Why Is Diabetes On The Rise In India
Diabetes has become a modern epidemic. It is thus of relevance to know what it is, what are the consequences if it is not properly treated, and how to effectively prevent and manage this serious illness.
The prevalence of diabetes is increasing worldwide. Unfortunately, in the years to come, most of this increase will be in developing countries such as India and China. Thus, in addition to the burden of infectious diseases, the brunt of diabetes (and other similar illnesses such as heart disease and high blood pressure) will be borne by countries which are poorly equipped to manage them. India already has the greatest number of diabetic individuals in the world, and this is likely to increase by 200 percent in the next 10 years. Unfortunately, there is an equally large number of patients who have mild abnormality in their blood sugar (not enough to qualify as diabetes), and a large proportion of these will later progress to diabetes. Another worry is that Indians develop diabetes at an earlier age (30's and 40's), and hence develop severe diabetes complications in their prime of life.
So, why is diabetes on the rise in Indians? The most likely reasons are a rapid urbanization of our society and a change in our lifestyles. Obesity (especially the kind in which weight gain is around the waist), a diet rich in fats and refined cereals, lack of exercise and increased levels of stress are all-important causes. The importance of these can be gauged from the fact that the rate of diabetes in rural Indians is far lower (5%) than in urban India (12 - 14%).
In the simplest terms, diabetes is merely an increase in blood glucose beyond the normal range. This can lead to a variety of symptoms such as tiredness, weight loss, infections, increased urination and thirst. Since symptoms in adults are not as severe as in children, they are often ignored. Unfortunately, this leads to a high frequency of the chronic complications associated with diabetes.
The reason why diabetes should be taken seriously is because of the long term complications it can result in. These include kidney failure, reduced eyesight and foot ulcers and infections. In fact, diabetes is a leading cause of blindness and renal failure in the West. This group of complications is related to blood glucose levels and the duration of diabetes. In addition, diabetes is associated with an increased risk of blockage of large blood vessels supplying blood to vital organs of the body. The result is an increased frequency of heart attacks, stroke and foot gangrene. These complications are related not only to blood glucose, but also to high blood pressure and body fats (such as cholesterol).
Let us first examine how we can prevent diabetes from occurring. The best way to do this is to inculcate a healthy life style. This is especially important for those at a higher risk of for developing diabetes, such as those who have a family history of diabetes, are obese, women who have history of high blood glucose during pregnancy or those who gave birth to a large baby. It is essential to try to maintain a weight appropriate for height and activity. Regular exercise ( at least 5 times per week), and a diet low in cholesterol, fat, and simple sugars and rich in grains, vegetables, pulses and fruit is essential. Avoid stress as far as possible. Since diabetes may not have any symptoms early on, check for blood glucose regularly on an annual basis after the age of 40 years (and even from an earlier age if risk factors are present).
As far as treatment of diabetes is concerned the principles are very simple. Most important are a nutritious diet and exercise. Regular monitoring for blood glucose is essential. Medicines (tablets or insulin injections) are effective only if there is a healthy life style. As important as treating diabetes is to treat hypertension and high cholesterol. Complications should be monitored annually by simple tests, most of which are easily available in all towns. Diabetic complications are easily treated if detected at an early stage.
In a country overwhelmed by a host of health related problems, all of which appear to be of greater significance and urgency, it is easy to forget the epidemic of diabetes which is already raging in our midst. However, we can continue to ignore it only at our own peril.