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  • Review Article
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Diabetes mellitus and its complications in India

Nature Reviews Endocrinology volume 12, pages 357–370 (2016)Cite this article

Subjects

Key Points

  • Asian Indian individuals have a high predisposition to type 2 diabetes mellitus (T2DM), which develops at a younger age and lower BMI than in western countries

  • Asian Indian people with T2DM tend to have a higher risk of coronary artery disease and, possibly, a lower risk of microvascular complications compared with white individuals

  • Since the 1960s, the prevalence of diabetes mellitus in India has increased in both the urban and rural areas of the country and has spread to involve individuals from all socioeconomic strata

  • Management of diabetes mellitus in India faces many challenges but novel interventions using readily available resources and technology promise to revolutionise care

  • Understanding how India deals with diabetes mellitus can help other low-income and middle-income countries in the treatment of this devastating disease

Abstract

India is one of the epicentres of the global diabetes mellitus pandemic. Rapid socioeconomic development and demographic changes, along with increased susceptibility for Indian individuals, have led to the explosive increase in the prevalence of diabetes mellitus in India over the past four decades. Type 2 diabetes mellitus in Asian Indian people is characterized by a young age of onset and occurrence at low levels of BMI. Available data also suggest that the susceptibility of Asian Indian people to the complications of diabetes mellitus differs from that of white populations. Management of this disease in India faces multiple challenges, such as low levels of awareness, paucity of trained medical and paramedical staff and unaffordability of medications and services. Novel interventions using readily available resources and technology promise to revolutionise the care of patients with diabetes mellitus in India. As many of these challenges are common to most developing countries of the world, the lessons learnt from India's experience with diabetes mellitus are likely to be of immense global relevance. In this Review, we discuss the epidemiology of diabetes mellitus and its complications in India and outline the advances made in the country to ensure adequate care. We make specific references to novel, cost-effective interventions, which might be of relevance to other low-income and middle-income countries of the world.

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Figure 1: The changing prevalence of diabetes mellitus in India.
Figure 2: Distinctive features of T2DM in India.

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  1. Madras Diabetes Research Foundation & Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control, IDF Centre of Education, No. 6 Conran Smith Road, Gopalapuram, Chennai, 600 086, India

    Ranjit Unnikrishnan, Ranjit Mohan Anjana & Viswanathan Mohan

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  1. Ranjit Unnikrishnan
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  2. Ranjit Mohan Anjana
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R.U. wrote the manuscript. All authors contributed equally to researching data for the article, reviewing and editing the manuscript before submission.

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Correspondence to Viswanathan Mohan.

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Unnikrishnan, R., Anjana, R. & Mohan, V. Diabetes mellitus and its complications in India. Nat Rev Endocrinol 12, 357–370 (2016). https://doi.org/10.1038/nrendo.2016.53

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