Integrated Surveillance and Monitoring Framework Could Help Combat Diabetes Globally

May 28, 2024


By Myra Patrick 

Diabetes is on the rise globally. It is especially prevalent in low- and middle-income countries like India, where over 100 million adults are living with diabetes.

The WHO Global Diabetes Compact was developed in 2021 to respond to the global rise of the disease. It set country-specific recommendations across the diabetes care continuum (for diagnosis, treatment, and control) to help countries lower their rates of diabetes. However, to report on these targets, countries must have appropriate surveillance systems in place.

In a new viewpoint article published in The Lancet Diabetes & Endocrinology  researchers from the Emory Global Diabetes Research Center, Rollins School of Public Health, and All India Institute of Medical Sciences highlight India’s diabetes surveillance and monitoring system. They discuss its current state, strengths and weaknesses, and future opportunities to strengthen surveillance of key diabetes care continuum indicators.

What They Found

India currently uses several different surveys for diabetes surveillance which differ in their data collection protocols and sampling methods. They also collect a variety of different biomarkers to determine control of diabetes and use different wording in questions that ask participants to self-report their diabetes status, both of which can make results hard to compare.

The differences between surveys have led to variation in reported numbers for diabetes care continuum indicators. The researchers suggest using the strengths of different surveys in combination with patient data obtained by other means. This, they say, will help strengthen available data and improve health outcomes.

“An integrated surveillance and monitoring framework can enhance decentralized decision-making by combining the strengths of different surveys and electronic health records,” said Nikhil Tandon, PhD, professor of endocrinology and metabolism at All India Institute of Medical Sciences and senior author on the article. “This framework, if implemented, can help state and district administrators monitor diabetes initiatives and compare progress with national and global standards.”

Why it Matters

“The challenges faced in harmonization of population-based diabetes datasets from India are emblematic of challenges faced by all countries in how they should monitor and improve diabetes care and lower morbidity and mortality,” said Jithin Sam Varghese, PhD, assistant research professor of global health at Rollins and part of the Emory Global Diabetes Research Center.

Many countries, especially low- and middle- income countries, face similar challenges to India, and would similarly benefit from the solutions the researchers propose. This approach would help track trends over time, monitor the success of diabetes screening and management interventions, and track progress toward Global Diabetes Compact targets.