1 in 5 people over 45 had diabetes in 2019: Lancet study

In India, 19.8% of adults over 45 had diabetes in 2019, with urban rates nearly double rural.

One in every five people aged over 45 years had diabetes in India in 2019, with the prevalence in urban areas nearly twice as high as in rural areas, according to a new study published in The Lancet Global Health journal on Thursday. It also pointed out that nearly 40% of individuals with diabetes were unaware of their condition.

1 in 5 people over 45 had diabetes in 2019: Lancet study

Titled ‘Prevalence, awareness, treatment, and control of diabetes in India: a nationally representative survey of adults aged 45 years and older’, the study defined diabetes prevalence as individuals self-reporting a previous diabetes diagnosis or having HbA1c (a blood test that provides an average of blood sugar levels over the past 2-3 months) of 6.5% or higher.

“In 2019 approximately one in five people aged 45 years and older had diabetes in India (19.8%), which amounts to 50.4 million individuals… two out of five people with diabetes (40%) were unaware of their condition, 46% regained control of their blood sugar levels, 59% achieved blood pressure control, and 6% were taking a lipid-lowering medication to reduce the risk of cardiovascular disease,” the study found.

To be sure, the study does not specify the type of diabetes and is seen to be indicating prevalence of both types 1 and 2 diabetes.

Globally, the number of adults with diabetes was about four times higher in 2014 than in 1980, making it one of the world’s most important public health challenges. According to the study, approximately one out of every seven adults with diabetes globally lives in India, a country with over 1.4 billion population.

“We conducted a cross-sectional, nationally representative survey of adults in India aged 45 years and older and their spouses from 2017 to 2019. Our sample included 57,810 individuals and their spouses from 36 states and union territories, reflecting a representative sample of India as a nation and of each state and union territory,” the authors said in the paper.

Participants had available data on glycated haemoglobin (HbA1c) measurement and non-missing information on diabetes diagnosis, household economic status, and BMI (body mass index), they added.

“Up to date evidence on the prevalence, awareness, treatment, and control of diabetes among middle-aged and older adults is important given that the risk of diabetes increases with age and that clinical and public health interventions can help to prevent diabetes complications,” the authors said.

The Union government’s Longitudinal Aging Study in India (LASI) had surveyed nearly 60,000 adults across the country aged 45 years or more between 2017 and 2019 to estimate the prevalence, awareness, treatment, and control of diabetes. It also found that rates of diabetes were similar among men and women (19.6% in men vs 20.1% in women). Urban diabetes prevalence (30%) was approximately twice as high as rural prevalence (15%), and areas of India with higher levels of economic development tended to have a greater prevalence of diabetes. In the population categorised as overweight, diabetes prevalence was found to be 24.7%, while the prevalence was 34.6% in the population with obesity.

“We designed the Longitudinal Aging Study in India as a nationally representative study to provide high-quality, comprehensive data on the health, social, and economic aspects of ageing in India,” the authors said.

In 2021, the WHO Global Diabetes Compact released worldwide targets for 2030 that at least 80% of people with diabetes are diagnosed, and out of those with a diagnosis, at least 80% achieve glycaemic control (HbA1c < 8%), 80% achieve blood pressure control (<140/90 mm Hg), and 60% use a statin (prescription drug meant to reduce bad cholesterol).

The authors said their findings emphasise the urgent need to scale up policies to better prevent, detect, manage, and control diabetes among middle-aged and older adults in India.

Health experts termed these findings as concerning.

“These findings are very concerning and I don’t see any deceleration in these figures over the last decade. Indeed, high blood sugar is the ‘new normal’. All concerned should rethink out of box strategies to prevent it, reverse it, and in established cases, control it,” said Dr Anoop Misra, chairman, Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology.