Why in the News?
A new series by The Lancet highlights a major shift in global health. Type 2 diabetes, which earlier affected mostly older people, is now increasing quickly among those under 40. Around 260 million young adults worldwide already have the disease.
What distinguishes early-onset type 2 diabetes from adult-onset in impact?
- Longer disease duration with increased complications: Being diagnosed at a younger age means living longer with the disease, increasing the risk of complications like kidney failure, heart disease, and nerve damage throughout life. A 25-year-old with diabetes may face multiple health issues by age 40, compared to someone diagnosed at 55.
- Greater loss in life expectancy: Individuals diagnosed before the age of 30 can lose up to 15 years of life expectancy, whereas older adults diagnosed later typically lose fewer years. A young adult may not survive past their 60s if the disease is poorly managed, while an older adult may live well into their 70s or 80s.
- More disruption to personal and economic life: Early onset affects critical life stages like education, job opportunities, and family planning, placing greater mental and financial stress. A person in their 20s may have to drop out of college or limit employment due to frequent medical care needs.
Why is early-onset diabetes a major concern for Indian health systems?
- Rising burden on already stretched public healthcare: India’s healthcare system is under pressure from both infectious and non-communicable diseases. Early-onset diabetes increases the demand for long-term care, monitoring, and medication. A 2023 ICMR study found that more than 25% of diabetes cases in India are now diagnosed before the age of 40.
- Economic impact on productivity and workforce: Early-onset diabetes reduces an individual’s healthy working years and impacts productivity, especially in labour-intensive sectors. According to the ICMR 2023 study, diabetic workers lose an average of 7–8 additional workdays annually, leading to reduced output, absenteeism, and rising employer costs.
- Greater lifetime healthcare costs and complications: Early diagnosis leads to decades-long care, including medication, check-ups, and complication management, increasing costs for families and public health insurance. Eg: A young diabetic using insulin, requiring eye and kidney screenings, adds a heavy burden on schemes like Ayushman Bharat.
How do socio-economic and environmental factors drive its rise?
- Unhealthy food environments and marketing: Easy availability and aggressive marketing of processed and sugary foods through social media influence poor dietary habits among youth. Eg: Fast food delivery apps and influencer-driven trends promote ultra-processed snacks in urban areas like Delhi and Mumbai.
- Inequality in access to healthcare and lifestyle management: Low-income groups lack access to nutritious food, safe exercise spaces, and preventive healthcare, increasing risks of obesity and diabetes. Eg: Children in urban slums of Kolkata face limited health awareness and inactivity, raising early-onset diabetes risk.
- Impact of early-life undernutrition and developmental challenges: Poor maternal nutrition, low birth weight, and childhood undernourishment raise the chance of developing type 2 diabetes later, even without obesity. Eg: In rural Madhya Pradesh, undernourished children show insulin resistance despite having a low BMI.
Why is prevention more effective than treatment in tackling this issue?
- Reduces lifelong health burden and complications: Preventing diabetes avoids decades of medication, monitoring, and risks of complications like kidney or heart disease. Eg: Promoting physical activity and healthy diets in schools can reduce diabetes risk and future hospital visits.
- More cost-effective for individuals and health systems: Prevention strategies like awareness campaigns and food policies cost less than long-term drug therapy and hospitalisation. Eg: Taxing sugar-sweetened beverages, adopted in over 100 countries, has reduced sugary drink sales and lowered obesity-related costs.
- Addresses root causes and promotes healthy behaviours: Focusing on prevention changes social and environmental conditions that lead to obesity and diabetes. Eg: Urban planning with parks, pedestrian paths, and fitness centres encourages active lifestyles, lowering diabetes risk.
Way forward:
- Strengthen preventive public health strategies: Implement nationwide programs promoting healthy eating, physical activity, and early screening in schools and communities to reduce risk factors from a young age.
- Ensure equitable access to care and awareness: Expand access to affordable diagnosis, lifestyle counselling, and essential medicines in both urban and rural areas, especially targeting low-income and high-risk groups.
Mains PYQ:
[UPSC 2022] The increase in life expectancy in the country has led to newer health challenges in the community. What are those challenges, and what steps need to be taken to meet them?
Linkage: This question directly addresses “newer health challenges” and the steps required to meet them. The need for “urgent investment in prevention, early diagnosis and targeted care” mentioned in the article directly aligns with the “steps to be taken” aspect of this question.
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