The big news this World Diabetes Day is one of hope — the possibility of a long, complication-free life with diabetes. Success cases of people who have lived over 40 years after being confirmed as diabetic, even 50 years and 60 years have been documented by city diabetologists.
A study done at Dr. Mohan's Diabetes Specialities Centre (DMDSC) here, by V. Mohan, R.M. Anjana, Ranjit Unnikrishnan and B. Parthasarathy has proven just this.
In about two lakh patients from various DMDSC units whose medical records were analysed, over 200 people have lived 40 years with diabetes. Over 20 have lived for over 50 years, and though smaller in number, there are people who have lived over 60 years after they were diagnosed.
“We ensured that we picked up only those who had confirmed diabetes and were on treatment, all types of diabetes — Type 1, Type 2, Maturity Onset Diabetes of the Young (a genetic disorder inherited that causes disruptions in insulin production) and fibrocalculous pancreatic diabetes (caused by pancreatitis),” Dr. Mohan says.
He goes on to add, “It is generally believed that diabetes affects the lifespan. There is not too much data on this, particularly from India. A couple of Western studies estimated that diabetics live 8-10 years less. In 2006, our CUPS study that followed up 1,262 individuals for six years concluded that the overall mortality among diabetics was higher in Chennai.” In Chennai it was 18.9 per 1,000 person-years; comparatively among the non-diabetic population it was 5.3.
However, no one looked at the other side — the longevity of patients with diabetes, Dr. Mohan says. “We now know it is possible among a significant group of people.” While genetic studies to see if this group has a protective longevity gene will be done, there is much to learn from their life and control of diabetes, he adds.
Dr. Unnikrishnan, director, DMDSC, says: “They are certainly not sick, or dying, they have a fairly good quality of life. Over 25 per cent of the people who have lived for over 40 years have no complications — of the heart, kidney, eyes, or foot.”
Children who had Type 1 diabetes detected as early as three years are now grandparents and great grandparents. Dr. Anjana, director, DMDSC, says: “This busts the myth that kids with Type 1 diabetes will not live long enough or even that they will be unable to bear children.”
Another myth — that over time every diabetic moves to insulin — has also been busted. Dr. Unnikrishnan says, “Almost 25 per cent of the T2 who have completed over 40 years of living with diabetes are still taking only tablets.”
However, the key is to focus on what is common between the members of this group.
According to Dr. Mohan, “One thing is very clear. They have all been meticulous with treatment for their condition. It also does not matter what the type of treatment is. Some of our older patients had none of the sophisticated, expensive drugs that are available now and, they have lived to tell the tale.”
The pattern is clear: They have all been somewhat careful with diet, had regular exercise, periodic blood sugar tests, kept their three month average (HbA1C) as close to 7 as possible.
The key, Dr. Mohan explains, is to keep the blood sugar under control for the first 10 years.
“If you don't do this, whatever else you try later, the game is lost. The message is that if you take your disease seriously right from the beginning, a long and healthy life is indeed possible.”
