India's diabetes model offers low-cost, tech-driven solutions for developing nations, says expert
India's four decades of experience in diabetes care could serve as a blueprint for other low- and middle-income countries seeking affordable, integrated, and technology-enabled interventions, according to Dr. V. Mohan, a Chennai-based diabetologist. His article, published in the journal Diabetologia on June 23, argues that India's approach—rooted in indigenous innovations rather than copying strategies from high-income nations—provides valuable lessons in addressing the unique challenges of diabetes in South Asia.
Dr. Mohan highlights that diabetes in South Asia differs from that in other regions: people develop the condition at a lower body mass index (BMI), with more visceral fat and greater insulin resistance. This calls for region-specific screening and treatment strategies, with emphasis on lifestyle factors such as diet high in refined carbohydrates and low physical activity.
Central to his argument is the 'total diabetes care' model developed at his centre, Dr. Mohan's Diabetes Specialities Centre in Chennai. This model goes beyond blood sugar testing to address the full impact of diabetes on the body, including metabolic disorders. An integrated approach—combining screening, treatment, education, laboratory work, and eye, kidney, foot, and nutrition services—reduces fragmentation of care, repeat visits, and delays, making delivery more efficient.
To overcome specialist shortages, the programme trains physicians, diabetes educators, and technicians using task shifting, extending care beyond tertiary and secondary settings. Dr. Mohan also recommends technology for continuity of care, citing an electronic medical record platform, an AI chatbot, a patient app for appointments and results, telemedicine (especially for ophthalmology), and a physician decision-support tool for classifying diabetes subtypes.
The article notes a shift from a one-size-fits-all approach to personalised precision medicine, recognising that individuals with diabetes vary in clinical characteristics, risk of complications, and treatment responses. It also showcases the clinic's dance-based high-intensity interval training programme, THANDAV, designed to improve physical activity among girls and women.
Dr. Mohan's insights emphasise that local solutions, integrated care, and technology can make diabetes management more effective and accessible in resource-limited settings.