 Online edition of India's National Newspaper Wednesday, Jul 01, 2009 ePaper | Mobile/PDA Version |
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Tamil Nadu
Our Genes have not changed over the past 100,000 yrs; But we have changed a lot…. Owing to this transition in lifestyle, there is more stress, less physical activity, faulty dietary habits, leading to many health related problems such as obesity, High BP, & diabetes – a lifelong, lifestyle disorder. Diabetes – you read about it, you hear about it, you see about it, everywhere. But do you know, what is pre-diabetes? How does it occur?. Before people develop type 2 diabetes, they almost always have “pre-diabetes” – i.e., blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes. It represents, an intermediate stage between normality and diabetes which is usually asymptomatic: Its known fact that Pre diabetes is a risky prodrome to diabetes. Diagnosis & Management In fact, millions of people have diabetes and don’t know it, because symptoms develop so gradually, people often don’t recognize them. Some people have no symptoms at all. Usual symptoms of diabetes include unusual thirst, a frequent desire to urinate, blurred vision, or a feeling of being tired most of the time for no apparent reason, unexplained weight loss. People with pre-diabetes don’t often have symptoms and diagnosis can only be made on the basis of 75g oral glucose tolerance test. (OGTT). Who should get tested for Pre-diabetes? Screening for adults-If they are overweight and age 30 yrs and above, for adults younger that 30 yrs and overweight, may undergo OGTT, if they have any other risk factors for diabetes or pre-diabetes. These include high blood pressure, low HDL cholesterol and high triglycerides, a family history of diabetes, a history of gestational diabetes or giving birth to a baby weighing more than 3.4 kg, or belonging to an ethnic or minority group at high risk for diabetes. Its’ known fact that, childhood obesity is a forerunner of diabetes. Steps should be taken to screen children for pre diabetes too. A study published in the March 14, 2002, issue of the New England Journal of Medicine found 25% of very obese children and 21% of very obese adolescents had pre-diabetes. Hence, early intervention, is mandatory. Why should we target Pre-diabetes? Pre-diabetes- being a forerunner of diabetes and remains to be the tip of an iceberg with underlying increased risk for cardiovascular disease, progression to diabetes, small vessel disease ( microvascular complications), several population based studies have shown that people with pre-diabetes have a 1.5 – fold risk of developing cardiovascular disease compare to people with normal blood glucose. About 11% of people with pre-diabetes in the Diabetes prevention Program – standard or control group developed diabetes each year during the average 3 years of follow-up. Other studies show that many people with pre-diabetes develop diabetes in 10 years. We can delay or prevent the onset of diabetes through lifestyle changes. One should not forget the fact that the “tickling clock hypothesis”, states that the risk of development of long term complications such as damage to eyes, kidneys, nerves & blood vessels – predates earlier i.e. much before the onset of diabetes. Hence, seeking treatment after the onset of the disease is relatively late. Do you know that “Any undue delay, is undue denial”.It is always worthwhile, to begin treatment in this stage itself, much, before the diagnosis of diabetes. Identification of high risk individuals, prior to the onset, is relatively more important in terms of secondary prevention of diabetes & its complications. Be active, Keep Fit, Stay healthy always…
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