NATIONAL DIABETES CONTROL PROGRAMME

Diabetes is a chronic disease caused by inherited and /or acquired deficiency in production of insulin by the pancreas or in its effects. As a result of this there is increased concentration of glucose in the blood. In one form, the pancreas fails to produce the insulin that is essential for survival. However, noninsulin-dependent diabetes is much more common. This form of diabetes occurs principally in adults and results from the body's inability to respond properly to the action of insulin. Malnutrition-related diabetes has also been described from some developing countries, like India.

Burden of Disease

The worldwide prevalence of diabetes is 4% (1995) which will be 5.4% in 2025. Prevalence in most Western communities is estimated as 2% - 5%. It is now known that some developing countries it may reach 10% or even 20%. Indian studies showed prevalence of diabetes mellitus ranging from 2.1% in New Delhi to 12.4% in Kerala and rural areas showed lower rates. Over a period of time it seems that the prevalence has increased because it was 2.1% in 1972 and 12.1% in 2001 (Pradeep et al. 2002, Dwivedi & Krishna 1999). In Southern India studies showed a 40% increased in prevalence over a period of 6 years (Ramachandran 1997). As diabetes is a chronic disease and need life long treatment causing economic burden on patients and family. The most important aspect of diabetes is occurrence of complications that increases the cost of management. Heart disease in diabetes is 21.4%, neuropathy 17.5%, peripheral vascular disease 6.3%-30% (Bal 2002) Retinopathy 19.0%, and Microalbumina 26.3% (Pradeep 2002). A diabetic patient spent Rs. 4510 per year and for foot care the cost increase to Rs. 7200 per year (Sobhana 2000,2001).

Programme

Based on these alarming figures Government of India started National Diabetes Control Programme on pilot basis during 7th Five year plan in 1987 in some districts of Tamil Nadu, J & K and Karnataka, but due to paucity of funds in subsequent years this programme could not be expanded further in remaining years. However, a sum of 12 lakh during 1995096 were allocated for the programme. In 1997-98 an allocation of one crore was made.

Objectives

1. Prevention of diabetes through identification of high risk subjects and early intervention in the form of health education;
2. Early diagnosis of disease and appropriate treatment morbidity and mortality with reference to high risk group;
3. Prevention of acute and chronic metabolic, cardiovascular, renal and ocular complication of the disease;
4. Provision of equal opportunity for physical attainment and scholastic achievement for the diabetic patients; and
5. Rehabilitation of those partially or totally handicapped diabetes people.