One of the most common noncommunicable diseases and a major cause of morbidity and mortality affecting nearly all age groups, diabetes has reached an alarming stage in India. Ekta Srivastava, ENN, delves upon the issue as the World Diabetes Day approaches on November 14th
The International Diabetes Federation (IDF) reports that there were approximately 40 million diabetics in India in 2007, and their number is estimated to go up to 70 million by 2025. Its no surprise why experts have written off India as the emerging Diabetes Capital of the World that is likely to replace China soon.
Diabetes has shaken medical practitioners across the country as its fast becoming a major health concern in urban and rural India. According to the World Health Organization (WHO), diabetes will be the seventh leading cause of death worldwide by 2030, including China and USA bringing down every fifth person suffering from the disease. These figures are not just increasing the economic burden, but also associated complications which lead to increased mortality and morbidity rate in the country. As per WHO study, mortality from diabetes, heart disease and stroke cost about USD 210 billion in India in 2005. Interestingly, much of these heart disease and strokes were linked to diabetes. WHO estimates that diabetes, heart disease and stroke together will cost about USD 333.6 billion over the next ten years in India alone.
Blame Lifestyle
Obesity is an important modifiable etiology for diseases like diabetes, heart problems and hypertension. By reducing weight, the risk for above diseases can be reduced significantly. Low calorie diet and exercise help in reducing weight, which also help control blood pressure. Modest weight reduction of five to seven percent leads to better diabetes control, says Dr Ajay Agarwal, Senior Consultant & HOD, Endocrinology department, Fortis Hospital, Shalimar Bagh.
However, if blood sugar levels still remain high, anti-diabetes medication can be used to control blood sugar. Stress and illnesses are important reasons for high blood sugar, which result from the release of certain counters regulator hormones to cope up with strums and illness, he adds.
With them rapid urbanisation and industrialisation have produced advancements on the social and economic front in developing countries such as India which have resulted in dramatic lifestyle changes leading to lifestyle related diseases. The transition from a traditional to modern lifestyle, consumption of diets rich in fat and calories combined with a high level of mental stress have compounded the problem further. There are several studies from various parts of India which reveal a rising trend in the prence of Type II diabetes in urban areas.
A National Urban Survey in 2000 observed that the prence of diabetes in urban India in adults was 12.1 percent. Recent data has illustrated the impact of socio-economic transition occurring in rural India. The transition has occurred in the last 15 years and the prence has risen from 2.4 percent to 6.4 percent.
 Proper diet and exercise is more expressed and most physiological treatment modality without any side effects for obesity control. Definitely, exercise and strict diet can help in ideal body weight management Dr Ajay Agarwal, Senior Consultant & HOD, Endocrinology department, Fortis Hospital |
Whats Missing?
In India, lack of proper healthcare infrastructure, rampant ignorance and absence of clear-cut guidelines mean that approach to the management of diabetes is done on ad hoc basis. Lack of awareness among patients and General Practitioners (GPs) is a key factor for poor care. There are practically no nurse educators or diabetic counselors, no podiatrists and very few dieticians who mean that the treating doctor has no support and has to take the entire burden of caring for these patients. The patients inability/unwillingness to pay for this additional support also hinders the treatment. Even after the diagnosis, monitoring of diabetes is very poor. Most of the patients initially visit a doctor and then discontinue their treatment once their symptoms and controlled. A majority of the patients abandon modern allopathic treatment in favour of indigenous treatments. Further, more patients with poor control avoid insulin for fear of injection and belief of addiction of insulin. Hence, they keep changing doctors and hop from one system of treatment to another leading to further complications and early death. Lack of resources, medical reimbursement and poor state funding for diabetes is a barrier to quality care often because the patient is unable to afford the high cost of treatment.
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Prashant Tandon, |
Monitoring Devices
While the disease has marked its strong foothold on the country, the new monitoring devices to get the exact calculation and safety measures have increased rampantly. Popular monitoring devices among customers include J&J OneTouch, AccuChek by Roche, FreeStyle from Abbott, and Contour from Bayer. For diabetes nutrition/ food, Splenda, Extend and Glucerna are doing very well, says As Prashant Tandon, Managing Director and Co- Founder of Healthkart.com “ an online shopping portal for medical devices.
Apart from insulin injections, insulin pump therapy is the new technological advancement that the medical fraternity has achieved for effective treatment of diabetes among children. Being flexible and eliminating the daily pain of insulin shots, it is becoming the foremost advantage of insulin pump therapy.
The latest technology in insulin pump therapy is the CGM-ready insulin pump with an automatic insulin shutoff mechanism. This is taking diabetes management to a new level. One risk associated with Type I diabetes is the risk of death through low blood sugar.
There is ample evidence to suggest that preventive measures to reduce the burden of diabetes are needed. Studies have conclusively proved that lifestyle modification including weight loss, increased physical activity and dietary changes can prevent or delay the onset of diabetes. The need of the hour is direct public education and mass media campaigns, awareness about diabetes and its complications. There is a need to spread the message that diabetes is preventable and we need to have a behavioral change to adopt a healthy lifestyle
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