Click to play videoNew Delhi: November 14 was World Diabetes Day and according to top medical journal, The Lancet, India has the largest number of diabetics in the world, but do Indians ignore the seriousness of diabetes? Why is it that so many Indians have diabetes?
Doctors say that diabetes does not have to suffered, it has to be instead, lived with. However, another new and disturbing aspect of diabetes is emerging and that is that a diet of pizzas and burgers means the dreaded disease is increasingly hitting children.
So does this mean that urban lifestyle is the real culprit?
CNN-IBN's Sagarika Ghose talks to Jitendra Mohan - a textile trader and an insulin dependent diabetic, Senior Endocrinologist, Apollo Centre for Obesity, Diabetes and Endocrinolgy, Dr Ambrish Mithal, and Food Critic and diabetes patient Sabina Sehgal Saikia.
Sagarika Ghose: Jitendra Mohan, tell us is one the problems of being a diabetic in India is the fact that Indians don't take diabetes seriously enough and you did not either when you first came to know that you had diabetes?
BITTER TRUTH ABOUT THE SWEET KILLER |
Diabetes more prevalent in India than in US. |
| Only 8 per cent of US population suffers from diabetes |
| 12 per cent of Indian adults between 30-50 years of age have diabetes |
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In the 70s, only 4 per cent Indian population had diabetes |
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World population of diabetics is 177 million |
| By 2025, there will be 300 million diabetics in the world |
| India has 40 million diabetics |
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By 2025 India will have 57 million diabetics |
| Diabetes is the fourth leading cause of death globally |
| Every fifth Indian is a diabetic |
| 20 per cent of the world's diabetic population is Indian |
| 2 out of every 1,000 children in India suffer from acute diabetes |
| Every fifth Mumbaikar will be a diabetic in the next 5 years |
| A leg is lost to diabetes every three years |
Jitendra Mohan: I was under the impression that it is a disease that will go away. And I took it in that manner. I was put on tablets and I was so busy building my career that I would sometimes forget to take the tablets. I didn't take the disease very seriously frankly speaking.
Sagarika Ghose: Was that because you really didn't know exactly what the disease was?
Jitendra Mohan: I didn't read up much on the issue. I just went to my family physician. He told me that I had diabetes and that there were certain precautions that I would have to take - take my medicines regularly and that maybe my medicines will continue for a lifetime. And my work pressure was so high that I really did not have the time to take care of myself.
Sagarika Ghose: So are you trying to say that anyone who has diabetes must take it very seriously because it has very serious consequences? What really are these consequences?
Jitendra Mohan: I once came to stage that the neglect caused serious hyperglycemia in my body. I would take my insulin and it would take me a little time before I could eat. And that's the time I realised that I was getting hyperglycemia quite frequently.
Sagarika Ghose: What exactly is hyperglycemia?
HARD-HITTING FACTS |
| Four diabetics are detected every minute across the globe |
| India expects a 57 per cent increase in the prevalence of diabetes by the year 2010 |
| 40-60 per cent of diabetics are likely to suffer from a heart attack |
| A diabetic is at a higher risk of developing blindness, infertility and kidney failure |
Jitendra Mohan: Hyperglycaemia is lack of sugar in the blood that is required to counteract the insulin that a diabetic has taken. Basically it balances the insulin intake. And the food has to go with it so there is a measured quantity of food that should go with the measured quantity of insulin that has been designated to the patient.
Sagarika Ghose: And for how many years now have you been taking your insulin injection?
Jitendra Mohan: I have been a diabetic for the last 30 years but for the last 27 years I have been on insulin.
Sagarika Ghose: So for all these years have you been living a comfortable life or do you always live with the fear of what may happen as a result of your diabetes?
Jitendra Mohan: Initially, I was upset. It was a trauma. But the more I read, the more I understood and I have a very competent doctor. He explained everything at length and I started taking the disease seriously thereafter. So my medication also became more seriously regulated and attended to. And since then, I haven't looked back. I am a normal person, working full hours, keeping a balance between exercise, medication and food - as these are the three things that help you live your life in a normal manner.
Sagarika Ghose: So what you are trying to say is that if one has diabetes, they should take it seriously and take proper care and nothing can stop people from leading an absolutely normal life. Dr Mithal, why are Indians so prone to diabetes?
Dr Ambrish Mithal: I think Indians are genetically prone to diabetes. With the changes in lifestyle, the incidence of diabetes has rapidly increased over the last few decades. What is happened is that with growing and easy availability of fast food, changes in exercise patterns, increase in stress and the so-called urbanisation, are all taking their toll. Therefore all of us who carried the genes for diabetes are now de-compensating and actually becoming diabetic.
Sagarika Ghose: What does de-compensating mean?
| DIET FOR DIABETICS | |
 Eat lean foods that are easily digestible | |
| Try becoming a vegetarian and eat more fibre | |
| Cucumbers, green beans, sprouts, garlic and tofu help regulate blood flow | |
| Avoid processed and sugary foods | |
| Cook food in monosaturated oils like olive oil | |
| Pick whole fruits over fruit juice, wheat breads over white bread | |
| Choose fish over meat | |
| Eat three regular meals a day |
Dr Ambrish Mithal: What it means is that if the same population was to live a different kind of a lifestyle - with more exercise and not so easy access to fat enriched food - then many of them would not be diabetic.
Sagarika Ghose: Is there a propensity of abdominal weight gain?
Dr Ambrish Mithal: Absolutely. Abdominal obesity is the key and that is the biggest risk factor for diabetes and its related complications. And South Asians as a whole - not just Indians - are uniquely prone to abdominal obesity. The fact is that for the same body weight, a western Caucasian person would have less weight on the tummy as compared to an Indian or a Pakistani.
Sagarika Ghose: Sabina Sehgal Saikia, you have been studying food patterns for such a long time, you have been looking at the sociological trends of food, do you think that given this threat of diabetes, when Indians eat or when they go out to eat, they have this feeling of 'what does it matter' and 'I have a short life so let me just tuck in'. Is the awareness factor high?
SYMPTOMS | RISK FACTORS | EFFICIENT MANAGEMENT |
Excessive urination | Family history | Dietary measures |
| Increased thirst | Obesity | Regular exercise |
| Weight loss | High blood pressure | Regular medication |
| Lack of energy | High cholestrol | Regular BP, eyes, sugar level check ups |
| - | Abnormal weight at birth | Working towards ideal body weight |
| - | Age above 30 | - |
| - | Sedentary lifestyle | - |
Sabina Sehgal Saikia: It's really paradoxical in a sense because you do have the influx of a lot of fast food and you see a lot of Indians 'lapping it up' at these American fast food chains, but there is a lot of awareness at the same time. It's not really the threat of diabetes till it actually hits you. But I think people are aware of having better bodies and being healthier so a lot more Indians are working out and stay conscious of what they are eating. So you have both situations but obviously diabetes is a very real situation.
Sagarika Ghose: Your diagnosis is particularly interesting because you had no symptoms. So how did you discover you were a diabetic?
Sabina Sehgal Saikia: My husband is a hypochondriac. He got a glucometer and it showed I was 300 plus.
Sagarika Ghose: That's scary really. Dr Mithal, if you have no symptoms, how are you going to detect that you suffer from diabetes?
Dr Ambrish Mithal: I think you need to look at risk factors and people should undergo testing. If you wait for symptoms in diabetes, then you are already too late. In fact, globally, 50 per cent of the world's diabetics are undiagnosed. If you have risk factors like you are overweight and you have family history, you should undergo a blood test very early. Even children who are grossly overweight say at the age of 10 or 12 and they have a strong family history of diabetes, even they should undergo a test at that age. So it's really not about symptoms, it's about testing.
Sagarika Ghose: What are the other complications that can arise?
Dr Ambrish Mithal: Diabetes per say causes no symptoms, but once diabetes starts affecting organs, it can really play havoc with your system. For example, there may be no sign that your eyes are getting affected but you may bet an eye bleed or you may require a laser treatment, you may get retinal problems or glaucoma. Kidney complications is one of the most dreaded complications of diabetes because the most common cause of renal failure is diabetes. Heart disease and foot problems are other complications of diabetes - amputations are several-fold higher in diabetics than in non-diabetics. There can be problems in blood supply so it's a very very serious condition indeed.
Sabina Sehgal Saikia: I have lived with diabetes for one-and-a-half-years now, and though it is a very serious condition, it is also the easiest to live with, without too much of effort really. So while it does sound alarming if it is unchecked and not taken care of seriously enough, it is also very easy to keep it under check. You have to watch what you are eating - eat carefully and sensibly and you don't have to give up anything. You have to exercise a bit, you have to bring down stress levels - but it's all very do-able. It's not a disease that's really terminal in that sense of the word.
Sagarika Ghose: Why is it that Indians - knowing what kind of a condition diabetes is - take it seriously enough?
Dr Ambrish Mithal: I think it's all about awareness. Awareness is changing everything. If I find a high blood sugar level in a patient, the patient's first reaction usually is that it is probably a wrong test by the doctor. It takes a while for things to sink in really. And I think it's the idea that this is not a lifestyle change that will last a week, it's for a whole lifetime. But the key point is that if you control it from day one, then there is no risk really.
Sagarika Ghose: So if you control your lifestyle, you can lead a close to normal life even if you have raging levels of diabetes. But there is also another factor and that is that diabetes causes mental illness and depression particularly among women.
Dr Ambrish Mithal: There is a bit of controversy here because the issue is that any chronic disease can cause mental depression. If one is told today that your lifestyle is going to change forever, it is a very restrictive feeling and that can depress you. People say there is no point in living. I'd rather eat and die is the attitude. It's the feeling that gets one rather than the problem itself.
Sabina Sehgal Saikia: It's my job to eat but really it's very workable.
Sagarika Ghose: So experts and people living with the condition say that it's not tough to live with diabetes. But the scary fact is that according to the World Health Organisation there are likely to be 80 million diabetics in India in the next 25 years so perhaps all Indians need to be careful. If you are careful, then you can lead an absolutely normal life and there is absolutely nothing to be paranoid about.
FOOT CARE IS IMPORTANT | |
| Check your feet everyday and report sores or changes or signs of infections |
| Wash feet daily with lukewarm water and mild soap. Dry well |
| Protect your feet well all the time |
| Exercise daily for good circulation |
| Stop smoking - it hinders blood flow to the feet |
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