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CHENNAI: If anything, the International Diabetes Federation's (IDF) Diabetes Atlas released early December in South Africa, only confirms what we already know: India has the largest number of people living with diabetes.

It is in the pre-diabetic phase, Impaired Glucose Tolerance, that China overtakes India, both in the prevalence and projections.

The Atlas, third in a series that began in 2000, begins with the preamble: "With the forces of globalisation and industrialisation proceeding at an increasing rate, the prevalence of diabetes is predicted to increase dramatically over the next few decades. The resulting burden of complications and premature mortality will continue to present itself as a major and growing public health problem for most countries."

The IDF has worked on the Atlas, hoping to create an impact on the public health policy of various governments across the world, advising them to factor diabetes into their plans, according to A. Ramachandran, Director, Diabetes Research Centre and M.V. Hospital for Diabetes, Chennai.

Dr. Ramachandran, who also served on the Atlas Committee where his research has been extensively quoted, says, "we need to push the cause of fighting diabetes with governments. We believe that politicians are convinced by numbers and the Atlas serves to provide the figures to convince them."

According to the publication, India has 40.9 million people with diabetes in India, and China follows right behind at 39.8 million diabetics.

As for the projections in 2025, India will still top the list, with 69.9 million diabetics but it is estimated that China will meanwhile put some distance between itself and India. China will have 59.3 million diabetics in 2025, the Atlas says.

However, the Atlas throws up figures that put China ahead of India in the pre-diabetic stage defined as Impaired Glucose Tolerance (IGT), again associated with insulin resistance.

In fact, China is currently way ahead of the rest of the world, with 64.3 million people with IGT, and will continue to be in 2025, according to the Atlas, with 79.1 million IGTs. India follows with a current prevalence of 35.9 million persons and a projected total of 56.2 million people in 2025.

Other key inputs in the Atlas are the extensive chapters on diabetes-related complications and cost assessments. "In virtually every developed society, diabetes is ranked among the leading causes of blindness, renal failure and lower limb amputation. Through its effects on cardiovascular disease, it is also one of the leading causes of death."

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