Diabetes assignment: Prevalence in Aging Population in India

Question

Task: Write a diabetes assignment on the prevalence of diabetes in aging population in India.

Answer

Introduction
The public health issue that has been considered for the study is diabetes, and the focus is on the country of India. Also, for better knowledge on the subject matter, the ageing population has been considered for a more detailed range of diabetes assignment. According to Indiatoday.in (2018), the number of people being affected with diabetes in India is constantly increasing, and the numbers show that there has been a spike from 26 million in 1990 to 65 million in the year of 2016. Also, about 11.8% of the entire affected population was the ageing group, implying that the individuals were 50 years or above. It has also been estimated by the WHO (World Health Organization) by the year 2030, about 98 million people of India would be affected by type 2 diabetes (Cadiresearch.org, 2016). The pace at which it is becoming one of the fastest cause of death in the country makes it viable to conduct research.

The body of the diabetes assignmentwould focus on the significance of the issue and the underlying determinants that continues to be persistent and focus on the research outcomes that specify the clear difference between the treatment of Urban India and Rural India.Furthermore, the controversial opinion and the contextual factors that may influence or hinder public health intervention is required to be considered as well. Besides, viable recommendations would be made by focusing on the successive notion of the disease and how it makes life difficult for the ageing population. The health ministry of India has been considered as the appropriate organization for this diabetes assignment.

Significance of the Issue
It is mainly the type-2 diabetes that is found to be increasingly common among the ageing population of India because of the combined effects of increasing resistance towards insulin and an impaired pancreas. Mainly it can be said in the diabetes assignment that the older population is prone to diabetes because of their weakening organ and health structure. Also, according to Jain & Paranjape (2013), given the fact that diabetes is a progressive disease, it is evident to say that it gets more aggressive over time and can only be treated properly after the medication suggested by the healthcare professionals. The medication eventually makes it possible to control the blood glucose levels for the individual affected to be able to live a proper life without any kind of hesitance. Type 2 diabetes is a serious concern for most of the elderly population, along with the long-lasting effects of hypertension. In the similar scenario of diabetes assignment, it has been found that the chances of the rural population of India acquiring type 2 diabetes is 8.03% and the prevalence is much higher among the female population as compared to males whose prevalence is only 6.79% (Singh et al., 2017). Type 2 diabetes has been considered as a major epidemic in rural parts of India.

However, Little et al. (2017), mentions that the main reason why this disease is considered to be prevalent in rural parts is because of genetics, a shift in dietary habits and rapid changes in the lifestyle of people.

Furthermore, it has been found herein diabetes assignment that the numbers are constantly increasing in rural areas instead of urban areas. In some of the remote areas, their lack of accessibility to proper healthcare system makes it difficult for them to know about their disease more and in a much detailed manner. Also, given that about 72.2% of the Indian population resides in rural areas, it eventually makes them more vulnerable to the disease and that no proper treatment is available in the current scenario. In the case of Urban India, the prevalence rate of diabetes is almost 6% which is much lesser than that of the rural population mainly because of the demographics and the essential population distribution in both the areas. Some of the prominent factors why Urban India is affected by this disease constitute of abdominal obesity, lack of physical activity and is more viable among the rich and affluent class of the population. However, as of now, it is constantly spreading towards the middle class and lower-middle-class income groups.

Body of the Report on diabetes assignment
The Underlying Determinants, Inequalities and Inequities
Determinants
According to Hills et al. (2018), the determinants of type 2 diabetes among the ageing population of India stands because of increasing age, low education level, family history of diabetes, hypertension and obesity. These have been identified as most of the commonly cited reasons as to why type 2 diabetes continues to be such a prevalent factor in most of the Indians. However, it has been found that among the ageing population of rural India, it was age, blood cholesterol and family history of diabetes that were primarily responsible. Then in the case of Urban India, it was found that almost increasing age, obesity and again,the family history of diabetes are the key determinants. Furthermore., the low education levels in the rural population plays an integral role because most of the time, the families of affected individuals fail to understand the magnitude of the disease.

Inequalities
Diabetes has always been considered as a major complication in India, and the inequality that underlies in the cases of treatment is visible and show the difference between the functionality of the Urban areas and the Rural areas of the country. According to Kulkarni, Kulkarni & Gaiha (2019), it is the patients of the rural settings that face the maximum amount of inequalities because there is an insufficient public health care system and due to the minimum income range, these populations cannot afford the treatment in urban areas and private healthcare settings. For the ageing population, it gets more difficult due to the lack of their physicality and income range. However, in the case of urban areas, most of the population prefers to get tested and treated in private healthcare settings because of the knowledge, experience and equipment available for the consumers. Also, the awareness of most of the urban people about their family history of diseases makes the treatment procedure much easier and convenient.

Inequities
According to Tripathy & Prasad (2018), it is the cost of diabetic care that presents and inequitable picture for most of the Indians because the urban population would be able to avail it easily, while the rural population would struggle to do the same. Given that households with diabetes would be subjected to catastrophic expenditure, the condition of the rural population would be much more difficult. Also, the public healthcare system is not equipped to tackle the situation as there is barely any advancement, and there are barely any investments made in that perspective.

Point of Contention or Controversies
According to Viswanathan & Rao (2013), about 61 million people in India are affected with diabetes, and these numbers have combined the population of both the urban and rural areas. The lack of medical equipment and extensive financial burden on most of the people belonging to the rural areas are considered to be tragic and unfortunate because the health ministry has failed to undertake any proper initiative that would allow in tackling that particular issue firmly. Also, there is a much lack of awareness among the rural population of the country, and thus, it can be said in this section of diabetes assignment that the healthcare system and the health ministry failed in acquiring the motivation to enhance the knowledge of people. It is one of the instances where 41% of the affected patients have always known that diabetes is curable. The situation gets much worse in the rural areas as most of the affected individuals are not even aware of the deadly disease that is diabetes. Thus, this can be considered as a major point of controversy from the side of the health officials that they have failed in providing basic education about diabetes to all of the affected individuals.

In the words of Korytkowski (2013), the major diabetic controversy is eventually associated with the impact of uncontrolled hyperglycaemia on the situation of early diagnosis and late morbidity as well. However, the instance of uncontrollability is more prevalent in the case of the rural areas, and that is because of the lack of awareness among the majority of the population. Also, there is a lack of consideration for insulin adjustment that would make it easier for people to access all the services that are to be offered by the public health care centres. Another key controversy that has been identified herein diabetes assignment is the lack of intervention from the side of public health administration, which has further weakened the position of the marginalized community. Also, the use of Basal Bolus Insulin (BBI) regimens has been only prioritized in the private health care system, but it is not being used by the public health care due to lack of sufficient funds. Thus, it has become essential for the majority of the health ministry officials to pay attention towards the development of healthcare system so that awareness can be spread and the use of proper funds is necessary to revive the condition of the people.

What are the Contextual Factors that may Influence or Hinder Interventionsdiscussed in the diabetes assignment?
According to Sendhilkumar et al. (2017), the contextual factors that may hinder the public health interventions comprise of political, economic and socio-cultural context because all of these factors have an essential role to play in the betterment of the public healthcare system. In the case of the political scenario, it has been found in the diabetes assignment that the party or health ministry in power has not invested much in the development or advancement of treatment procedures in India. The average expenses of a diabetic patient in India cost around Rs 3000 to Rs 8000 per month and given that a significant range of population is still found in the BPL (Below Poverty Line), that population can't afford the treatment that would allow them to assure their treatment. India is extremely close to being called as the diabetic capital in the world. However, in the urban areas, where most of the people can afford the treatment that needs to be provided by the health ministry. It gets increasingly difficult for the rural population to afford that much amount of money for the treatment that they know nothing.

Secondly, the economic situation is required to be paid attention to as well because the financial condition of most of the rural families is minimum and that needs to be paid attention to subsequently. According to Unnikrishnan, Anjana & Mohan (2016), about 84 million Indians are incapable of affording the treatment procedure making it a basic necessity that the health ministry must intervene and make diabetic medicines more accessible and affordable. If the population remains unsuccessful in affording the treatment, then the public health opportunities would be hindered. In the socio-cultural context here, it has been found that the people with lower socio-economic or socio-cultural position have less accessibility to the treatment options available, mainly because of the lack of awareness that is consistent among the population. Most of the time, the young population who have been witnessing symptoms do not reveal their condition or take medications due to social stigma attached in terms of finding spouses (Viswanathan & Rao, 2013). In the case of the ageing population considered herein diabetes assignment, even they tend to ignore the disease due to financial conditions and the lack of support from family members. Thus, it gets much difficult for public health interventions to determine the intensity of the disease in everyone.

Conclusion and Recommendations
This report on diabetes assignment allowed in a better understanding of the prevalence of type 2 diabetes in India among the ageing population and the amount of work that has been done by health ministry so far in tackling the issue. It has been found that the health ministry needs to invest more in the public healthcare system of rural India and make provisions for the elderly to be able to deal with every aspect. The following recommendations mentioned in the below sections of diabetes assignment are suggested towards the Health Ministry of India:

• The ministry must ensure to garner more investment in the treatment of diabetic patients for both rural and urban areas.
• The ministry must make it prevalent to permit free testing options for the people residing in rural India.
• The health ministry must make the medicines and insulin accessible for the people of the country, especially the ones who reside in rural areas.

References
Cadiresearch.org. (2016). .Diabetes in Urban India. diabetes assignmentRetrieved from https://cadiresearch.org/topic/diabetes-indians/diabetes-urban-india#:~:text=A%206%2Dfold%20higher%20prevalence,been%20reported%20from%20South%20India.&text= Other%20studies%20show%20an%20even,diabetes%20and%2011%25%20for%20prediabetes.

Hills, A. P., Arena, R., Khunti, K., Yajnik, C. S., Jayawardena, R., Henry, C. J., ... & Misra, A. (2018). Epidemiology and determinants of type 2 diabetes in south Asia. The Lancet Diabetes & Endocrinology, 6(12), 966-978.

Indiatoday.in. (2018). Diabetes epidemic: 98 million people in India may have type 2 diabetes by 2030. Retrieved from https://www.indiatoday.in/education-today/latest-studies/story/98-million-indians-diabetes-2030-prevention-1394158-2018-11-22

Jain, A., & Paranjape, S. (2013). Prevalence of type 2 diabetes mellitus in elderly in a primary care facility: An ideal facility. Indian journal of endocrinology and metabolism, 17(Suppl1), S318.

Korytkowski, M. T. (2013). In-patient management of diabetes: controversies and guidelines. Indian journal of endocrinology and metabolism, 17(Suppl 3), S630.

Kulkarni, V. S., Kulkarni, V. S., & Gaiha, R. (2019). Persistence of Non-Communicable Diseases, Affluence and Inequality in India.

Little, M., Humphries, S., Patel, K., & Dewey, C. (2017). Decoding the type 2 diabetes epidemic in rural India. Medical anthropology, 36(2), 96-110.

Sendhilkumar, M., Tripathy, J. P., Harries, A. D., Dongre, A. R., Deepa, M., Vidyulatha, A., ... & Mohan, V. (2017). Factors associated with high stress levels in adults with diabetes mellitus attending a tertiary diabetes care center, Chennai, Tamil Nadu, India. Diabetes assignmentIndian journal of endocrinology and metabolism, 21(1), 56.

Singh, P. S., Sharma, H., Zafar, K. S., Singh, P. K., Yadav, S. K., Gautam, R. K., & Pious, T. (2017). Prevalence of type 2 diabetes mellitus in rural population of India-a study from Western Uttar Pradesh. International Journal of Research in Medical Sciences, 5(4), 1363-1367.

Tripathy, J. P., & Prasad, B. M. (2018). Cost of diabetic care in India: An inequitable picture. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 12(3), 251-255.

Unnikrishnan, R., Anjana, R. M., & Mohan, V. (2016). Diabetes mellitus and its complications in India. Nature Reviews Endocrinology, 12(6), 357.

Viswanathan, V., & Rao, V. N. (2013). Problems associated with diabetes care in India. Diabetes assignmentDiabetes Management, 3(1), 31.