Poverty and diabetes, twin burdens

Prevalence of diabetes is increasing among urban poor. Managing the disease costs upwards of Rs 40 daily, beyond reach of many

Written by Adil Akhzer , ANURADHA MASCAREHNAS | Chandigarh | Published:June 8, 2017 12:54 am
Diabetes, Urban poor, Rural Poor Photo for representational purpose.

The most worrying aspect of the new research findings on diabetes is that the epidemic is now spreading to those who can least afford to pay for its management, doctors said. “The situation is serious because the disease is expensive. You have to pay not less than Rs 40 on its treatment per day, and the government has no plan to help out as yet. Diabetes brings along many more problems, and needs to be treated properly,” said Dr Sanjay Bhadada, senior faculty at the Department of Endocrinology at Chandigarh’s Post Graduate Institute of Medical Education and Research.

Diabetes is becoming common among people of “Low Socio-Economic Status (SES)” living in cities and towns in the more affluent states, shows an ongoing study funded by the Indian Council of Medical Research and the union Ministry of Health. Findings from 14 states and the union territory of Chandigarh were published online in The Lancet Diabetes & Endocrinology Wednesday.

Endocrinologist Prof Satinath Mukhopadhyay of the Institute of Post Graduate Medical Education and Research in Kolkata said changing lifestyles among low SES individuals could be a key reason for the increased incidence.

“Diabetes occurs from a combination of increase in high calorie food intake and reduced energy expenditure. In low SES group, the intake of high calorie food is going up across the country, along with growing physical inactivity. Even in remote areas, people prefer to use 2-wheelers now rather than walk or cycle,” Dr Mukhopadhyay said.

Dr Bhadada agreed: “It is multi-factorial. In most cases, we are seeing that physical activity among low SES is gradually coming down, and the intake of junk food is adding to the problem.”

Dr Mohd Ashraf Ganie, who was until recently associated with AIIMS, Delhi, and is now a professor at Srinagar’s Sher-i-Kashmir Institute of Medical Sciences, said the movement of rural folk to towns and cities is accompanied by a change in lifestyle. “When they move to cities, they have access to high calorie food that is cheaper,” he said. Dr Ganie added that a study conducted among the Gujjar-Bakerwals in J&K had shown a lower prevalence of diabetes, as the community continues to follow its older and more traditional lifestyle.

Dr Vijay Vishwanathan, chief diabetologist at Chennai’s M V Hospital for Diabetes, said, “A study we did a couple of years ago showed that people of lower socio-economic status in urban areas had diabetes due to an increasing sedentary life, consumption of carbohydrates, and lower intake of fruits and vegetables. Another factor was environmental pollution, as a majority of their homes faced the road.”

The study, which is ongoing, is the largest of its kind, and aims to sample a total 1,24,000 rural and urban residents of 31 states and union territories who will be representative of the country as a whole. The published results are based on findings from 57,117 individuals (16,909 urban and 40,208 rural), 54,128 of whom provided blood samples.

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