Contemporary Approaches to Diagnosis and Management of Chronic Diseases

Abstract

Chronic non-communicable diseases (NCDs), principally cardiovascular disease, diabetes, chronic respiratory disease, cancer and chronic kidney disease, account for about three-quarters of deaths worldwide, and their burden is rising fastest in low- and middle-income countries such as India. Many people live with several chronic conditions at once, which complicates care and increases costs. This review summarises contemporary approaches to diagnosing and managing major chronic diseases. Diagnosis is shifting towards earlier detection through risk-based screening, validated risk scores, simple point-of-care tests such as glycated haemoglobin and urine albumin-to-creatinine ratio, improved imaging and, increasingly, digital tools and artificial intelligence. Management has been transformed by new therapies with benefits beyond their primary targets: sodium–glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists reduce cardiovascular and kidney events in people with type 2 diabetes, and SGLT2 inhibitors are now recommended in heart failure and chronic kidney disease regardless of diabetes. Single-pill combinations improve blood pressure control, intensive lipid lowering reduces cardiovascular events, and incretin-based therapies achieve substantial weight loss in obesity. Guidelines now emphasise individualised targets, organ protection and patient-centred care. Across conditions, effective management depends on lifestyle modification, self-management support, team-based and integrated primary care, telemedicine and remote monitoring, and attention to multimorbidity and social determinants of health. Major challenges include late diagnosis, poor treatment adherence, the cost and availability of new medicines, and fragmented health systems. Strengthening primary care, task-sharing, digital health and population-level prevention will be essential to reduce the burden of chronic disease.