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Diabetes: city at high risk

Shastry V. Mallady
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A quarter of Madurai’s population is diabetic, say doctors

The spiralling number of diabetes cases in the city has set alarm bell ringing. A 12 per cent increase in three decades has put the medicos on alert mode. It is time to understand, prevent, control and manage the D-disease, they emphatically say.

A sample study by Government Rajaji Hospital has revealed that two per cent of Plus Two children in Madurai suffer from Type-2 diabetes which is common among adults. Scores of Madurai Medical College students are also diabetic. Obesity and mental tension are cited as the major factors.

The last survey carried out in 2011-12, in all pin code areas of Madurai city, revealed disturbing results. Random screening of 10,104 people above 30 years showed 13 per cent to be suffering from diabetes and another 12 per cent in the pre-diabetic stage.

In two rural camps where 220 villagers were screened, seven per cent of them were diagnosed as diabetic and another 10 per cent of were found to be borderline cases. The ‘sugar’ check-up done in a slum in Sellur area indicated similar diabetes prevalence as in the city.

“The data collated from these surveys indicates that a quarter of Madurai’s population has diabetes. The increase in the number of new cases is a matter of concern. The issue is real,” says Dr.A.J.Asirvatham, Head, Department of Diabetology, GRH, who led the survey.

A sample study of 2,000 households in K.K. Nagar and Anna Nagar on the prevalence of diabetes was done in 1978 by E.S. Johnson, the then diabetologist at Government Rajaji Hospital (GRH). The prevalence rate was found to be one per cent then.

So where does the problem lie and what are the do’s and don’ts? The common advice coming from diabetologists is that a person must voluntarily go for a ‘sugar test’ when he or she is 40 and it should be continued once in six months.

As there are no visible symptoms for diabetes, the call should be taken by people in their own interest. The experience of a 50-year-old bank officer in Madurai is an example. He was detected with diabetes 14 years ago and is now on medication, follows strict diet control along with regular physical exercises as per his doctor’s advice.

“My family members insisted that I visit a doctor when they noticed my weight loss and fatigue. The medical test showed my blood sugar level was as high as 295 mg. Ever since I am on medication and I realise that nobody should ignore the sugar test,” he says.

Prevention of diabetes in the unaffected population is as important as the control of blood sugar levels on a daily basis in the confirmed diabetic patients. The daily check helps to prevent morbidity/ mortality in the long run, say medicos. The rise in Type-2 adult-onset diabetes is a matter of concern given the fact that the trend among children is equally worrisome.

Asserts Dr.K. Kannan, Director, Madurai Institute of Diabetes Endocrine Research and Practice, “Sedentary lifestyle, junk food and decreased physical activity are contributing to the rapid rise in diabetes. If your bodyweight is 10 per cent more than the normal weight in relation to the height, you should go for a sugar test and then start reducing weight.”

“If diabetes is neglected now, it leads to micro and macro vascular complications in 10 years time,” he cautions.

No symptoms

The message for diabetes control is to eat smart. Dr.A.Kannan, consultant diabetologist at Dr.Mohan’s Diabetes Specialities Centre in the city, confirms that the middle and upper middle class section of the population are falling to diabetes at an early age.

“Though diabetes is not curable, it can be kept under check and one can lead a normal life. Fifty per cent of cases have no symptoms and sugar test is the only way to detect it. Screening camps help in early detection,” he says.

The Indian Council of Medical Research-India Diabetes Study Report of 2011 points out that the weighted prevalence of diabetes (both known and newly diagnosed) was 10.4 per cent in Tamil Nadu and the prevalence of pre-diabetes (impaired fasting glucose and/or impaired glucose tolerance) was 8.3 per cent.

This report estimates that Tamil Nadu has 4.8 million people with diabetes and 3.9 million with pre-diabetes.

Dr.Kannan of Mohan Diabetes Centre says that people from lower strata and below poverty line category need special attention as they are not aware of the side effects. “The complications of diabetes could be severe as it can affect eye, heart, kidney and nerve functioning. A diabetic should eat less rice, avoid fried items and take a low cholesterol diet,” he says.

The killer disease does not discriminate on the basis of gender or age. Men and women are equally vulnerable and the disease is prevalent in families that do not encourage physical activity.

“Diabetes can be a killer if not kept under control. It puts the productivity levels under threat. How will a family cope if the earning member becomes a liability?” doctors ask.

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