20 मार्च 2013

we must change diabetes to truly reform health care in India

To truly reform health care in India  we must change diabetes.

As we work to change health care in INDIA  we must recognize the need to dramatically change diabetes.   Twenty-four million Indian  have diabetes at a cost to our nation of an estimated $218 billion for diabetes and pre-diabetes, according to a series of studies recently published in various papers.  Imagine the effects diabetes will have on our health and economy in the future if we don’t take action now. The prevalence and economic burden of undiagnosed and pre-diabetes make the case for the importance of policies that promote early diagnosis and prevention.  About 50 percent of Indian with diabetes aren’t even aware they have the disease.
The numbers associated with pre-diabetes, a precursor to type 2 diabetes, are equally as staggering.  Pre-diabetes affects an estimated 57 million Indian  . The costs stem from the fact that people with the condition have higher rates of medical visits than those with normal blood-sugar levels.  They also seek medical attention more often for issues associated with diabetes, including high blood pressure and metabolic and renal complications. While the rates of undiagnosed diabetes and pre-diabetes are alarming, studies show that type 2 diabetes can be significantly prevented, or at least delayed, by losing weight through diet and regular exercise.  But, even with evidence supporting prevention, our nation isn’t allocating adequate resources.  In 2005, a study by the National Diabetes Program found that the government spent much amount  more on those with diabetes than those without the disease, and only part of that was spent on prevention and health promotion.   Early diagnosis and prevention are good places to start, but we must also take measures to improve diabetes care and management.  The first step to care improvement is to measure the quality of care being delivered in a consistent way.  A recent study (to be published) documents tremendous variability of how care quality is now being measured. Aggressive treatment is another key component of changing diabetes.  Studies show that intensive treatment to reduce blood sugar levels can delay or prevent debilitating and costly complications of diabetes, such as heart disease, stroke, blindness, kidney failure and amputation. Changing diabetes is not a simple task and requires coordination.  Strategies and activities that impact diabetes need to be aligned in order for us to succeed in the fight against this disease.  We must also look at our budget process and make adjustments to more accurately assess the long-term impact of prevention programs.  The current 10-year budget window doesn’t take into account that the value of prevention and improved treatment needs to be assessed over a longer period of time.       To truly reform health care in India  we must change diabetes.

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