Together we can beat DIABETES

The world diabetes day is the largest worldwide awareness campaign reaching an audience of over 1 billion people in about 162 countries

Dr M Shafi Kuchay
Srinagar, Publish Date: Nov 13 2017 11:27PM | Updated Date: Nov 13 2017 11:27PM
Together we can beat DIABETES

The number of people living with diabetes has been rising for several decades all over the globe. There is ample evidence to suggest that it is the awareness about diabetes that makes difference as far as halting its increasing trend is concerned. The International Diabetes Federation (IDF) and the World Health Organisation (WHO) joined hands in this regard and launched the world diabetes day in 1991. The day chosen was November 14, in memory of Frederick Banting’s birthday, the man who made discovery of insulin possible. The world diabetes day is the largest worldwide awareness campaign reaching an audience of over 1 billion people in about 162 countries. This campaign draws attention to issues of utmost importance to the diabetes community and keeps diabetes in the limelight.

According to WHO 2016 data, there are estimated 422 million adults in the world living with diabetes. India is one of the worst hit nations. Currently there are more than 62 million Indian adults living with diabetes. This means more than 7.1% of the adult population of India is having diabetes. Indian Council of Medical Research-funded recent study was conducted in 15 states of India. In the community, 57,117 individuals were sampled. The overall prevalence of diabetes and pre-diabetes were found to be 7.3% and 10.3% respectively. Most importantly, 47.3% of them were not knowing that they have diabetes. They were diagnosed for the first time when their glucose level was checked for the study. Thus, awareness regarding diabetes among community is a need of the hour. The main aim of world diabetes day is to increase awareness about diabetes, so that it can be treated adequately in those who have it and prevented in those who don’t have it yet.

Diabetes mellitus is a chronic condition characterised by a high level of glucose in the blood, that often lead to complications. It is a group of diseases as there are various types of diabetes, caused by different pathological processes. For instance, type 1 diabetes, type 2 diabetes, gestational diabetes, drug-induced diabetes, and so forth. But for general population, type 2 diabetes needs to be discussed time and again. This is the most common type of diabetes, comprising more than 90 percent of all cases of diabetes and is the prototypal lifestyle disease. Majority of patients with type 2 diabetes do not feel symptoms initially for many months and years. This is the reason why diabetes is called silent killer or silent thief.  This is also the reason why the American Diabetes Association (ADA) has advised testing blood glucose after 40 years of age, even if you have no symptoms. And if the result is normal glucose, then blood glucose test is to be repeated after every three years in the absence of symptoms. For people like us (Asians), blood glucose testing should probably be more frequent, as we are more prone to develop diabetes than caucasians.

Usual type 2 diabetes begins as a small increase in fasting blood glucose levels above the lower normal limit of 100 mg/dL. This rise of fasting glucose above the lower normal limit of 100 mg/dL is called pre-diabetes till it reaches 126 mg/dL or above when it is called diabetes. The same slow rise happens in post-prandial (after meals) glucose levels as well as in glycated hemoglobin (HbA1C) levels-the other measures of blood glucose status. This rise is very slow, often taking months and years. The body adapts to the new raised blood glucose levels and the patient does not feel symptoms. This absence of symptoms comes at a cost. The cost is harm to other organs like retina and kidneys. When diabetes is severe and has caused complications, then it causes symptoms. These symptoms include being very thirsty, frequent urination, weight loss, increased hunger, blurry vision, irritability, tingling or numbness in the hands or feet, frequent skin, bladder or gum infections, wounds that don't heal, unexplained fatigue, and many more.

A message on the world diabetes day is that a healthy lifestyle can delay and even prevent type 2 diabetes. A healthy lifestyle consists of two components-physical activity and dietary pattern. Regular physical activity like brisk walk, jogging, cycling, etc., helps in maintaining normal weight. Exercise is beneficial to metabolic health independent of weight loss. That means if you are obese and you exercise regularly, even if you do not lose weight, you still are benefiting your body. It also includes stress management by engaging in healthy habits like walking, gardening, yoga, music, community services, religious activities, etc. Healthy dietary pattern means consuming a balanced diet. A diet that is high in fibre and low in refined carbohydrates and fats. Avoid fast and junk foods like sugary beverages, fruit juices, ice-creams, deep fried foods, chips and pizzas. Cut back on refined carbohydrates like white bread, white rice, white pasta and potatoes. Consume diet that is rich in fruits, vegetables, beans, whole grains, nuts and seeds. Use milk and milk-products. Reduce consumption of red meat and instead use chicken and fish.

I would want to raise consciousness of people by giving an example of twin brothers, Zaid and Jasim, 20-years of age. Both share similar lifestyle and environment, except for one thing. Zaid consumes a can of coke everyday while Jasim likes to take a bottle of simple water instead. Zaid thinks consuming 250 mL coke a day is harmless, as it gives him no trouble. He is, in a way, right as there is no short-term harm of consuming coke (or any other sugary beverage for that matter). But we are not talking here of short-term harms. We are talking of health that has to be maintained for years and decades. Let’s see how different would Zaid be from Jasim after four decades, who otherwise lead similar lives, but with that one difference. After four decades, at ages 60, Zaid would have consumed more than 14,000 cans of health-harming coke (7 a week, 365 a year, 14,600 in 40-years) while Jasim would have consumed equal quantity of health-giving water. The negative impact of that much of sugary beverage on health over years and decades would be anybody’s guess. Let’s see what the scientific evidence is saying. A study by Nutritional department, Harvard Medical School, Boston, USA showed that people who consume sugary drinks regularly—1 to 2 cans a day or more—have a 26% greater risk of developing type 2 diabetes than people who rarely have such drinks. Another study that followed 40,000 men for two decades found that those who consumed one can of a sugary beverage per day had a 20% higher risk of having a heart attack or dying from a heart attack than men who rarely consumed sugary drinks. Another 22-year-long study of 80,000 women found that those who consumed a can of sugary drink a day had a 75% higher risk of gout than women who rarely had such drinks. So when you consume any unhealthy thing on a regular basis, do not think about its harm in terms of short periods of time. Always think in terms of years and decades and a true picture would be in front of your eyes.

Diabetes is a chronic condition and needs life-long measures. In recent times, diabetes is treated by ‘individualized approach’. That means out of many lifestyle measures and medicines, a particular set of advices and medicines are prescribed to a particular patient, that is supposed to work best for that individual, based on the current scientific knowledge. The best way to obtain sustained results is to teach the patients about the disease, its complications, life-style measures and about diabetes medicines. This is called ‘patient empowerment programme’ (PEP), as this will help them in the long run to manage diabetes on scientific and evidence-based lines. 

World diabetes day lay emphasis on the fact that awareness about diabetes is not only for people with diabetes, but more so for people with no diabetes. This is because diabetes can be treated and controlled in those who have it, delayed and even prevented in those who don’t have it, if healthy lifestyle is followed on daily basis. Remember together we can beat diabetes.

 

Dr M Shafi Kuchay is a Kashmiri Endocrinologist, presently working as consultant at Medanta The Medicity, Gurugram, India.

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