India houses over 61 million diabetics and the forecast is that there will be 100 million diabetics by 2030. China is the world capital for diabetes with India a close second. More than 70 per cent of middle aged Indians will suffer with non-insulin dependent diabetes during their lifetime. India contributes nearly one-sixth to the global disease burden of 422 million.
Almost every organ in the body can be adversely affected with the onset of diabetes. But with timely intervention and care, the disease can be kept under check. It is true that increase in longevity and population growth have been responsible for the spike in diabetes in India, but going forward it is rising levels of obesity that could well be the more significant contributing factor. Obesity is the most important risk factor for diabetes. According to the paper published in The Lancet,the number of obese men in India increased from 0.4 million in 1975 to 9.8 million in 2014; and from 0.8 million to 20 million women during the same period.Indeed,in 2014 there were 3.7 million severely obese women in the country.Though diabetes is caused by a complex interaction of genetic and lifestyle factors, the another most obvious reason for this increase in the number of young diabetics is their frenetic lifestyle.
LOOK FOR SYMPTOMS
Symptoms could be excessive thirst,excessive appetite and excessive urination and swelling of feet.Delayed wound healing, frequent infections,nausea,vomiting and weight loss may be other symptoms.Diabetes is one of the diseases that affects the endocrine system.The pancreas produces the hormone insulin.In Type 1 diabetes, the insulin producing cells in the pancreas are destroyed. In Type 2 diabetes, insulin is still produced but the body becomes resistant to it. Endocrinologists can help you manage your diabetes, by prescribing insulin and/or medications, and offering diet plans.
KIDNEY TROUBLE
Diabetes may damage almost every tissue and organ of the body, the kidney being one of them. If neglected, a person could go into diabetic nephropathy. Albumin in the urine, blood urea and creatinine levels should be checked once a month. Diabetics should avoid painkillers.They should watch out for swelling of the feet, extreme fatigue, weakness and breathlessness. Obese children should also be screened for diabetes.
FEET FIRST
A diabetic should take special care of his feet. Watch out for numbness, foot ulcers and carefully examine spaces between the toes and the soles of the feet. Socks should be washed regularly and changed every day and one should use footwear, preferably with ankle support. Nails should not be cut short and sharp edges should be filed. Special care should be taken by those who plan to go on temple visits and have to walk barefoot. Almost 75 percent of amputations are carried out in neuropathic feet with secondary infection, which are potentially preventable.
EYES
The eyes of a diabetic also need special attention and care. Regular eye check-ups are a must. The retina could get affected, and blood vessels in the eye could leak blood. Diabetes also produces early cataract. In extreme cases, the patient can lose eyesight.
DEPRESSION AND ANXIETY
There is also a link between depression and diabetes.Research studies have also demonstrated that the chances of developing diabetes was more amongst persons with current depressive and/or anxiety disorders. Some of the newer drugs used in the treatment of mental disorders might increase blood sugar levels. It is now important to monitor all patients on such drugs for their blood sugar levels.
HEART MATTERS
Diabetics have a higher risk of cardio vascular disease (CVD). Diabetes is a generalised micro and macro vascular disease, affecting various organs. A concerted attempt to identify pre-diabetics and intervene to reverse the metabolic abnormality will prevent further increase in the prevalence of diabetes.
DETECTING AND DELAYING DIABETES
Preventive health check-up and a year-round management of health and wellness customised to one’s health profile and screening are absolutely essential.Coherent efforts must be directed at preventing and delaying the onset of the disease.A relatively easy and short-term intervention that can go a long way in keeping the disease burden under check is to diagnose and treat gestational diabetes — mostly through dietary changes and physical activity. The management of gestational diabetes, which can prevent the disease in mother and child, has unfortunately not got the same attention as prevention of vertical transmission of HIV. Another missed opportunity is early detection of pre-diabetes when the blood sugar level is higher than normal but not elevated enough to be classified as diabetes. The progression to full-blown diabetes can be effectively delayed and even prevented through dietary changes and increased physical activity. This is why public awareness is crucial.
Dr. Tasaduk Hussain Itoo is a doctor at Acharya Shri Chander College of Medical Sciences and Hospital Sidhra Jammu/Social Activist and can be reached at drtasadukitoo@gmail.com
