Trends in diabetes epidemiology in Indian population in spite of regional disparities: a systemic review

Diabetes mellitus has emerged as a serious health problem and India has the distinction of having the second largest number of diabetics in world after China. We have performed a systemic review to evaluate the trends of prevalence, extent of diabetic problem in India based on available literatures over a period of 52 years (1960 to 2011). Pertinent literatures providing details of sample size, age group, along with prevalence of any of the three outcomes of interest, i.e. diabetes mellitus, impaired fasting glucose, impaired glucose tolerance were included. In this report, we have analysed the changes in prevalence of diabetes mellitus and prediabetes in India from 103 potential literatures. A secular trend regarding increase in diabetic prevalence was observed in India, though in rural areas it is slower than urban areas. Prevalence of impaired glucose tolerance and impaired fasting glucose was found high in different parts of India, suggesting the presence of a large pool of people with potential to develop diabetes. Change in lifestyle, food habit, physical inactivity and genetic variation may be responsible for such situation. Extent of lack of awareness and carelessness to undergo screening for diabetes was clearly demonstrated in the recent study. Though regional disparities, lack of well designed studies, differences in diagnostic protocol and lack of follow-up studies are the major limitations to understand the effect of diabetes mellitus throughout the equally. A multidisciplinary approach and situation based policy are needed to combat the pandemic.