Type 2 Diabetes

Type 2 Diabetes Diagram
Diabetes is a chronic condition that affects the body's ability to convert sugar into energy. This allows sugar (glucose) levels to build up in the blood. 

Type 2 Diabetes (T2D) is the fifth leading cause of death worldwide, and a major contributor to development of coronary heart disease, stroke, peripheral vascular disease and end-stage renal disease.  

The International Diabetes Federation reports that the number of people with T2D will escalate from 285 million to 438 million 
between 2010 and 2030 and the number of persons with impaired glucose tolerance will grow from 344 to 472 million.  

This means that by 2030, there will be over 900 million people globally with or at high risk of T2D. 

India alone has ~50 million people with T2D, more than any other nation.  Conservative estimates based on population growth, aging and rates of urbanisation show that T2D cases in India will rise to ~80 million by 2030.  T2D prevalence is currently ~9% in rural India, ~18% in urban India, and ~22% amongst Indians living in Europe (compared to ~6% among indigenous Europeans).  Similar patterns are observed among South Asians in Pakistan, Bangladesh, and Sri Lanka.  Though T2D among South Asians was considered to be more prevalent among the more affluent, recent data show that T2D rates are rapidly rising among low and middle income South Asians, who are also more susceptible to T2D complications, due to reduced access to quality health care in these settings.

Age of onset of T2D among South Asians has also been shifting towards ever-younger people.  Among South Asians in their late teens, ‘adult-onset’ T2D already manifests itself more often than ‘juvenile-onset diabetes’.  In the UK, T2D prevalence is ~14 times higher in South Asian than in European children, substantially increasing lifetime risk of complications, especially cardiovascular disease in the offspring of South Asian migrants to Europe.

The economic burden of T2D among South Asians makes this an important global clinical and public health challenge.  Economic disparities, scarcity of adequate health-care, and educational challenges present a major obstacle to reducing the burden of T2D in South Asian countries.  The economic toll of T2D is especially high among low income groups who spend 25-34% of their income on diabetes care.  Further, cost of care increases substantially with complications of T2D, or when admission to hospital, surgery, or insulin are needed.  T2D will also continue to place a heavy burden on the health expenditures of European countries to which South Asians have emigrated in large numbers, notably the UK, France, and Germany.