August 20, 2008

Gujarat: Capital of Silent Killer, Diabetes

By Radha Sharma

AHMEDABAD: A surgeon in the city felt a sudden blur in his vision recently. On consulting an ophthalmologist, he was shocked to find that he has been silently suffering diabetes since the past many years to the extent that it has even damaged his eyes!

"Not only was the diabetes high, it had led to eye complications of retinopathy and damaged the vision of the surgeon," says endocrinologist Tiven Marwah. Gujarat may be the capital of the silent killer disease diabetes in India but many people in the state continue to silently suffer the disease without actually knowing it.

Interestingly, given the high incidence of the disease in their state, Tamil Nadu government has decided to intensify the battle against diabetes by not just launching an intense public screening but also offering a sixmonth certification course on diabetology .

This would train the doctors, particularly, general practitioners, for early diagnosis and treatment of the disorder. While the TN government has decided to pull up its socks, the doctors in the state say there is a definite need for an intensive drive against diabetes which is adding the health-cost burden of the state.

According to conservative figures, 10 to 12 per cent adult population in the state suffers from diabetes. In urban areas, the incidence is as high as 16 to 18 per cent. The problem is getting more serious by the day as more and more young people are being diagnosed with the disease.

The catch here is that most people are either not diagnosed or diagnosed accidentally! "Over 50 per cent of diabetes cases are not diagnosed in the state. Of those which are, 50 per cent are diagnosed accidentally when the patient gets fever, goes for surgery," says leading diabetologist Mayur Patel whose institute Swasthya offers certificate courses in diabetology for the doctors.

"A huge percentage of my patients confess to being diagnosed with diabetes accidentally. Mostly it is prior to a surgery or medical check-up for VISA applications and employee medical examinations," says Dr Marwah.

Tushar Patel, 31, was found to have diabetes when he suffered angina and was advised a complete body-profile check-up. "Not only were my two arteries blocked, there was a very high per cent of glucose in my blood. Doctors said that the undiagnosed, untreated exposure of high blood glucose many have accelerated the blockages of the heart arteries," says Patel, an executive who underwent an angioplasty recently.

"Nearly 70 per cent of my patients have been diagnosed with diabetes just by chance when they went for an orthopaedic surgery after an accident, heart problem or even during pregnancies ," said diabetologist Banshi Saboo . Doctors feel that till the state government wakes up to the alarmingly high number of people suffering with diabetes, mostly silently, people need to take matters in their hand and go for a simple blood sugar test if they fall in a certain high-risk category.

"If a person is above 35 with a family history of diabetes, has a waist size more than 90 cm, suffers hypertension, he should go get a blood sugar test now. This is important as any exposure to the high blood glucose causes damage to the organs," says Dr Marwah.

What is diabetes?

It is a condition in which the body's mechanism for breaking down glucose is hampered. Thus the blood level of glucose rises. The prescribed normal standard for glucose in blood is 110 mg/ml

Type I diabetes

Patients have little or no ability to produce insulin and are entirely dependent on injections of insulin for survival

Type II diabetes

The pancreas retains its ability to produce insulin, but either the quantity is inadequate or insulin cannot be used to the full extent by the tissues

Fruits, vegetables are not on the platter for many

At least 50% of the population in India does not eat even one vegetable a day. Worse, only 11% of them eat at least one fruit a day. (ICMR study) Another study by Diabetes Foundation (India) found a section of children skip breakfast, don't carry lunch boxes to school, choosing to snack on fast food instead, and thereby becoming susceptible to diabetes

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