The final results of a long-term, cross-sectional, population-based study across 31 States, Metabolic non-communicable disease health report of India, by the Indian Council of Medical Research and India Diabetes (ICMR-INDIAB) paint a bleak picture of Kerala, which figures amongst the top three States with the worst overall indicators.
The study was conducted from 2008 to 2020, in five phases. Kerala figured in the fourth leg of the study and the data from the State were collected between December 10, 2018 and July 10, 2019. The sample size was close to 4,000
The study throws up little surprises for Kerala, where several well-acclaimed studies done since the early 2000 had established non-communicable diseases to be the biggest health challenge of the State. The INDIAB study, however, brings up the heterogeneity between States for the first time and shows where Kerala stands in comparison to the rest of the country.
Diabetes prevalence in Kerala is 23.6% and the State is at the third place, after Goa (26.4%) and Puducherry (26.3%). The percentage of population in the State with pre-diabetes is 18.1%. However, with the ratio of weighted diabetes prevalence to pre-diabetes prevalence at 1:1, Kerala’s challenge ahead is much bigger.
More alarming is the prevalence of hypertension, at 44% in both urban and rural areas. When it comes to the NCD risk factors, Kerala is perhaps the one State which is showing up consistently in the red in the nation’s metabolic health report.
“Newly detected diabetes cases in the population was 6.1%. The prevalence of young diabetes – adults between 18-40 years of age – is alarmingly high. The heterogeneity in data is quite inexplicable in some cases. Eg: Diabetes prevalence in Tamil Nadu is 14.4% but in Puducherry it is 26.3%. Unhealthy diet and sedentary lifestyle is the ruin of Kerala,” says P.K. Jabbar, Director, Indian Institute of Diabetes, which led the study in Kerala.
Researchers have pointed out that the States need evidence-based approach and State-specific strategies to prevent pre-diabetes progression to diabetes. States with high diabetes prevalence will need to put in place systems to ensure optimal risk factor control to effectively prevent long-term consequences.
The mean HbA1c value in Kerala, at 8.3 mg/dl indicated poor glycaemic control. Poor achievement of glycaemic targets despite the widespread use of NCD drugs suggests a lack of timely escalation of treatment, which is usually due to poor monitoring and follow-up care, researchers point out.
The report has been just published in The Lancet (Diabetes and Endocrinology).
