India has a public health care system run by the constituent states and territories of India. Parallel to the public health sector, and more popular than it, is the private medical sector. Both urban and rural Indian households tend to use the private medical sector more frequently than the public sector. The Government of India started the National Diabetes Control Programme on a pilot basis during 7th Five year plan in 1987, but due to lack of funds in subsequent years this programme could not be expanded further in remaining years. There is another programme called National Programme on Prevention and Control of Diabetes, Cardiovascular Diseases and Stroke (NPDCS) being run by the government of India.

What happens if you need to see a doctor?
Here in major cities of India you can easily find a doctor and also a diabetologist who would guide you in diagnosis, treatment and follow-up but the condition is not so well treated in rural India, which includes smaller towns and villages. Some Doctors do not give the attention which is supposed to be given to a diabetic person and simply prescribe some medicine to control sugar levels and do not encourage regular check-ups and precautions. The scenario is changing as now medical students have to undergo their internships before getting a Medical degree. These internships are mostly in the smaller towns and villages. So even the doctors in these towns and villages get updated by the young students and together they try to spread more awareness about diabetes.

Who decides what medicines a doctor can prescribe?
The India Medical Council Regulations, under the Medical Council of India, have set rules and regulations which all the Doctors have to follow and prescribe medicine accordingly. Their most important direction is that doctors should prescribe drugs with generic names as much as possible to save costs.

Practically, what is it like to live with type 1 diabetes in India?
There is a huge diversity of income among people in India. With such a huge population, the general situation of a person living with diabetes in India varies dramatically. Factors like cost of insulin and medicines, lack of awareness, social barriers, and poverty still play a major role. It is hoped that the scenario as a whole will improve due to the proper support from not only the Government but also the NGOs working in India. The idea of seeing doctors regularly for check-ups and keeping a track of your sugar levels is still not that popular.

What about getting admitted to hospital?
There are Civil Hospitals which are controlled by and partially funded by state government and then there are AIIMS (All India Institutes of Medical Sciences) owned and controlled hospitals. These are referral hospitals with specialty facilities. Both these Government funded hospitals provide free of cost medical care for people with diabetes in India.

How does diabetes care vary throughout the country?
In India due to the huge geographical and cultural diversity, diabetes care varies throughout the country. The metro cities like Mumbai, Delhi, Chennai, Kolkata have the best of private hospitals and highly educated doctors who provide the right guidance and treatment for diabetes but the smaller towns and villages have to rely on government hospitals and clinics and the doctors who serve there. So availability of insulin, medicines, glucometers, clinics and doctors, etc. very much depends on where you reside.

Thanks to Binit Gandhi in India for supplying information for this section.

To learn more about diabetes in India, check out our interview:
Interview with Nityaasha Foundation: Type 1 diabetes in India