas, with a threefold increase (from 2. India over a 1. 4- year period. The reasons are the same as those behind the diabetes epidemic worldwide. One set of factors is urbanisation, a rise in living standards and the spread of calorie- rich, fatty, fast foods cheaply available in cities to rich and poor alike.
Another is the increased sedentariness that has resulted from the replacement of manual labour by service jobs, and from the advent of video games, television and computers that keep people seated lethargically watching screens for hours every day. Among lifestyle factors predicting the incidence of diabetes in India, some are familiar from the West, whereas others turn expectations upside down. Although poor Indians are currently at lower risk than affluent Indians, the rapid spread of fast food exposes even urban Indian slum dwellers to the risk of diabetes. In India, diabetes is no longer a disease of the affluent or a rich man's disease. It is becoming a problem even among the middle income and poorer sections of the society. Studies have shown that poor diabetic subjects are more prone to complications as they have less access to quality healthcare.
The nutrition transition refers to a shift from consumption of simple, traditional foods to heavily marketed foods high in calories, sugar, and animal fat but low in vitamins and minerals derived from fruits and vegetables. Although the nutrition transition has reduced under nutrition, it increases diabetes risk. Obesity is a key risk factor for diabetes. In 2. 00. 5, urban obesity prevalence in India was in the range of 1. Although obesity is a risk factor for diabetes both in India and in the West, the disease appears at a lower threshold of obesity in India, as is also the case in China, Japan and other Asian countries. The key is to harness its positive aspects to improve the equitable distribution of healthier, higher- quality food. These global trends have an increased impact on the Indian population, who have the following biological susceptibilities to diabetes: (1) Lower threshold for development: Indians have, on average, a lower body mass index (BMI) than those of European descent, and risk of diabetes starts to increase at very low levels of BMI for Indians.
Higher percentage of body fat that is concentrated in the abdominal area: Indians have, on average, a higher percentage of body fat than those of European descent, and it is concentrated in the abdominal area. Abdominal obesity is a key risk factor for development of diabetes. Programmed during pregnancy: Because of the coexistence of underweight and overweight, children are often born underweight and adapted to a low- nutrition environment.
Low- birth weight infants are more susceptible than those of normal birth weight to obesity and diabetes, especially when raised in an obesogenic environment. Insulin resistance: Excessive insulin resistance has been observed in Asian Indians as a predominant mechanism leading to Type 2 diabetes; ENPP1 1. Q has recently been identified as one of the genes that may contribute to this resistance.
This alarming scenario led the Government of India to start the National Diabetes Control Programme on pilot basis during the seventh five year plan in 1. Tamil Nadu, J & K and Karnataka, but due to paucity of funds in subsequent years this programme could not be expanded further in remaining states. However, during 1. The objectives of the programme were: 2.
No national awareness survey has been performed, but a study in Chennai found that awareness of diabetes as a public health priority and knowledge of diabetes prevention is poor, especially among women and people with little education. Nearly 2. 5% of Indian city dwellers (the subpopulation most at risk) have not even heard of diabetes. The community empowerment can greatly increase physical activity. For example, it motivated a community in Chennai to construct a public park with its own funds, which suggests that community involvement can strengthen government efforts.
Central/state governments can drive diabetes prevention and treatment efforts. A positive step is Healthy- India. Ministry of Health and Family Welfare and the Public Health Foundation of India (PHFI), which advocates healthy living and the prevention of diabetes and other non- communicable diseases. Central and state governments could develop better surveillance systems.
More research is needed to understand diabetes risk factors in India and to guide effective policy. The Integrated Disease Surveillance (IDS) programme analyses chronic disease risk factors and could be improved to obtain data more frequently and systematically using high- quality methods. To prevent diabetes through healthier diets, India's dietary guidelines should be revised to reflect principles of chronic disease prevention and health promotion; food availability and affordability should reflect these guidelines through agricultural policies. In Brazil, for example, updated Food Guidelines were implemented in 2. In 2. 00. 0, Brazil also legislated that at least 7. Ghee, a saturated fat, is popular in traditional Indian cooking.
Replacing it with healthier cooking oils could reduce intake of fatty acids, serum cholesterol levels, and ultimately Cardiovascular Disease (CVD) — risk factors associated with diabetes. A successful model of such government intervention comes from Mauritius, where changes in government nutrition policies in the 1. Healthier packaged and processed foods are possible through government intervention, with food industry support. Through amendments to the Prevention of Food Adulteration Act of 1. Governments should implement urban design policies to facilitate physical activity as a component of daily life.
In India, management of urban transportation currently rests with state governments, but a central policy is needed. Globally, cycling shows potential as a cost- effective way to encourage physical activity, especially in cities. Because of India's tropical climate, cycling may be more difficult to encourage than in less extreme climates; such initiatives should be considered and evaluated in an India- specific context. The private sector can collaborate to implement many of the prevention- oriented governmental policies proposed above, through funding, expertise in distribution systems for provision of healthier foods (and low- cost medicines for treatment), and market innovation encouraging healthy eating and physical activity. Research suggests that providing incentives for food manufacturers is an effective way to improve dietary habits, especially where the cost of healthier foods is an issue. The food industry should work with the health ministry to implement a national nutrition policy by developing foods that comply with dietary and labeling guidelines and are thus more marketable as healthy options.
Expertise in distribution systems for providing affordable fruit and vegetables to hard- to- reach populations is the key. Non- Governmental Organizations (NGOs) have a role in both prevention and treatment. In India, NGOs wield significant power—much occurs at the grassroots level, bolstered by NGO support.