Non-communicable diseases (NCDs; including coronary heart disease and type 2 diabetes)
are rapidly increasing in India causing nearly 5.8 million deaths per year. Primary reasons for
rise in NCDs in India are nutrition and lifestyle transitions. Further, presence of higher body fat, abdominal
fat, liver and pancreatic fat and lower lean mass than whites, contribute to heightened metabolic
and cardiovascular risk in Asian Indians. Importantly, conversion from pre-diabetes to diabetes
occurs more rapidly, and reversion to normal glucose regulation with appropriate lifestyle measures
is more difficult in Asian Indians than white population. Huge number of patients with diabetes and
with complications increase morbidity, mortality and pose substantial economic burden. It is difficult,
though not impossible, to decrease pace of rapidly expanding juggernaut of NCDs in India.
Only concerted efforts from multiple stakeholders, consistently sincere efforts and intensely focused
attention from health officialdom and clear political will may help counter this increasingly difficult
challenge. Finally, all prevention and management approaches should be cost-effective, pragmatic,
and focused on children and underprivileged populations.