According to World Health Organization diabetes is now the most pressing health priority globally. High Blood glucose is third leading factor affecting premature mortality after tobacco use and high blood pressure. The risk of premature death among diabetic people is double the risk than the non-diabetic population.

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Diabetic Scenario

It is estimated that 7.8% adults in India has diabetes in 2015. Many people of these with diabetes are unware of the ongoing disease. Even people who are aware of their status does not have access to the regular treatment due various reasons like affordability, availability or awareness about the requirement for the adherence treatment. Diabetes has tendency to create severe complications like blindness, loss of limbs and kidney failure. High blood sugar, which not reached to a level of diabetes threshold can increase the risk of strokes, heart diseases and other complications. The rising prevalence of non-communicable diseases and diabetes is driven by combination of factors like unhealthy diet, sedentary lifestyle, rapid urbanization and increasing life expectancy. Large population with diabetes are preventable. Emphasis to promote healthy diet and physical activity delays type 2 diabetes among people at high risk. Maintain normal body weight, eating healthy diet and regular physical activity can reduce the chances of having diabetes. 

Diabetes in India

60 million people out of total population India are suffering from Diabetes. Awareness about diabetes status varies from state and region. Nearly 900 thousand annual death are indirectly or directly attributed to diabetes. Type 1 diabetes is not common, though 542 thousand children aged up 14 years had type 1 diabetes in 2015 globally. India had around 70 thousand children affected by diabetes second largest number after United States. India also rank highest among list of top 10 countries with 36.5 million with disability of glucose tolerance. According to partial result available from ICMR-INDIAB study reveals there is large inter states variance in the diabetic ranging from 4.3% in Bihar to 13.6% in Chandigarh.

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Healthcare System India

India has always been in the front lines to fight against the NCD’s with the deployment of NCDs few years back. There is high recognition to tackle the situation of diabetes epidemic. This has been reflected in new draft national health policy, which is intended to reduce premature death from cancer, diseases, cardiovascular and chronic respiratory disease by 25% by 2025.

The Government of India has initiated national program for prevention and control of cancer, diabetes, cardiovascular diseases and stroke in the year 2009-2010. By the end of 2015 year, the program covered more than 350 districts in India. NPCDCS conceive a primary care method to tackle NCDs and also boarder line the required manpower at different level. NCD cells have been established with required manpower, which was recommended at state, district and national level. NCD clinics are also available to deal with patients that are visiting community health centers, government hospitals and district hospitals. In the 12^th five-year plan, it is said that NCD clinics should be established in each CHC in the country.

Medical Nutrition Therapy

MNT is the most important in preventing diabetes, slowing the rate of diabetes, managing existing diabetes and rate of development of diabetes related complication.

1.         Life style change, which include behavior modification, nutritional education, reduced calorie and fat intake, reducing over weight and physical activity.
2.         Daily fiber intake of 20-35 g/ 1,000 kcals.
3.           Saturated fat intake of <7% of total minimal, calories, cholesterol and trans-fat of <200 mg per day for individual with plus carbohydrate, diabetes and monitoring to regulate blood glucose.
4.        Normal Dietary protein intake around 20% of energy and neglecting of high protein weight loss diets and micronutrient supplement for specific deficiencies.
5.        Limiting daily intake of alcohol.