The rise in diabetes cases among children in India has alarmed health experts who caution against decreasing physical activity among children, especially of the middle class.

"Diabetes in children is increasing, primarily due to increase in childhood obesity. Rapid urbanisation and economic growth create social dynamics that promote diabetes risk factors. These include over-weight, decrease in physical activity, increase in sedentary activities such as television viewing and high fat and high energy diet," says Anoop Misra, director, Department of Diabetes and Metabolic diseases, Fortis Hospitals.

According to market research firm ORG-MARG report, the sale of anti-obesity drugs in 2006-2007, prescribed by doctors, has grown by around 44 per cent compared to 2005-2006.

Health ministry figures say that there are 37.8 million cases of diabetes in India and it accounts for 1.09 lakh deaths per year.

However, the exact number of diabetes cases among children is not available. "It is a growing concern. World Health Organisation has already predicted that by 2030 India will have 80 million diabetic patients out of a world figure of 366 million and also remarked that India will be the diabetes capital of the world," says Ritu Rana, consultant, Ministry of Health and Family Welfare.

An independent study conducted by Delhi Diabetes Research Centre claims that prevalence of obesity has doubled in children in the past 15-20 years. About 85 per cent of children diagnosed with Type 2 diabetes are overweight or obese, it says.

Overweight and obesity ranges are determined by Body Mass Index, a number calculated from a child's weight and height, it adds.

Ashok Jhingan, chairman, DDRC, says, "It's a serious condition as obesity can lead to diabetes, heart disease and even heart attacks. We should start curbing this disease from the grassroot level, ie, schools."

Of the 15 schools we surveyed in Delhi, the findings show that about 18 per cent children in public schools are overweight and of these three per cent are obese, and in private schools six per cent children are overweight, he adds.

DDRC study reveals that 62 per cent children prefer eating fast food like burgers and pizzas than green vegetables, and 47 per cent children drink at least one cold drink daily.

Economic liberalisation brought a lot of western culture, which includes fast food restaurants and availability of snacks and chocolates which have increased the carbohydrate and fat intake in children, says Misra.

"Currently children of less than 10 years of age mostly suffer from Type 1 diabetes, but in children of 10-20 years, the ratio of Type 1 and Type 2 diabetes is equal. Type 2 diabetes in children, teenagers and adolescents is a serious new aspect of the epidemic and is an emerging health problem of significant proportions," he adds.

In Type 1 diabetes, cells of the pancreas produce little or no insulin (the hormone that allows glucose to enter body cells) and Type 2 diabetes arises from either an insufficient amount of insulin secretion by the pancreas or development of insulin resistance in which the cells are unable to get the glucose they need to function, Misra says.

Jhingan says the reason for increasing obesity in children is that we don't have a sporting culture and parents want their children to give more time to study than going out to play games.

Misra points out that with more families having both parents at work and less time for cooking at home, the extra disposable income is spent on eating outside.

City children are spending more time in front of television and the computer than doing physical exercise, he says.

According to an All India Institute of Medical Sciences survey, about 17 per cent of 2,000 teenagers in New Delhi are obese or overweight, which is above the global average of 15 per cent for all children.

International Diabetes Federation report says that lifestyle changes and environmental changes can result in dramatic improvements.

Governments worldwide should act now by developing national diabetes prevention plans and opportunistic screening programmes to identify those at high risk of developing the disease, says IDF.

"There is a problem, there is a remedy. Reduction in weight for those who are overweight or obese, following a regular physical activity regime, eating a well balanced diet, which should be low in fats and high in fibre and decrease in television viewing and computer usage are some of the steps to stop the spread of this disease," says Misra.

We have launched two programmes, CHETNA and MARG, to make children aware about obesity and educate them about importance of healthy diet and exercise, he says.

Jhingan, who has sent proposals to Human Resource Development Minister Arjun Singh and Education Minister of Delhi Arvinder Singh Lovely regarding the implementation of health courses in schools, says that he is still awaiting the response.

"Our own health ministry has a slogan, "Healthy Habits, Healthy Life, Healthy India," he says.