India is the diabetes capital of world with estimated 72 million cases of diabetes. Around 8 - 10% of adults Indians have diabetes. Diabetes is a chronic but largely preventable non-communicable disease. Diabetes is the leading cause of debilitating complications like kidney failure, blindness, heart attack, stroke, lower limb amputations etc. With over 77 million, India records the second largest number of people living with diabetes worldwide and the figures keep increasing every year. To fight this condition there is a need to make people aware about the right precautions to control the risk of diabetes. To describe the possible reasons behind the growing cases of diabetes in the past decade, the need to know various ways to manage diabetes, necessary precautions for a diabetic and ways to prevent the risk of diabetes, we spoke to different experts. Here are some details, expert opinion and insights from Dr. Phulrenu Chauhan (Consultant Endocrinology) and Dr. Mahesh. D. M (Consultant Endocrinology).
Diabetes: Why diabetes cases are on a rise? What the most pressing causes?
Dr. Phulrenu Chauhan explains, "Indian genetic composition is such that one is inherently more at risk for diabetes. On background of this risk there lot of unhealthy life style factors have emerged particularly in last two decades. The most important of this is unhealthy food pattern such as eating unhealthy foods, over eating, over dependence on processed foods, energy drinks and fast foods. Other is the lack of activity or exercise. With busy work schedule and long commute time making time for exercise is a big task. With technology making way in day to day life, activity level of an individual has decreased dramatically. Availability of cars, lifts, online shopping etc. have decreased the time spend in activities. Also congested cities and lack of open space and availability of television and video games for children have made everyone spend more time indoors. Another factor responsible is stress which has become an integral part of daily lives. All these risk factors have caused a massive increase in number of people with diabetes in India."
Growing diabetes cases: The need to manage diabetes naturally
Dr. Mahesh. D. M explains, "In the era of globalization and changing lifestyles, no country, rich or poor is immune to the epidemic of diabetes. It is therefore important that ongoing diabetes education and medication support be accessible to all people with diabetes and their families to reduce the impact of the disease on quality of life."
"Diabetes is a chronic condition and the patient has to live with it. Hence ensuring round the clock blood sugar control is must. It is measured in by checking sugars in fasting state, 2 hours after meal and third test known as HbA1c, which is average sugar over last 3 month. In diabetes management it is important to keep all three in target range for that person. Diabetes management is important because failure to maintain blood sugar in normal range over long time causes damage to eyes, nerves, kidney, heart, foot and various other organs of the body," Dr. Phulrenu adds.
Diabetes symptoms: The need to understand early signs and symptoms and risk factors of diabetes
Early detection can help you control the complications of diabetes on time. Dr. Phulrenu shares the symptoms and risk factors associated with diabetes. "It is important to remember that diabetes is mostly asymptomatic. Means if sugars are not controlled patients won't have any symptoms but damage will continue to occur inside. Hence best way to detect diabetes is to check sugars regularly. Internationally checking once a year after age of 45 is recommended but due to the increased risk of diabetes in Indians all adults should check sugar once a year. If blood sugars are high then one may have symptoms like recurrent urination, increase thirst, increase hunger, weight loss, fatigue, lethargy, non-healing wound or even ants on urine. But these are only in severely uncontrolled diabetes.
Indians are at a higher risk for diabetes due to the genetic structure. In addition those who are overweight (BMI > 23.5) or obese (BMI > 27.5] are at a higher risk. Also, other risk factors include history of diabetes in mother during pregnancy, family history of diabetes, those having hypertension, high cholesterol levels and polycystic ovary syndrome."
Is there any significant change in the pattern of occurrence of diabetes in the past decade?
Dr. Phulrenu elaborates, "Yes, the pattern has changed. Apart from increase in incidence of diabetes there is trend towards occurrence of disease at earlier age. It is no longer a disease exclusively for greying hair but there are a significant number of patients diagnosed with diabetes are in twenties and thirties and thus of working age group. Also, previously diabetes in pregnancy (called as gestational diabetes mellitus) was relatively rare. But now almost 20-25% of pregnant patients develop diabetes.
Way to manage diabetes
Dr. Mahesh explains the various methods to manage diabetes. Managing diabetes is possible only through an active participation. Medications alone cannot yield desired benefits in the long run. Following tips are important in managing diabetes-
- Eat a balanced diet: 50% complex carbs, 30% natural healthy fat and 20% protein
- Walking or exercise for 30 min daily and a healthy BMI
- Give up alcohol and smoking
- Take medications regularly
- Keep your blood pressure and cholesterol levels under control
- Monitor your blood glucose and HbA1C (3 month average blood glucose) levels regularly
- Life is better when family supports in management of diabetes
Remember: Hence eat healthy, be active, and think positive, and never forget to check blood glucose!
(Dr. Phulrenu Chauhan Consultant Endocrinologist, Head Department of Endocrinology, P.D. Hinduja Hospital, Mumbai)
(Dr. Mahesh. D. M, Consultant – Endocrinology, Aster CMI Hospital)
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