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. Results of a 10-year analysis from Southern India (1994 - 2004) reveal a trend towards increasing prevalence in both urban and rural population with more number of younger persons, particularly women, afflicted with diabetes.
“Though diabetes is caused by a complex interaction of genetic and lifestyle factors, the most obvious reason for this increase in the number of young diabetics is their frenetic lifestyle”, says Rajesh Shah, consulting physician and cardiologist, Better Health Foundation.
“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,” explains M. Ravi Kiran, endocrinologist, Agada Health Care. “Endocrinologists can help you manage your diabetes, by prescribing insulin and/or medications, and offering diet plans,” he says.
Kidney trouble
According to Soundarajan, head of the Department of Nephrology, SRMC, “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,” he advises.
Feet first
A diabetic should take special care of his feet, says V.Ramnarayan, consultant orthopaedic surgeon SRMC. “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,” he says.
Special care should be taken by those who plan to go on temple visits and have to walk barefoot. “Trivial foot lesions precede 85 per cent of leg amputations in India. Almost 75 percent of amputations are carried out in neuropathic feet with secondary infection, which are potentially preventable.”
The eyes of a diabetic also need special attention and care. Regular eye check-ups are a must says Amar Agarwal, chairman and managing director, Agarwal’s Eye Hospital. “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. According to Dr. Thara, Psychiatrist and Director, SCARF, “... 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,” she says.
Heart matters
Diabetics have a higher risk of cardio vascular disease (CVD). “Diabetes is a generalised micro and macro vascular disease, affecting various organs” says S. Thanikachalam, Chairman & Director of Cardiac Care Centre, Prof Emeritus, Sri Ramachandra University. “A concerted attempt to identify pre-diabetics and intervene to reverse the metabolic abnormality will prevent further increase in the prevalence of diabetes.”
According to M. Thanikachalam, cardiac surgeon, (American Board of Thoracic Surgery) preventive health check-up and a year-round management of health and wellness customised to one’s health profile and screening are absolutely essential. This led him to follow his dream project Agada, a one stop institute for comprehensive therapy with the focus on preventive treatment. It was established in association with the world leader in Diabetes Prevention Management and Care, Joslin Diabetes Centre, Harvard Medical School, Boston USA. “We believe in empowering you with skills to take ownership and manage your health optimally,” he says.
Look out
* 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
* Neglected, diabetes will affect the heart, eyes, kidneys and all major organs.
* With proper treatment, counseling and personal management, diabetes can be controlled.
