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610 Primary Prevention of Type 2 Diabetes Make In India

sions on lifestyle factors and relaxation breathing risk of developing T2D. These studies have shown
techniques brought about improvement in health the feasibility of preventing diabetes with LSM and/
seeking behavior. In 7 months period, the interven- or by use of metformin. LSM is found to be practi-
tion helped to reduce blood glucose levels in indi- cal and safe. In order to translate the research find-
viduals with prediabetes and diabetes. It was also ings at national level, support of the government,
encouraging to note that the intervention improved non-governmental agencies, research organizations
dietary intake, and obesity parameters. This study such as American Diabetes Association (ADA), IDF,
showed that even short term health education had WHO and World Diabetes Foundation (WDF) are re-
preventive effects on youth as well as adults. quired. Use of telemedicine, mHealth and training of
lay health educators and community health workers
Several community based diabetes prevention and has to be taken up on a large scale. There is also an
management programmes have been initiated in In- urgent need for help from funding agencies such as
dia both in urban and rural setting.
the WDF and IDF to encourage these translational
A large medical education programme for children research projects.
and adolescents conducted by the Diabetes Foun-
dation of India, focused on primary prevention with Highlights
the aim of creating awareness about diabetes, obe- India has a high prevalence of type 2 diabetes (T2D)
sity, lipid disorders and heart diseases. The MARG and prediabetes.
(Path) programme was funded by the World Diabe-
tes Foundation, Denmark. This programme reached Several Indian Primary Prevention Programmes have
large numbers of children, parents and teachers in 3 demonstrated that T2D is preventable in people with
cities in Northern India over a period of 3 years. At high risk for diabetes.
baseline, the knowledge on health care and health
seeking behavior was poor and following the inter- Despite having several biological characteristics, Indi-
vention, scores improved even in the children. ans respond well to lifestyle modification (LSM).
Education of the public on healthy living habits has
Challenges shown rewarding results.
Several challenges and barriers exist in the imple- Use of mHealth and other mass media programmes
mentation of prevention programmes. These include are promising in large scale management of diabetes
economic constraints, socio-cultural problems, poor and also in conducting preventional studies.
health seeking behavior, screening for high risk
population and lack of knowledge and skills. Sever-
al patient related barriers, societal barriers related to Acknowledgement
diabetes management and barriers related to medical We acknowledge Mrs. Mary Simon for helping in
profession have been identified. The Indian studies preparation of the chapter and Mrs. L.Vijaya for sec-
have also shown methods to face these challenges retarial assistance.
and have set examples for developing countries to
carry out similar programmes. A mismatch of national References
health care budget and health care burden, especially 1. IDF Diabetes Atlas, 7th ed. International Diabetes Federation, 2015. www.
due to the epidemic of non- communicable diseases idf.org/diabetes atlas
poses a huge challenge to the country. 2. Nanditha A, Ma RC, Ramachandran A, Snehalatha C, Chan JC, Chia KS,
Shaw JE, Zimmet PZ. Diabetes in Asia and the Pacific: Implications for
To promote primary prevention of diabetes, there is the Global Epidemic.Diabetes Care. 2016;39:472-85.
a need to improve nutrition and enhance physical
activity. These require major behavioral changes in 3. Ramachandran A, Snehalatha C, Samith A Shetty, Nanditha A. Primary
Prevention Trials in Type 2 Diabetes. Chapter-4 Global Health Perspectives
the community and several hurdles including social, in prediabetes and Diabetes Prevention. Editor. Michael Bergman. World
political, economic and administrative in nature have Scientific Publication. 2014; P.No. 49 – 74.
to be overcome to achieve the goals. 4. Ranjani H, Weber MB, Venkat Narayan KM, Mohan V. Real life diabetes
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Conclusion prediabetes and Diabetes Prevention. Editor. Michael Bergman. World
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Primary prevention of diabetes is of paramount im-
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The Indian Diabetes Prevention Programme shows that lifestyle modifica-
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GCDC 2017