Diabetes risk mitigation – Sentinelassam

The rapidly rising number of diabetes patients in India is a serious health burden for the country. More than 10 crore people are currently living with diabetes in India, according to the Indian Council of Medical Research, and the estimates are projected to double over the next 20 years. As a large number of diabetes cases go undiagnosed, the incidence of other health complications like kidney and heart diseases and loss of eyesight will stretch the limits of the country’s health budgets. Building awareness is the key, as a changing lifestyle, a healthy and balanced diet, regular physical activity, and a timely health checkup can significantly reduce the country’s diabetes burden. Diabetes is an integral part of the National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD), as part of the National Health Mission (NHM). The programme focuses on strengthening health infrastructure, human resource development, health promotion, and awareness generation for prevention, early diagnosis, management, and referral to an appropriate level of healthcare facility for treatment. The Central Government Department of Health and Family Welfare provides technical and financial support to the States and Union Territories under the programme. The establishment of 724 district NCD clinics, 210 district cardiac care units, 326 district day care centres, and 6,110 community health centre NCD clinics under NP-NCD speaks volumes about the strengthening of healthcare facilities under the programme. If the number of diabetes patients keeps on increasing at the current rate, these facilities will soon be overwhelmed, which remains the biggest worry for policymakers. The Central government informed the Rajya Sabha that under the Comprehensive Primary Healthcare rolled out in the country under NHM, persons more than 30 years of age are targeted for screening for common NCDs, i.e., diabetes, hypertension, and common cancers. While this population-based strategy has been hailed by health experts as a correct approach, reaching out to this population group in every nook and cranny is crucial. States with a lower incidence of diabetes, by prioritising this government-supported healthcare intervention, will be able to identify pre-diabetic patients and prevent an increase in the number of type 2 diabetes cases through timely medical advice. Screening of the common NCDs is an integral part of service delivery under Ayushman Bharat Health and Wellness Centres, which generates awareness on risk factors for NCDs, including diabetes, and emphasis should be laid on convincing more and more people over 30 years of age to visit the nearest wellness centres for screening. Awareness building can produce the desired result only when it is adopted at the community level and also spreads through word of mouth. An effective approach to mitigating diabetes is promoting nutritious foods and avoiding junk food. In this backdrop, the campaign by the Food Safety and Standards Authority (FSSAI)—”Eat”Right Initiative, Safe and Nutritious Food at Home, and Aaj se thoda”kum”—needs to take centre stage in the awareness campaign. The campaign is aimed at persuading people to reduce their intake of salt, sugar, and fat in their daily diets to reduce their diabetes risk. The daily diet varies from community to community and region to region, depending on what foods are locally produced or available in the market. With the advent of digital technology and business ideas of aggregating and selling cooked food online, food practices have gradually changed in urban areas as well as some rural areas well connected to the internet. Roping in the food aggregators and online food entrepreneurs, restaurants in promotion of healthy, safe, and nutritious food can go a long way in making use of technology to reach out to people to be volunteers in FSSAI’s Eat Right Campaign. Mothers and women heads in households play the most crucial role in what is to be put on the food table for the daily diet of family members. Taking the FSSAI campaign directly to women in households can bring about a qualitative and quantitative change in the daily diet. Convincing mothers and others who cook for the family and guests to reduce salt, sugar, and fat can be easier than convincing other members to consume less. Doing away with the practice of keeping raw salt on the food table or during community feasts can significantly reduce sodium intake for diabetes and hypertension patients. Strengthening sports infrastructure in educational institutions by state governments, the construction of community playgrounds, a community hall for daily yoga by panchayats, and other local administrations are necessary to supplement the promotion of healthy eating. Conducting screening camps at these community congregation centres at regular intervals can help awareness about diabetes spread quickly. The objective to mitigate diabetes risk through lifestyle changes, physical activity, and regular health screening is aimed at reducing the burden of NCDs on health infrastructure and human resources. The amount that can be saved from the health budget will be available for better utilisation in improving basic healthcare services.