SYLLABUS
GS-2:Issues relating to development and management of Social Sector/Services relating to Health
Context: Recently, a study published in the Lancet Diabetes and Endocrinology reported that India had the world’s second-largest adult diabetes population in 2024.
Key Findings of the Study
- India had 90 million adults (20–79 years) living with diabetes in 2024.
- China ranked first with 148 million, while the United States ranked third with 39 million.
- The findings are based on the 11th edition of the International Diabetes Federation (IDF) Diabetes Atlas.
- The Atlas provides national, regional, and global estimates for 2024 and projections up to 2050.
- Estimates covered 215 countries and territories, using data from 246 studies (2024-2025).
- Populous countries such as China, India, the United States, and Pakistan contribute a large share of the global diabetes cases.
- Pakistan is projected to surpass the United States by 2050.
- Globally, over 11% of the world’s adult population (589 million adults) had diabetes in 2024.
- By 2050, nearly 13% (853 million adults) are projected to be affected.
- Over 80% of people with diabetes lived in low and middle-income countries in 2024.
- These countries will contribute over 95% of the global increase by 2050.
- Prevalence peaked at nearly 25% among adults aged 75–79 years.
- Diabetes prevalence was higher in men than in women and higher in urban than rural populations.
Key reasons for the rise in diabetes
- The researchers point to a mix of drivers:
- Population growth and ageing, which increase the number of people at risk
- Rapid urbanisation, often linked to sedentary lifestyles
- Dietary shifts, including higher consumption of ultra-processed foods
- Lower levels of physical activity, particularly in cities
- Together, these factors are fuelling a steady rise in diabetes across much of the developing world.
About Diabetes
- Diabetes mellitus (DM) is a disease of inadequate control of blood levels of glucose.
- It is a chronic disease that occurs when the pancreas doesn’t produce enough insulin or the body cannot use insulin effectively.
- Insulin is a hormone that helps regulate blood sugar levels.
- The islets of Langerhans in the pancreas contain two primary types of endocrine cells:
- Beta Cells: Produce insulin, which lowers blood glucose levels.
- Alpha Cells: Secrete glucagon, which raises blood glucose levels.
Types of Diabetes
- Type 1 Diabetes:
- Known as juvenile diabetes or insulin-dependent diabetes.
- Type 1 diabetes is a lifelong autoimmune disease that prevents the pancreas from making insulin.
- It is characterized by autoimmune destruction of beta cells, leading to little or no insulin production and requiring daily insulin injections.
- This type often develops in children or young adults but can occur at any age.
- Symptoms can develop rapidly over weeks or months. They may lead to severe complications such as Diabetes-Related Ketoacidosis (DKA), characterized by vomiting, stomach pain, fruity-smelling breath, and labored breathing.
- Type 2 Diabetes:
- Type 2 diabetes affects how the body uses sugar (glucose) for energy.
- It can result from the pancreas not producing enough insulin or the body not using insulin properly (insulin resistance).
- Often develops gradually, influenced by factors such as obesity and aging.
- While it usually affects older adults, it is increasingly common in children.
- Symptoms: high blood sugar levels might only be detected during routine blood tests. A potential sign of prediabetes is acanthosis nigricans, which causes darkened skin in certain areas like the neck or armpits.
- Type 1.5 Diabetes:
- Type 1.5 diabetes, also known as LADA (Latent Autoimmune Diabetes in Adults), is similar to Type 1, involving an immune response against insulin-producing cells but develops more slowly.
- People with LADA often do not need insulin immediately but they may develop a need for it over time.
- Gestational diabetes: Gestational diabetes is a condition of high blood glucose during pregnancy that increases the risk of complications for both mother and child and raises their future risk of type 2 diabetes.
- Prediabetes: Prediabetes is a state in which blood glucose levels are higher than normal but not yet diabetic, significantly increasing the risk of developing type 2 diabetes.
- Monogenic diabetes: Monogenic diabetes is a rare form of diabetes caused by a mutation in a single gene.
- Type 5 diabetes: Type 5 diabetes is a newly recognised form affecting lean, malnourished young people in low- and middle-income countries, marked by abnormal pancreatic beta-cell function and inadequate insulin production.