Diabetes Day 2024: Currently, India is grappling with a major health concern, it can also be called a diabetes crisis as our citizens make up a quarter of the world’s diabetes patients. According to a new report published in The Lancet, a staggering 212 million adults live with the disease in India. While we can say that our country is changing slowly, its rapid urbanization, sedentary lifestyle, and increasing consumption of processed foods have significantly contributed to this health crisis we face today. There have been many studies that show how the fast-food industry is aiding our citizens in hurting their health.

But if we talk about the global landscape of diabetes, it is equally concerning. China follows India with 148 million diabetic adults, which also highlights the significant burden of the disease in Asia. The United States, Pakistan, Indonesia, and Brazil round out the top six countries with the highest number of diabetic adults. These nations, particularly those in Asia and South America, are facing significant challenges in managing and preventing diabetes.

Challenges of the Treatment Gap of Diabetes

One of the major challenges in this crisis is the treatment gap we are facing. Globally speaking, 445 million adults above the age of 30 are deprived of proper care and in India, almost 133 million people are living without diabetes care. This means when there is a dire need for medication and treatment, many Indians will have to go without which leads to significant complications including heart disease, kidney failure, blindness and limp amputation.

There has been a dramatic surge of the disease over the past three decades and it is also four times higher than the 1990s. Professor Majid Ezzati from Imperial College London, the senior author of the study, highlighted the urgent need to address this rising burden, especially in lower income areas of Asia and Africa.

What Are Some Risk Factors?

A lot of risk factors that are associated with diabetes are lifestyle-based and can be changed with some discipline and restraint.

Type 1 diabetes is said to be caused by an autoimmune reaction in our body i.e. our body reacts to itself mistakenly. Currently, there is no way to prevent type one diabetes but some risk factors include family history like having someone in your close family who has had it and the other risk factor is age. It can develop at any age whether it is children it is teenagers.

Risk factors for type 2 diabetes are almost the same as prediabetes. If you get a prediabetes diagnosis, you are at a higher risk of developing type 2 diabetes. You can still keep your condition in check and prevent it. The risk factors include being overweight or obese, being above the age of 45, having a family member who has had type 2 diabetes like a sibling or grandparents. Other risk factors include not being active or having any proper exercise less than 3 times a week if you have gestational diabetes or non-alcoholic fatty liver.

The risk factors for gestational diabetes which is basically diabetes while you are pregnant is if you had the same condition in your previous birth experiences or you have a baby that weighs over 9 pounds or around 4 kgs. It is also more probable when you are overweight or obese, above the age of 25 and have a family history of type 2 diabetes.

Preventive Measures You Can Take

While type 1 diabetes does not have clear preventive measures, other ones like prediabetes, type 2 diabetes, or gestational diabetes can be prevented. By incorporating regular physical activity into daily routines, adopting a healthy diet, and managing weight, individuals can make significant strides in preventing these conditions. Even small, incremental changes can yield substantial benefits for overall health and well-being.

New Delhi is witnessing a modest increase in COVID-19 cases, with 23 active infections reported as of May 22, Health Minister Dr. Pankaj Singh confirmed on Friday. Emphasizing that there is no reason to panic, Singh said all patients are currently stable. “Two to three patients are admitted to private hospitals while the others are being monitored. We will verify if these patients are residents of Delhi or from outside. The strain is similar to influenza,” he noted.

The minister also reassured the public about the state’s preparedness. “We’ve had conversations with medical superintendents. Eight senior officials are visiting hospitals daily to ensure everything is in order. Our hospitals are equipped with oxygen, oximeters, and essential medical supplies,” Singh added.

In line with this, the Delhi health department has instructed all private and government hospitals to ensure the availability of beds, oxygen, essential medicines, and vaccines. An advisory will be issued shortly to provide further guidance.

Omicron Sub-Variants Fuel Regional and Global Spike

The rise in COVID-19 cases in Delhi and other Indian states comes after a spike was observed in several Asian countries. Health authorities have attributed the increase to Omicron-related sub-variants—primarily LF.7 and NB.1.8—descendants of the JN.1 variant, which in turn evolved from the BA.2.86 (Pirola) strain.

These sub-lineages are known for their high transmissibility but relatively mild symptoms. Despite the rise, experts maintain that the current wave is manageable and no immediate threat of severe disease has been identified.

Advisory To Hospitals

In an internal order, Delhi’s health department directed all hospitals to ensure critical equipment like ventilators, BiPAP machines, and oxygen concentrators are functional. Staff are being asked to undergo refresher training, and all hospitals must report Influenza-like Illness (ILI) and Severe Acute Respiratory Illness (SARI) cases daily on the Integrated Health Information Platform (IHIP).

Additionally, 5% of ILI cases and 100% of SARI cases must undergo COVID-19 testing, in accordance with ICMR guidelines. Positive samples are to be sent to Lok Nayak Hospital for genome sequencing to detect any emerging variants.

Neighboring States And Others Also Report Mild Cases

Haryana: Two mild COVID-19 cases were reported in Gurgaon—a 62-year-old man and a 31-year-old woman who had recently travelled from Mumbai. Both are in home isolation. Meanwhile, a 28-year-old security guard from Faridabad tested positive at Delhi’s Safdarjung Hospital. None had a travel history abroad or known contact with infected persons. Health officials emphasized that these are isolated, mild cases and do not indicate a severe outbreak.

Maharashtra: The state has reported 95 new COVID-19 cases in Mumbai this month, with a total of 106 since January. At least 16 patients are hospitalized, mostly shifted to Seven Hills Hospital from KEM Hospital. Pune, although not reporting any active cases currently, has reserved 50 beds at Naidu Hospital as a precautionary step.

Tamil Nadu: In Chennai and Puducherry, health officials are seeing a shift in viral diagnosis, where fevers initially linked to influenza are now being identified as COVID-19. Public Health Director Dr. TS Selvavinayagam has urged caution in crowded places but reassured the public not to panic.

Karnataka: The state currently has 16 active COVID-19 cases, confirmed by Health Minister Dinesh Gundu Rao.

Gujarat: Seven new cases were reported in Ahmedabad in a single day—a sharp spike for a city that has averaged one case per month over the past year. All patients are in home isolation, and their samples have been sent for genomic sequencing. Officials say the infections are from the JN.1 variant and are mild in nature.

International Spike

Singapore and Hong Kong are witnessing a noticeable surge in COVID-19 cases, primarily driven by LF.7 and NB.1.8 sub-variants. Singapore’s Ministry of Health has urged citizens to get vaccinated, especially those who haven’t received their initial doses. Hong Kong has reached its highest case numbers in over a year and is encouraging mask-wearing and crowd avoidance.

What Are the Current Symptoms?

Unlike earlier variants, the current wave presents some slightly different symptoms. While cough and sore throat remain common, additional symptoms include nausea, vomiting, brain fog, and conjunctivitis. Most cases are mild, but health authorities advise individuals to monitor symptoms and seek medical attention if needed.

The U.S. Food and Drug Administration (FDA) has approved Nucala (mepolizumab) as an add-on maintenance treatment for adults with chronic obstructive pulmonary disease (COPD) that remains inadequately controlled despite existing therapies. The approval offers new hope to patients whose symptoms persist despite being on inhaled triple therapy.

What is COPD?

According to the World Health Organization (WHO), COPD is a common, preventable, and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation due to airway and/or alveolar abnormalities. It typically results from significant exposure to noxious particles or gases.

Symptoms of COPD include:

• Chronic cough
• Shortness of breath
• Wheezing
• Chest tightness
• Excess mucus production

Causes of COPD range from long-term smoking and air pollution exposure to occupational dusts and fumes. Genetics and respiratory infections in early life can also contribute.

COPD is progressive and often worsens over time, severely impacting quality of life. One of the most critical challenges in managing the condition is reducing exacerbations—flare-ups that may require hospitalization or emergency treatment.

Why Nucala Matters

Nucala is the only approved biologic that has been specifically studied in COPD patients with an eosinophilic phenotype defined by a blood eosinophil count (BEC) of ≥150 cells/μL. This is important because up to 70% of U.S. COPD patients who are not adequately managed on inhaled triple therapy fall into this category.

Biologics like Nucala work by targeting specific pathways in the immune system. Mepolizumab, the active ingredient in Nucala, is an anti-IL-5 monoclonal antibody that reduces eosinophilic inflammation—a key contributor to COPD exacerbations in certain patients.

Clinical Trial Evidence

The FDA’s approval of Nucala is based on results from two large Phase 3 clinical trials, MATINEE and METREX, which evaluated its use alongside optimal inhaled therapy. Both were randomized, double-blind, and placebo-controlled.

In the MATINEE trial, involving 804 patients with a BEC ≥300 cells/μL, Nucala showed:

A significant reduction in moderate or severe exacerbations: 0.80 vs 1.01 events/year (rate ratio, 0.79).

A 35% decrease in emergency visits or hospitalizations for COPD exacerbations (rate ratio, 0.65).

The METREX trial produced similar outcomes. Patients on Nucala had:

Fewer moderate or severe exacerbations: 1.40 vs 1.71 events/year (rate ratio, 0.82).

Adverse events were comparable between the Nucala and placebo groups, suggesting a favorable safety profile.

A New Era for COPD Management

“COPD isn't just a disease, it's a relentless cycle,” said Dr. Jean Wright, CEO of the COPD Foundation. “Even with current therapies, managing exacerbations remains a daily battle. Biologics like mepolizumab offer new hope.”

The FDA approval was granted to GSK, the pharmaceutical company that developed Nucala. With this decision, clinicians now have a novel option for patients with eosinophilic COPD who are still struggling despite standard treatment.

While in the cases of listeria and other food-related diseases, products are recalled. In another news, supermarket chain Publix has issued a recall for its Greenwise Pear, Kiwi, Spinach & Pea Baby Food pouches after routine product testing detected elevated levels of lead, federal health officials announced. The affected items were sold across eight states in more than 1,400 Publix stores.

What Prompted the Recall?

The 4-ounce baby food pouches, manufactured by Bowman Andros—a French company with a production facility in Mount Jackson, Virginia—were voluntarily recalled by Publix on May 9. However, the recall wasn’t listed on the U.S. Food and Drug Administration (FDA) website until late Thursday.

Testing by North Carolina officials—the same team that first discovered a widespread 2023 lead contamination in applesauce pouches—detected 13.4 parts per billion (ppb) of lead in the product. This exceeds the FDA's recommended limit of 10 ppb for food consumed by infants and young children.

No Reported Illnesses Yet

While no health issues have been reported in connection with this product, Publix has removed all possibly contaminated pouches from store shelves. Customers are encouraged to return them for a full refund.

This is the second recall in two months involving baby food pouches due to lead contamination. In March, Target recalled over 25,000 units of its Good & Gather Baby Pea, Zucchini, Kale & Thyme Vegetable Puree for the same reason.

A Wider Concern

North Carolina continues to partner with the FDA to conduct routine food safety testing. The state played a key role in the 2023 lead poisoning investigation involving WanaBana Apple Cinnamon Fruit Puree, which was linked to over 500 cases of illness across 44 states. Those pouches contained lead levels up to 2,000 times the FDA’s safety limit and were found to contain chromium as well.

The Centers for Disease Control and Prevention (CDC) led the response during that outbreak, identifying 566 confirmed, probable, or suspected cases. However, the CDC’s childhood lead poisoning prevention program was cut in April during federal budget reductions under the Trump administration. A CDC spokesperson confirmed the agency is aware of the Publix recall but has not been asked to investigate.

Why Lead Is Dangerous

According to the CDC, no level of lead exposure is safe, especially for children. Lead can cause serious neurological and developmental damage, including learning disabilities and delayed growth.

The American Academy of Pediatrics notes that heavy metals like lead can enter food through soil, water, air, or industrial contamination, making rigorous safety checks critical for baby food products.

Recently, to ensure that baby foods are produced ensuring the safety procedures, the US Department of Health and Human Services (HHS) and the US Food and Drug Administration (FDA) have now begun a comprehensive review of the nutritional value of infant formula. This program by the agencies is dubbed as Operation Stork Speed.

This operation aims to review the nutrient content of infant formula. How will it be done? The agencies will increase testing for heavy metals and contaminants in the formula. The agencies will also encourage companies to develop new formulas, and clarify ways to better inform consumers about their ingredients.

The individual nutrient requirements for infant formula are already reviewed at regular intervals, however, this will be the first comprehensive review since 1998.

As part of Operation Stork Speed, the FDA has issued a Request for Information (RFI) to solicit public input on the nutritional composition of infant formula.