Rise in diabetes across J&K
A recent ICMR-INDIAB (Indian Council of Medical Research (ICMR) and the Madras Diabetes Research Foundation (MDRF)), study has revealed a concerning rise in diabetes cases across Jammu and Kashmir, with at least 7.8% of the population diagnosed with diabetes and over 10.5% considered pre-diabetes.
A similar study by the ICMR-INDIAB in the Jammu region also revealed an alarming diabetes prevalence of 18.9%, with urban areas showing a significantly higher rate of 26.5% and rural areas 14.5%. Jammu’s pre-diabetes rate is pegged at 10.8%.
This data highlights a significant diabetes burden in across Jammu and Kashmir, particularly in urban areas where the prevalence is higher than in rural areas.
Over the past decade, the growing prevalence of diabetes has become a significant concern, with an alarming rise that may lead to severe health complications. This surge, mirroring global trends but exacerbated by local socioeconomic, environmental, and cultural shifts, has turned diabetes into what experts term "the other pandemic."
The increase in Kashmir is affected by genetic, environmental, and lifestyle factors, says Dr Shariq Masoodi, Head of Endocrinology Department and Dean of Medical Faculty at SKIMS Soura.
While Kashmir traditionally had lower diabetes prevalence compared to other parts of India, recent studies show a steep rise across age, gender, and socio-economic divides. "The prevalent scenario is the same across both national and local levels, affecting approximately one among every ten individuals," he points out.
Diabetes is one of the fastest-growing health emergencies globally and a major public health concern in India, where cases are expected to increase from 74.2 million in 2021 to 124.9 million by 2045.
The scale may be much higher due to undiagnosed cases. The National Library of Medicine estimates that more than 50% of individuals with diabetes in India remain undiagnosed. IDF 2021 reports undiagnosed diabetes prevalence at 53.1%, totalling 39.4 million individuals.
Globally, diabetes cases have risen from 108 million adults in 1980 to an estimated 422 million in 2014 (WHO, 2016), reflecting a near doubling of age-standardized prevalence from 4.7% to 8.5% in the adult population.
Cause and Symptoms
Dr Masoodi explains that diabetes risk factors fall into two categories: non-modifiable and modifiable. "Non-modifiable factors, like genetics, are beyond our control," he explains.
Modifiable factors include diet (energy-dense, fat-dense, and carbohydrate-dense foods lacking fiber, antioxidants, vitamins, and protein), lack of exercise, sleep disturbances, substance abuse, and stress – all of which can trigger predisposing genes.
He emphasizes focusing on risk factors including "genetics, physical inactivity, obesity, hypertension, abnormal cholesterol/triglyceride levels, high uric acid, or a history of conditions like PCOS in women."
"Type 2 diabetes accounts for 90-95% of all cases, often developing subtly with mild symptoms like gradual weight loss, fatigue, or body aches. Less than 20% of patients experience more apparent signs like excessive urination, increased thirst, or vision changes," Dr Masoodi explains.
Obesity is a leading cause of diabetes, with studies showing strong correlation between BMI and diabetes risk. The ICMR-INDIAB study reveals that in Kashmir, 57.6% of adults are obese, 30% hypertensive, and 62.7% in Jammu suffer abdominal obesity – a trifecta of metabolic dysfunction.
Dr Shariq Masoodi notes that diabetes, once primarily urban, is now growing in rural areas due to the "rural-urban mix" where rural populations adopt urban lifestyle habits. The ICMR data also shows diabetes rates rising more rapidly in rural areas.
Studies also indicate gender-based patterns: men generally have higher diabetes prevalence, while women may experience different complications, particularly related to hormonal changes during menstrual cycles and menopause.
Treatment Facilities and Preventive Measures
With diabetes on the rise, hospitals are bursting beyond capacity. The endocrinology OPD at SKIMS sees high patient volumes, with two rooms handling at least 100 registered patients over five days, plus many unregistered. Approximately 60 have diabetes, including 10 new cases and 50 returning patients, reveals Dr Masoodi.
"More than medical care, lifestyle changes are required to combat the epidemic," he says. While medications like oral drugs, sulfonylureas, and insulin are available, he advocates for public awareness, regular screening, and disease management through weight loss, exercise, less screen time, good sleep, and stress control.
He recommends "annual screenings for high-risk individuals after age 25. Diabetes often remains asymptomatic until severe complications arise, such as kidney failure, heart attacks, vision loss, or pregnancy loss. Many patients are diagnosed only after these critical issues manifest."
Dr Masoodi explains that diabetes is a chronic condition, often misunderstood. Patients may initially manage their weight or medications but discontinue these practices, mistakenly believing they are "cured" when symptoms improve. "Both pre-diabetes and diabetes can be controlled and go into remission, but they are not medically considered fully curable," he points out.
He warns that diabetes can lead to heart disease, stroke, kidney disease, blindness, and nerve damage. "But it's important to remember that diabetes is not a death sentence. With proper management, people with diabetes can live long and healthy lives," says Dr Masoodi.
Lived-In Realities
Some diabetes patients agree with the effectiveness of change in lifestyles. A PhD scholar shared her father’s journey with battling hypertension and diabetes, explaining that her family now takes care of him by ensuring daily early morning walks and a fibre-rich diet. “It’s a tough journey,” she admits, “but we are committed to taking control of his health,”
“Unfortunately he also has heart related issues, for which doctors have recommended a pacemaker,” she adds.
Similarly, 35-year old Farah (name changed) from Sheerwani Pora Boniyar reveals, “Diabetes has changed everything for me. I have to be mindful of what I eat, monitor my blood sugar levels regularly, and ensure I stay active. It’s a lot to manage, but I try to stay positive and take one day at a time.”
For many, the diagnosis is a life-altering event that brings with it a host of challenges physical, emotional, and financial. Some, however, develop multiple complications that are beyond control.
For instance, Mohd Maqbool from Sheerwani Pora Boniyar recounts the tragic loss of his cousin to diabetes at the young age of 35, leaving behind four children. “The disease progressed rapidly in the late stage, causing severe skin damage and the appearance of large wounds on his body. This devastating experience has deeply impacted us. Adding to the family’s trauma - now even his younger brother and his wife are diagnosed with diabetes.”
For some the cost of managing diabetes is unbearable.
Sheikh Tabarat from Uri shares the experience of his cousin, “My cousin is a labourer and lives with diabetes and it has become a constant battle for him. The costs of medication and regular check-ups are overwhelming, and the fear of complications looms large. His family and he have had to make many sacrifices to manage his condition.
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