Tackling the silent epidemic of Type-I Diabetes Mellitus (Type-1 DM) through National Health Programmes- A narrative review of available evidence

Authors

  • Om Prakash Bera Principal Consultant (Implementation), Global Health Advocacy Incubator, India https://orcid.org/0000-0003-0513-7658
  • Vandana Shah Regional Director (Southeast Asia), Global Health Advocacy Incubator
  • Sudip Bhattacharya Independent Global Public Health Researcher, Dehradun, India https://orcid.org/0000-0001-7935-9013
  • Sheikh Mohd Saleem Independent Global Public Health Researcher, Srinagar, Jammu & Kashmir, India https://orcid.org/0000-0001-8575-0713

DOI:

https://doi.org/10.47203/IJCH.2021.v33i02.004

Keywords:

Diabetes Mellitus, Type 1, Epidemics, Hyperglycemia, National Health Programs

Abstract

Type 1 diabetes mellitus (T1DM) is an autoimmune ?-cell destruction, usually leading to absolute insulin deficiency, insulin resistance, or by a combination of both. Both the incidence and prevalence of diabetes T1DM is suspected to be high in India, but in the absence of nation-wide registry, the possibility of exact numbers is unsure. Till date, studies done among the population have seen prevalence more than the incidence of the disease, which has led to late screening and diagnosis of the disease within the community settings. India is already suffering from the burden of type 2 DM, in the process of screening those, patients with T1DM are somewhat getting ignored. Furthermore, cost associated with the treatment expenditure and social status of the people suffering from the disease too have a role to consider which has been totally side-lined in national programmes like National Program for Control of Diabetes, Cardiovascular disease, and Stroke (NPCDCS). There is also scarcity of data on the incidence of T1DM which could aid in formulating better policy avenues for the patients suffering from the disease.  Reports on trends in T1DM are more commonly available from countries with better established public health surveillance systems and diabetes research infrastructure. From India, due to scarcity of data on T1DM, we had to rely on published literature of some major centers across the country. Results from the Indian Council of Medical Research (ICMR) first phase, till July 2011 which included 5546 patients found T1DM among 63.9% cases and predominately among children; at registration 11.1% had already developed chronic complication of T1DM. As India is already suffering from the burden of type 2 DM, during current management and treatment, the problem lies at various levels which needs to be addressed. We propose a setting based, life course approach for T1DM where every age group will have access to the health care system either directly or indirectly from intra-natal life till elderly age group through health approach based on scientific methods delivered through health system. In this regard a central registry having enumeration and provisioning of mandatory Insulin to all through a national policy being implemented by NPCDCS is what policy makers must take up at urgent bases if we want to bend the curve of rising T1DM and prevalence of overall diabetes in India.

Downloads

Download data is not yet available.

References

Classification and diagnosis of diabetes: standards of medical care in diabetes — 2019. Diabetes Care 42 (Suppl. 1), 13–28 (2019)

Cnop, M. et al. Mechanisms of pancreatic ?-cell death in type 1 and type 2 diabetes: many differences, few similarities. Diabetes 54 (Suppl. 2), 97–107 (2005). 2. American Diabetes Association.

American Diabetes Association. Diagnosis and classification of diabetes mellitus [published correction appears in Diabetes Care. 2010 Apr;33(4):e57]. Diabetes Care. 2010;33 Suppl 1(Suppl 1):S62-S69. doi:10.2337/dc10-S062

Al-Mutairi HF, Mohsen AM, Al-Mazidi ZM. Genetics of type I diabetes. Kuwait Med J 2007;39:107e15.

Pociot F, McDermott MF. Genetics of type 1 diabetes mellitus. Genes Immun2002;3:235e49

Mobasseri M, Shirmohammadi M, Amiri T, Vahed N, Hosseini Fard H, Ghojazadeh M. Prevalence and incidence of type 1 diabetes in the world: a systematic review and meta-analysis. Health PromotPerspect. 2020 Mar 30;10(2):98-115. doi: 10.34172/hpp.2020.18. PMID: 32296622; PMCID: PMC7146037.

Ramachandran A, Snehalatha C, Abdul Khader OM, Joseph TA, Viswanathan M. Prevalence of childhood diabetes in an urban population in south India. Diabetes Res ClinPract. 1992;17:227–31.

Ramachandran A, Snehalatha C, Krishnaswamy CV. Incidence of IDDM in children in urban population in southern India. Madras IDDM Registry Group Madras, South India. Diabetes Res ClinPract. 1996;34:79–82.

Kumar P, Krishna P, Reddy SC, Gurappa M, Aravind SR, Munichoodappa C. Incidence of type 1 diabetes mellitus and associated complications among children and young adults: results from Karnataka Diabetes Registry 1995-2008. J Indian Med Assoc. 2008;106:708–11.

Kalra S, Kalra B, Sharma A. Prevalence of type 1 diabetes mellitus in Karnal district, Haryana state, India. DiabetolMetabSyndr. 2010;2:14.

Bhatia V, Arya V, Dabadghao P, Balasubramanian K, Sharma K, Verghese N, et al. Etiology and outcome of childhood and adolescent diabetes mellitus in North India. J PediatrEndocrinolMetab. 2004;17:993-9.

The Indian Council of Medical Research (ICMR), India. Executive Summary: The Indian Council of Medical Research Registry of People with Diabetes with Young Age at Onset (ICMR-YDR), Phase 1 (2006-2011) Report. Available from: http://www.icmr.nic.in/sites/default/files/reports/Executive%20summary. Accessed June 14, 2021.

Vijayakumar, G., Manghat, S., Vijayakumar, R. et al. Incidence of type 2 diabetes mellitus and prediabetes in Kerala, India: results from a 10-year prospective cohort. BMC Public Health 19, 140 (2019). https://doi.org/10.1186/s12889-019-6445-6

Oberoi S, Kansra P. Economic menace of diabetes in India: a systematic review. Int J Diabetes Dev Ctries. 2020 Jun 17:1-12. doi: 10.1007/s13410-020-00838-z. Epub ahead of print. PMID: 32837090; PMCID: PMC7299136.

Poverty and Equity - India The World Bank (2012)

Downloads

Published

2021-06-30

How to Cite

1.
Bera OP, Shah V, Bhattacharya S, Saleem SM. Tackling the silent epidemic of Type-I Diabetes Mellitus (Type-1 DM) through National Health Programmes- A narrative review of available evidence. Indian J Community Health [Internet]. 2021 Jun. 30 [cited 2024 May 24];33(2):245-9. Available from: https://iapsmupuk.org/journal/index.php/IJCH/article/view/2125

Issue

Section

Review Article

Most read articles by the same author(s)

1 2 3 > >>