Lok Sabha Question No. 3054 (UNSTARRED), answered on 2019-12-06
Subject: Diabetes
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Prathap Simha

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUEST ION NO. 3054 TO BE ANSWERED ON 6 TH DECEMBER, 2019

## DIABETES

## 3054. SHRI PRATHAP SIMHA:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a)  whether  the  number  of  cases  of  diabetes  including  juvenile  diabetes  is  on  the  ris country;
- (b) if so, the details thereof and if not, the reasons therefor indicating the number diabetes and juvenil diabetes detected during each of the last three years and the current State/UT - wise;
- (c) whether the Government has conducted any study/survey in this regard, if so, the det the outcome thereof; and
- (d)  the action  plan  drawn  by  the  Government  for  prevention,  early  detection  and  afforda treatment of diabetes including juvenile diabetes along with the funds allocated and uti the purpose during the above said period, State/UTwise?

## ANSWER THE MINIST ER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI ASHWINI KUMAR CHOUBEY)

(a)  to  (c): As  informed  by  Indian  Council  of  Medical  Research  (ICMR),  ICMR -INDIAB Study estimated 62.4 million people with diabetes (> 20 years of age) in 2011 and 73 million are projected to have Diabetes in 2018. From this study, data in respect of 15 States published, details of which are at Annexure - I .

The  Government  of  India  with  the  support  from  UNICEF  has  conducted  the  f irst  ever Comprehensive National Nutrition Survey (CNNS) during the year 2016 to 2018 in 30 State As  per  survey  report,  the  prevalence  of  diabetes  was  low  among  both  children  (1.2%) adolescents  (0.7%).  However,  10.3%  of  school - age  children  (5 - 9  year s)  and  10.4%  of adolescents  (10 - 9  years)  were    found  as  pre - diabetic  based  on  fasting  plasma  glucose  and HbA1c levels in the blood.

(d): Public  health  and  hospitals  is  a  state  subject .  The  Central  Government  however supplements  the  efforts  of  the  State Governments.  National  Programme  for  Prevention  and Control  of  Cancer,  Diabetes,  Cardiovascular  Diseases  and  Stroke  (NPCDCS)  is  bein implemented under National Health Mission (NHM), with focus on strengthening infrastructu human  resource  development,  h ealth  promotion  &  awareness  generation,  early  diagnosis, management and referral to an appropriate level institution for treatment.

To tackle the challenge of Non Communicable Diseases (NCD), including diabetes, 59 NCD Clinics at District level and 3,274 NCD Clinics at Community Health Centre level have been set up under the NPCDCS.

A  population  level  initiative  of  prevention,  control  and  screening  for  common  N (diabetes, hypertension and common cancers viz. oral, breast and cervical cancer) ha s also been rolled out under NHM, as a part of comprehensive primary health care. Under this initi frontline health workers such as Accredited Social Health Activists(ASHA) and Auxiliary N Midwives(ANM), inter alia, are leveraged to carry out scr eening and generate awareness about the  risk  factors  of  NCDs  including  diabetes  among  the  masses.  The  initiative  is implementation in over 215 districts across the country. Screening for common NCDs including diabetes is also an integral part of serv ice delivery under Ayushman Bharat -Health and Wellness Centres.

Under NHM, support is provided to States/UTs through their Programme Implementation Plans(PIPs) for primary and secondary health care needs. State/UT - wise details of approval under PIP and Utilization under NPCDCS during the year 2017 - 18 to 2019 - 20 is at Annexure - II .

The treatment in Government Hospitals is either free or highl y subsidized for the poor and needy. Under National Health Mission, essential drugs and diagnostics are provided fre cost in public health facilities.

Quality generic medicines are being made available at affordable prices to all, under 'Jan Aushadhi Scheme', in collaboration with the State Governments. Also, 169 AMRIT (Affordable Medicines  and  Reliable  Implants  for  Treatment)  stores  have  been  set  up  in  hospitals, essential life - saving medicines including for diabetes are being provided at a subs tantial discount vis - à- vis the Maximum Retail Price.

## ANNEXURE - I

| S.NO   | STATE/UT          | PREVALENCE OF DIABETES (%)   | PREVALENCE OF DIABETES (%)   | PREVALENCE OF DIABETES (%)   |
|--------|-------------------|------------------------------|------------------------------|------------------------------|
| S.NO   | STATE/UT          | RURAL                        | URBAN                        | OVERALL                      |
| 1.     | Andhra Pradesh    | 6.3                          | 12.6                         | 8.4                          |
| 2.     | Arunachal Pradesh | 4.9                          | 5.8                          | 5.1                          |
| 3.     | Assam             | 4.4                          | 12.4                         | 5.5                          |
| 4.     | Bihar             | 3.5                          | 10.8                         | 4.3                          |
| 5.     | Chandigarh(UT)    | 8.3                          | 14.2                         | 13.6                         |
| 6.     | Gujarat           | 5.1                          | 9.8                          | 7.1                          |
| 7.     | Jharkhand         | 3.0                          | 13.5                         | 5.3                          |
| 8.     | Karnataka         | 5.6                          | 11.1                         | 7.7                          |
| 9.     | Maharashtra       | 6.5                          | 10.9                         | 8.4                          |
| 10.    | Manipur           | 4.4                          | 7.1                          | 5.1                          |
| 11.    | Meghalaya         | 3.5                          | 8.9                          | 4.5                          |
| 12.    | Mizoram           | 3.6                          | 7.9                          | 5.8                          |
| 13.    | Punjab            | 8.7                          | 12.0                         | 10.0                         |
| 14.    | Tamil Nadu        | 7.8                          | 13.7                         | 10.4                         |
| 15.    | Tripura           | 7.2                          | 15.5                         | 9.4                          |

## State/UT - wise details of approval under PIP and Utilization under NPCDCS during the year 2017- 18 to 2019 - 20.

(Rs. in Lakhs)

| S.No.                    | State                     | 2017-18        | 2017-18     | 2018-19        | 2018-19     | 2019-20( upto 30.09.2019)   | 2019-20( upto 30.09.2019)   |
|--------------------------|---------------------------|----------------|-------------|----------------|-------------|-----------------------------|-----------------------------|
| A. High                  | Focus States              | SPIP Approvals | Expenditure | SPIP Approvals | Expenditure | SPIP Approvals              | Expenditure                 |
| 1                        | Bihar                     | 532.31         | 75.69       | 1028.83        | 307.69      | 741.37                      | 59.49                       |
| 2                        | Chattisgarh               | 427.23         | 702.14      | 479.01         | 331.03      | 486.34                      | 81.59                       |
| 3                        | Himachal Pradesh          | 429.07         | 160.69      | 236.28         | 184.62      | 304.00                      | 24.80                       |
| 4                        | Jammu & Kashmir           | 594.07         | 280.09      | 460.61         | 285.26      | 573.17                      | 24.55                       |
| 5                        | Jharkhand                 | 901.78         | 109.35      | 465.33         | 96.98       | 569.78                      | 18.72                       |
| 6                        | Madhya Pradesh            | 178.05         | 136.04      | 399.06         | 142.53      | 530.77                      | 44.10                       |
| 7                        | Orissa                    | 366.77         | 229.28      | 2485.68        | 307.99      | 661.30                      | 143.12                      |
| 8                        | Rajasthan                 | 934.78         | 740.50      | 604.68         | 558.12      | 1983.90                     | 736.85                      |
| 9                        | Uttar Pradesh             | 3998.39        | 2252.51     | 5055.87        | 4225.22     | 5015.06                     | 1600.90                     |
| 10                       | Uttarakhand               | 123.46         | 257.11      | 64.25          | 25.61       | 323.94                      | 20.67                       |
|                          | Sub Total                 | 8485.91        | 4943.39     | 11279.59       | 6465.06     | 11189.62                    | 2754.79                     |
| B. NE States             | B. NE States              |                |             |                |             |                             |                             |
| 11                       | Arunachal Pradesh         | 654.71         | 270.52      | 521.80         | 93.45       | 327.51                      | 56.36                       |
| 12                       | Assam                     | 1080.29        | 369.04      | 1959.54        | 307.74      | 1225.22                     | 232.08                      |
| 13                       | Manipur                   | 609.04         | 94.46       | 126.02         | 93.14       | 183.92                      | 71.64                       |
| 14                       | Meghalaya                 | 90.91          | 77.08       | 123.32         | 101.98      | 30.20                       | 20.95                       |
| 15                       | Mizoram                   | 309.11         | 12.96       | 62.57          | 19.66       | 54.48                       | 14.48                       |
| 16                       | Nagaland                  | 257.57         | 43.76       | 219.80         | 176.53      | 195.04                      | 18.64                       |
| 17                       | Sikkim                    | 127.48         | 64.40       | 56.90          | 76.72       | 68.31                       | 11.38                       |
| 18                       | Tripura                   | 307.40         | 264.06      | 360.79         | 206.37      | 191.13                      | 95.04                       |
|                          | Sub Total                 | 3436.51        | 1196.29     | 3430.74        | 1075.60     | 2275.81                     | 520.58                      |
| C. Non-High Focus States | C. Non-High Focus States  |                |             |                |             |                             |                             |
| 19                       | Andhra Pradesh            | 589.67         | 1276.18     | 391.78         | 484.39      | 445.11                      | 3.20                        |
| 20                       | Goa                       | 61.92          | 24.95       | 84.70          | 59.13       | 58.10                       | 23.05                       |
| 21                       | Gujarat                   | 675.74         | 599.55      | 440.79         | 337.69      | 419.38                      | 37.91                       |
| 22                       | Haryana                   | 254.03         | 251.73      | 387.51         | 218.52      | 134.09                      | 89.59                       |
| 23                       | Karnataka                 | 1183.39        | 757.77      | 796.70         | 548.53      | 535.49                      | 158.66                      |
| 24                       | Kerala                    | 365.46         | 211.06      | 552.10         | 443.41      | 1494.70                     | 52.26                       |
| 25                       | Maharashtra               | 902.59         | 443.03      | 1651.24        | 1023.33     | 2705.78                     | 198.15                      |
| 26                       | Punjab                    | 185.06         | 90.74       | 211.40         | 103.81      | 184.45                      | 21.52                       |
| 27                       | Tamil Nadu                | 758.78         | 416.08      | 520.86         | 624.10      | 1999.58                     | 285.26                      |
| 28                       | Telangana                 | 427.00         | 375.41      | 1035.84        | 399.04      | 736.04                      | 122.84                      |
| 29                       | West Bengal               | 334.16         | 260.79      | 1191.34        | 527.44      | 901.04                      | 290.78                      |
|                          | Sub Total                 | 5737.80        | 4707.29     | 7264.26        | 4769.39     | 9613.76                     | 1283.23                     |
| D. Small States/UTs      | D. Small States/UTs       |                |             |                |             |                             |                             |
| 30                       | Andaman & Nicobar Islands | 79.52          | 28.13       | 84.55          | 54.21       | 52.00                       | 7.71                        |
| 31                       | Chandigarh                | 27.19          | 28.19       | 7.22           | 0.40        | 2.80                        | 0.67                        |
| 32                       | Dadra & Nagar Haveli      | 34.97          | 28.05       | 9.60           | 30.53       | 45.32                       | 9.29                        |
| 33                       | Daman & Diu               | 12.96          | 5.74        | 5.60           | 2.10        | 5.84                        | 3.50                        |
| 34                       | Delhi                     | 132.40         | 9.03        | 117.48         | 6.17        | 141.88                      | 5.75                        |
| 35                       | Lakshadweep               | 14.50          | 0.00        | 13.80          | 0.00        | 3.48                        | 0.40                        |
| 36                       | Puducherry                | 103.99         | 18.37       | 41.18          | 7.46        | 24.15                       | 4.93                        |
|                          | Sub Total                 | 405.53         | 117.51      | 279.43         | 100.87      | 275.47                      | 32.26                       |
| Grand Total              |                           | 18065.75       | 10964.48    | 22254.02       | 12410.93    | 23354.66                    | 4590.86                     |

1. SPIP means State Programme Implementation Plan.

Note:

2. Expenditure includes expenditure against Central Release, State share & unspent balances at the beginning of  the year. It is updated upto 30.09.2019, hence provisional.
4. The above data comprises of Non Recurring : Renovation and furnishing, furniture, computers, office equipment (fax, phone, photocopier etc.), District CCU/ICU & Cancer Care, District NCD Clinic, NCD Clinic at CHC . Recurring grant: Mobility , Miscellaneous & Contingencies, Information, Education & Communication & Training, Public Private Partnership (NGO, Civil Society, Pvt. Sector), Research & Surveillance, Integration with Ayush, Innovation/Rheumatic Heart Diseases/Rheumatic Fever Intervention.
3. The above data is provisional.