Healthcare outlook for 2022 with special reference to non-communicable diseases like diabetes

In 2020 and 2021 the whole world was affected very badly due to the Covid pandemic. Almost all occupations and industries were in a turmoil and ran into huge losses. However, even during these difficult times, the healthcare industry did reasonably well because of hospital admissions for Covid infections. The pharma industry also did well. As we enter 2022, notwithstanding the threat of Omicron variant, I am hopeful that this year we will see the end of the Covid pandemic once and for all, and this will lead to better health of the people.
Till 10 – 15 years ago, communicable diseases contributed to the major share of mortality and morbidity in India. Gradually, the communicable diseases were conquered one by one, but this was rapidly replaced by non-communicable diseases such as diabetes, obesity, hypertension, heart disease, cancers and mental health etc. Diabetes is a good example of non-communicable diseases (NCDs) as its prevalence can be easily monitored.
The prevalence of NCDs in general and diabetes in particular has been rising very rapidly. In the 1970s, in large metropolitan cities like Chennai, Delhi, Mumbai, Hyderabad, Bangalore etc., the prevalence of diabetes among adults was only 2%. These figures rose to become 8 – 10% in the 1980s and today, almost 25% of all adults in big cities, have diabetes. This is mainly due to obesity due to sedentary habits and consumption of junk foods with high sugars and fat content. Indeed, obesity is one of the major contributors to both diabetes and hypertension. Today, over 60% of all deaths in India are due to NCDs. It is therefore important to focus on the prevention and control of noncommunicable diseases like diabetes and hypertension and heart disease.
In the coming years, one can expect the prevalence of diabetes to rise further in villages, where, till recently, there was not much of obesity and diabetes. Lifestyle diseases like type 2 diabetes, once considered as a ‘rich man’s disease’, it is affecting the middle class and even the poor people today.
Importantly, unless diabetes is well controlled, there could be a rapid rise in blindness, kidney failure, heart attacks and strokes and also amputation of limbs. The good news is that, by controlling diabetes and hypertension, major complications like heart attack, strokes and kidney failure can be prevented.
We all know that even in the context of Covid pandemic, it is those with the comorbidities like diabetes and obesity who fared worse. India had one of the worst complications of Covid 19 in the form of mucormycosis, a deadly fungal infection affecting the nose and eyes, leading to disfiguration and even death. Mucormycosis was almost exclusively seen in people with uncontrolled diabetes.
Hence, my New Year message for everyone would be to detect diabetes early and to keep it under good control. I wish to emphasize the importance of the ABCD mantra. A- for A1c or glycosylated hemoglobin, which should be below 7% ; B for blood pressure, which should be at least below 140/90 Hg; C- for cholesterol, i.e LDL (bad) cholesterol which should be atleast less than   100mg/dl and D- for discipline, is includes eating a healthy diet, having adequate physical exercise, reducing stress, no smoking or tobacco in any form and moderation or no alcohol intake.
If this ABCD mantra is followed it will help not only to prevent diabetes related complications, but also to improve your health. It could  and also be your best safeguard against morbidity due to Covid infections in general and  including Omicron in particular.
Authored by:
Dr.V. Mohan,
M.D., FRCP (London, Edinburgh, Glasgow & Ireland), Ph.D., D.Sc.
D.Sc (Hon. Causa), FNASc, FASc, FNA, FACE, FACP, FTWAS, MACP
Awarded Padma Shri by Govt. of India
Chairman & Chief of Diabetology,
Dr. Mohan’s Diabetes Specialities Centre & Madras Diabetes Research Foundation,
Chennai, India.