World Diabetes Day To Be Celebrated At Aligarh Muslim University
Prof Jamal Ahmad, Director, Rajiv Gandhi Centre for Diabetes and Endocrinology, J.N. Medical College, Aligarh Muslim University said that diabetes in India has reached epidemic proportions and is increasing with Tsunamic speed. He was speaking on the World Diabetes Day that is celebrated on November 14 every year which is also an official United Nations Worlds Diabetes Day. Named to celebrate the birthday of Frederick Banting, who along with Charles Best, is credited with the discovery of Insulin. This day is marked with the global awareness campaign against Diabetes led by the International Diabetes Federation (IDF) that engages millions of people worldwide in diabetes advocacy and awareness.
Prof. Ahmad said that India at present has more than 62.2 million people with diabetes and 95% of this population is suffering from Type 2 diabetes. The increase in its prevalence is due to genetic predisposition, sedentary life style, increase in obesity, urbanization and change in lifestyle pattern. We must work hard to prevent the occurrence of metabolic syndrome/type 2 diabetes by preventing obesity (waist circumference 80 cm in females and 90 cm in males) accounting for its association with more than 60% of type 2 diabetes population. We must make all possible effort to reduce atleast 5-10% of weight. This is possible by walking 4-5 kms per day on all days and by eating carefully. The emphasis should be to consume food of low glycemic index values like mixed chapaties (wheat, barley and grams), beans, green leafy vegetables, curd, oats, salads and fruits with limited amount of apple, guava, orange etc. and to avoid food of high glycemic index values like potatoes, rice, bread, french fries, fast food etc. By brisk walking for half an hour per day and by careful eating and healthy habits (no smoking, no alcohol) and cutting down the intake of saturated fat, trans-fat (butter, dalda, animal fat etc) and salt intake, it is possible to reduce the prevalence of diabetes by 50 percent.
Prof. Ahmad said that it might also be noted that the incidence of Type 1 diabetes (5% of diabetes population) is also increasing. If a child complains of weakness, tiredness, weight loss otherwise eating well and having night bed-wetting or being hospitalized as a case of gastroenteritis, his blood sugar needs to be done. It is likely that he/she is suffering from Type 1 diabetes. To save the life of such children, the above Centre with the help of Diabetes India Initiative/ pharmaceutical companies is providing free Insulin to all children especially the girl child up to the age of 21 years if they are reporting endocrine clinic of the hospital regularly. Attempts are also being made with the support of Diabetes India to provide free Insulin to everybody reporting for diabetes management to the Centre.
Prof. Ahmad further said that there is a tremendous increase in the complications associated with diabetes, especially in those who are not under optimal control. In India, diabetes is the single largest cause of legal blindness which can be prevented by taking care of A,B,C, of its management. A vast majority of patients undergoing renal dialysis and transplant have diabetes as the underline cause. Presently around 1% of the population has got diabetes renal disease per year besides more than 20 million populations already having diabetes renal disease. Most of these patients having diabetes renal disease do not enter End-Stage Renal Disease and die off cardiovascular complications. It is also being observed that 75% hospitalized patients of acute myocardial infarction either are known diabetic or undiagnosed. Further, associated with this disease there is a substantial increase in morbidity and mortality.
Diabetes is the single largest cause of Atraumatic amputation. A person with diabetes does not have to lose the lower limbs every 30 seconds if one takes simple steps like daily inspecting the feet, avoiding bare foot walking, looking for any cuts, cracks, dust accumulation and by use of proper foot-ware (neither loose nor tight). He should also report to his doctor in case he develops neuropathic symptoms (tingling, numbness, hypoesthesia’s, hyperesthesia’s, and decreased sensations in globe- and-stocking distributions) and peripheral vascular disease (cramping pain in the calf and thigh muscle especially at night and walking).
Prof. Ahmad appealed to all to join the campaign to prevent all diabetic complications and be careful to have optimal glycemic control, blood pressure & lipid control, to avoid smoking and alcohol and insisted careful eating and changing the lifestyle pattern. He requested all diabetic persons to simply remember A,B,C of diabetes management. “A” stands for A1c test that should be less than <6.5% (to be done every 3 months); “B” for Blood Pressure (should be <140/90 mmHg, <130/80 mmHg if urine is positive for albumin); “C” to keep LDL cholesterol < 100mg/dl, Triglycerides < 150 mg/dl and HDL-cholesterol >45mg/dl. In elderly and those associated with co-morbid conditions like heart disease, stroke, advanced retinopathy, the A1c should be <7%, besides cessation of smoking and alcohol and to continue lifestyle modification.