Diabetes Management in India - From Ivory Towers to Ground Reality

There is an Emerging global epidemic of diabetes is at hand .It is predicted to become the 7 leading cause of death in the world by the year 2030. In the year 2012, diabetes was the direct cause of 1.5 million deaths. Surprisingly, 80% of diabetes deaths occur in low- and middle-income countries. In developed countries, age preponderance is >50 years, whereas in developing countries age preponderance is between 35 and 64 years. It is a lifestyle associated disease and largely preventable, diagnosis is easy and if adequately treated most of the complications particularly microvascular can be prevented as seen in Diabetes Control & Complications Trial(DCCT) & United Kingdom Prospective Diabetes Study (UKPDS) and numerous other studies. There are guidelines for diabetes management from different associations like American Diabetes Association, International Diabetes Federation, American Association of Clinical Endocrinologists etc & there is lot of research going on and now many new molecules are available in the market, but in our country all the newer antidiabetic medications and newer Insulins are costly and out of reach for low income group patients .There are barriers at many levels, which prevents proper management of the disease in the community. Ground reality is very different from ideal situation.