Ms Marcette Buttigieg

The rising incidence of diabetes in India

is linked to the rapidly changing lifestyle

The theme for this year’s World Diabetes Day is “access to diabetes education”.

Diabetes is a widespread disease affecting over 530,000,000 adults throughout the word. An additional 1,200,000 children and adolescents have another form of the disease known as Type 1 diabetes. This means that 1 in 10 persons throughout the world has diabetes, and the number keeps increasing.

In India the burden of diabetes is relatively higher and growing at a faster rate. In 2019, there were 77 million persons with diabetes in India: that means over 11 persons in 100 have the disease. The number is sure to increase since the level of pre-diabetes is also very high, even compared to Western, affluent countries: it ranges from 6.8 – 14.7% in rural populations and 7.2 – 16.2% in urban areas.

Diabetes mellitus (known colloquially as ‘sugar’) is a chronic disease in which the pancreas does not make enough insulin to deal with the sugar from the food we eat. This leads to high levels of glucose in the blood stream. Diabetes is a progressive disease because the presence of too much sugar in the blood leads to serious health problems: mainly heart disease, kidney disease, reduction in vision due to damage in the retina, and damage to the nerves and the blood vessels all over the body, especially at the periphery.

A combination of factors causes diabetes, with the most significant ones being genes and lifestyle. The rising incidence of diabetes in India is linked to the rapidly changing lifestyle: there is an increased intake of meat, refined carbohydrates, oils and fats, and low intake of fruits, nuts and whole grains. The use of alcohol also contributes to diabetes. The picture is further aggravated by insufficient physical activity.

The Adivasi population is at an increased risk of developing diabetes because their body processes (metabolism) was developed for the prevalent rural lifestyle: a diet low in fats and meat and heavy physical work. This metabolism is unable to cope with an urban lifestyle that includes excessive food intake of the harmful kind combined with sedentary work and reduced physical activity.

The common symptoms of diabetes are feeling thirsty constantly, passing urine often, including several times at night, feeling hungry and tired, and losing weight. Diagnosis is carried out through blood tests and a blood sugar level of 126 mg/dl (2 tests) and above is considered as Diabetes Mellitus.

Since the low levels of insulin – and therefore diabetes itself – are due to damage to the pancreas, there is NO CURE for diabetes and treatment has to be lifelong. Allopathic medicine is effective in CONTROLLING the sugar levels: when diagnosed in the early stages, medicine in the form of tablets is sufficient, while insulin injections are used for the more serious forms of the disease. There is some evidence that the herbal medicine ashwagandha may help lower glucose levels.

While the general population knows that there is ‘sugar disease’ a relatively recent study shows that only 55% of those with diabetes were taking treatment with 16% having it under control. These are worrying statistics given the long term effects of the disease on the person affected and their families, as well as the burden of cost of treatment – financial, personal and social.

All this helps us understand that in India, prevalence of diabetes is high while levels of awareness, treatment and control are low. “Access to diabetes education” is certainly an apt theme and continued efforts are needed to bring it about. Of the two major factors contributing to diabetes, we cannot do anything about the genes we have inherited, but the lifestyle we follow lies in our hands. it is therefore the responsibility of each one suffering from diabetes to help themselves live a life as normal as possible and reducing the risk of progressive complications by adopting a healthy lifestyle, in line with their condition.

And it is the responsibility of all of us, as we spread knowledge about diabetes – its causes, prevention and treatment – to live well, enjoying our food in quality and quantity and keeping fit through active physical work, to prevent the development of the disease.

For those who have diabetes and want to know more and understand better how to control this illness, information can be accessed at www.worlddiabetesday.org a site of  the International Diabetes Federation (IDF).

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