Diabetes is a global health problem growing at such a rapid pace that the World Health Organization (WHO) describes it as an “epidemic”. In India, its prevalence started increasing in the 1980s and began escalating rapidly after the opening up of the economy in 1991.
Rapid economic growth has led to industrialisation and mechanisation, leading to a marked reduction in physical activity. Moreover, as people become more affluent, they tend to eat foods rich in sugar, salt and fat. All this leads to an epidemic of non-communicable diseases such as diabetes, hypertension, heart disease and cancer. Of them, diabetes stands right on top.
Since its prevalence can be measured easily, we have quite accurate statistics on diabetes affliction. In the metropolitan cities of India, its prevalence has increased several- fold in the past few years. In Chennai in the 1970s, 2% of adults above 20 years of age had diabetes; today, it is present in over 25%. In people above 55, almost 40% living in big cities have diabetes and almost an equal number have pre-diabetes (the stage before diabetes).
Domino effect
Every year, November 14 is observed as World Diabetes Day by WHO and International Diabetes Federation (IDF) to mark the birth anniversary of Frederick Banting, who discovered insulin.
The IDF puts out a theme for the day and this year, it is ‘Family and diabetes’. This theme aims to raise awareness of the impact diabetes has on the family, and the support network necessary for those affected.
There is no doubt that if one person has diabetes, his or her family members too will be feel its impact. For example, when the dietary habits of the patient have to be modified, the rest of the family too have to make changes. If he or she develops diabetes-related complications affecting the eye, feet, heart or kidney, the morale of not just the patient but the whole family is affected.
The others feel guilty about eating sweets. Some families handle this well as everyone decides to cut down on, or avoid, sweets. For example, during a festival like Deepavali, they would say, “This year, let us not buy sweets. We will not only save money but also improve the health of the family.”
So what are the alternatives to sweets?
There are so many healthy eats. Nuts, for example, make a good choice not only as a snack but also as a gift. Instead of gifting sweets, why not give healthy nuts such as almonds, pistachios, ground nuts and cashew nuts. They are high in fibre, protein and healthy fats such as monounsaturated fats. They give you a lot of energy and are good for the heart. They do not increase the blood sugar levels but help improve your cholesterol levels, especially of good cholesterol.
Family members can encourage a person with diabetes to exercise regularly. The family, as a unit, can decide to go for a walk. This will ensure the patient gets the required exercise. This not only helps control the sugar levels of the patient but also prevents diabetes in others.
Yoga, meditation, indoor and outdoor games, spending time together and having a positive attitude are all excellent examples of how a person with diabetes can get support from his family.
Very often, patients forget to take their medicines.
The spouse or children can remind the patient to do so. This will go a long way in keeping diabetes under control.
Yet another way in which the family can help is to make sure that the patient keeps the appointment with the doctor. Diabetics need follow-up regularly and check-ups at least three or four times a year. We have published data to show that if patients do this, they can prevent the dreaded complications and live a long and healthy life.
Live long and healthy
We have a large number of patients living beyond 90 years of age and some are nearing their 100th birthday. Many have been living with diabetes for 50 to 60 years and are still doing well without complications.
To achieve this, it is mandatory to test the eyes, kidneys, heart and feet at least once a year. If detected early, complications may even be reversed. If left uncontrolled, diabetes can cause havoc in the body and in many instances, it is even worse than some of the cancers.
Thus, the theme “Family and diabetes” is appropriate because it is only with family support that a person with diabetes will be able to live a long and healthy life.
(The author is the chairman & chief of diabetology of Dr. Mohan’s Diabetes Specialities Centre, Chennai)
drmohans@diabetes.ind.in
