Type 2 diabetes accounts for over 90 percent of all diabetic cases in India. Diabetes is a progressive disorder, if left undiagnosed and untreated, it could lead to disabling complications affecting multiple organs and systems in the body. Coronary heart disease, retinopathy, strokes, and nephropathy to mention a few. This, in turn, could result in premature morbidity and mortality with reduced life expectancy. The financial burden of diabetes can be distressing, specifically for the socio-economically disadvantaged, belonging to the lower wealth index in the country. The average annual expenditure on type 2 diabetes care amounts to roughly 14 thousand Indian rupees and over 350 thousand Indian rupees in a lifetime. Further, the economic burden on the Indian healthcare system could be profound, impacting households and, consequently, key macroeconomic indicators.
Diabetes and wealth
Commonly referred to as a rich man’s disease, studies show that random high glucose levels for the poorest 20 percent of households were the lowest. By contrast, these levels were highest for those belonging to the wealthiest 20 percent. People belonging to the higher end of the wealth spectrum can afford to buy processed and fast foods, which are generally costlier than buying foods closer to their source. The rapid socioeconomic transition together with industrialization and urbanization, belong to some of the major factors contributing to the diabetes epidemic. A poor diet exacerbated by a sedentary lifestyle, limited physical activity, and stress leads to metabolic dysfunction and can be the onset of diabetes.Challenges and management
Besides the exponential rise in the number of diabetics, access to insulin presents as a problematic, and not just due to increasing demand. Surprisingly, there is yet no market for generic insulin. But what is more is that human insulin prices along with the logistics, particularly the storage and refrigeration of this temperature-sensitive drug, make it virtually inaccessible to people living in less developed and remote rural areas. This calls for a deeper understanding of how infrastructure can be improved for more effective delivery and affordability. Some of the major suppliers of insulin in India are controlled by multinational pharmaceuticals like Sanofi and Novo Nordisk. The latter made a quantum leap, and is currently working on a once-a-week insulin regime for the Indian population which could greatly enhance their lifestyle.95 percent of the diabetic population belongs to the lower and middle-income class with very limited access to treatment. Timely detection and the right management can support patients in leading a normal life. Further, the next steps for India would be to identify an affordable and comprehensive treatment plan to more effectively curb the economic burden for diabetic and prediabetic people. For instance, biotech-based innovations such as a self-monitoring glucometer or a guidance app can be crucial in managing and transforming diabetes care in India. For the long term, a prevention plan that includes fostering healthy eating and exercise habits can go a long way in mitigating this epidemic for the population.
