Diabetes is rapidly escalating into a critical public health crisis throughout South Asia, with India standing out as a major hotspot. The International Diabetes Federation (IDF) reports that diabetes currently impacts 77 million adults in India. This figure is expected to rise, driven by lifestyle changes, an ageing population, and deteriorating environmental conditions. Health experts are raising alarms as the epidemic intensifies due to rising pollution levels, further straining healthcare systems and escalating costs.

Dr. Sachin Kumar Jain, Professor and Head of Endocrinology at Amrita Hospital, Faridabad, stated, "Diabetes remains a significant health crisis in India, currently impacting over 77 million adults, as noted in the IDF's 2023 report." The World Health Organisation supports recent research in The Lancet Diabetes & Endocrinology that underscores the crucial role of regular blood glucose monitoring and timely interventions in averting severe complications. As winter approaches, the increase in smog and pollution levels poses significant health risks, particularly for diabetic patients, as it worsens insulin resistance and inflammation. Effectively managing diabetes requires continuous commitment throughout the year, transcending seasonal focus.

Pollution and diabetes present a perilous intersection that poses significant health risks. As environmental contaminants continue to rise, so too does the prevalence of diabetes, raising urgent concerns for public health officials and communities alike.

A mounting collection of scientific evidence underscores the connection between pollution and diabetes. Environmental Health Perspectives recently published a study that reveals a concerning link between urban smog pollutants and their detrimental effects on diabetic individuals. The research highlights that these pollutants exacerbate insulin resistance and elevate oxidative stress, raising alarms about public health in densely populated areas. During the winter months, environmental stressors intensify significantly, with smog and pollution peaking across South Asia. The World Health Organization (WHO) has highlighted the significant dangers that pollution presents for individuals with diabetes. It warns of potential increases in inflammation, reduced glycaemic control, and elevated risks of cardiovascular complications.

"In India, the prevalence of diabetes is alarming, with one in every eleven adults affected," stated Dr. Jain. "The National Family Health Survey (NFHS-5) and WHO have issued a stark warning regarding the rising prevalence of diabetes among all demographics." Recent studies published in Diabetes Care highlight a concerning trend: rising air pollution and smog in urban environments are exacerbating health risks through heightened inflammation and oxidative stress. Emphasising the importance of early diagnosis, effective lifestyle management, and stringent air quality measures holds the potential to significantly impact public health and save lives.

Healthcare costs in South Asia are on the rise, prompting concerns among citizens and policymakers alike. This trend poses significant challenges to the region's economic stability and public health systems.

The economic impact of diabetes in South Asia is significant. The World Bank reports a concerning trend in healthcare expenses linked to diabetes, highlighting a sharp rise in costs fueled by a surge in complications, including cardiovascular disease, kidney failure, and vision loss. The Israeli Defence Forces (IDF) have disclosed that healthcare costs associated with diabetes rank among the highest in low- and middle-income nations, highlighting the ongoing difficulties in accessing quality medical care in these regions. A significant number of undiagnosed cases exacerbate the situation. According to the WHO, millions of individuals in India are unaware of their diabetic condition, often discovering it only after serious complications arise.

"Recent research published in the Journal of Clinical Endocrinology & Metabolism reveals that unmanaged or undiagnosed diabetes significantly heightens the risk of cardiovascular complications," stated Dr. Jain. The World Health Organisation has issued a warning about the alarming number of undiagnosed cases in India, often detected only after significant progression of complications. Recent studies indicate that increased smog and air pollution levels significantly contribute to inflammation, deteriorate glycaemic control, and elevate cardiovascular risks among individuals with diabetes. Managing diabetes extends beyond merely regulating sugar levels; it encompasses safeguarding overall health amidst a complex landscape.

Understanding Impacts is Crucial for Diabetes Management during Winters 

As winter descends, individuals managing diabetes face a distinct set of challenges that require careful attention and adaptation. Colder weather and heightened pollution exposure in densely populated areas are leading to an alarming rise in blood sugar levels, while reduced physical activity is becoming a concerning trend. The European Journal of Endocrinology recently published a study that reveals a concerning link between winter inactivity and increased diabetes risks, suggesting that sedentary behaviour during colder months may elevate the likelihood of complications for those living with diabetes by as much as 15%.

According to Dr. Jain, the winter months frequently result in reduced physical activity and a heightened risk for individuals managing diabetes. A recent study from 2023 reveals a concerning link between inactivity during the colder months and a significant increase in diabetes risks. The winter months present diabetic patients with intensified challenges as pollution levels continue to rise. The worsening of glycaemic control and the triggering of inflammation present significant hurdles for those managing diabetes. The World Health Organization's recent warnings regarding air pollution underscore the critical need for individuals to remain active, closely monitor their health, and take proactive measures to safeguard themselves from environmental threats. Effective diabetes care in these circumstances requires a comprehensive and attentive approach.

Urgent Need for Holistic Diabetes Care

Recognized as India's largest private multispecialty hospital, Amrita Hospital in Faridabad stands out as a prominent leader in diabetes care, amidst escalating challenges. Established in 2022, the hospital boasts a comprehensive array of resources, featuring a 2,600-bed facility and a 150-seat MBBS program dedicated to cultivating the future of healthcare professionals. The hospital stands out with its advanced departments and unwavering commitment to medical education, offering essential support for diabetes patients in the region.

With diabetes rates on the rise, experts emphasize the urgency of both preventive measures and comprehensive care strategies. The WHO has launched the Global Diabetes Compact as a crucial initiative to empower countries in confronting the growing diabetes epidemic. This program emphasizes the importance of early diagnosis, ensuring accessible treatment, and encouraging healthy lifestyles to reduce the disease's impact on populations worldwide. As pollution levels soar and sedentary lifestyles become more prevalent, South Asia faces a critical challenge in combating diabetes. Addressing this escalating epidemic demands a unified response, ongoing public health initiatives, and heightened investment in healthcare to mitigate its profound effects.