In today’s blog entry, I would like to write about diabetes. I am not a physician but have a brother who was diagnosed with Type-2 diabetes three years back, and am so concerned about it. Yesterday, I read an article on the New York Times which gave details about how only about 7 percent of the diabetic patients in US are getting the treatment they need. Usually doctors focus only on the reduction of the blood sugar levels because higher levels over a period of time lead to dreadful complications like blindness, amputations and kidney failure. However, controlling blood sugar is not enough. Research unequivocally suggests that controlling cholesterol and blood pressure are equally important. Almost everyone with diabetes eventually gets killed of heart diseases. In the words of a doctor, “it’s not the diabetes that kills you; it’s the diabetes causing cardio-vascular disease that kills you.” While for a healthy person, LDL cholesterol (the bad cholesterol) levels of 100 to 139 are normal, for a person with diabetes the levels should preferably be within 70 to 80. Unfortunately, most practicing doctors are unaware that what is normal cholesterol level for a healthy person is not for someone with diabetes. After reading the article, I understood that a person with diabetes should not just be taking medication or insulin to control his blood sugar, but should also be taking medications to keep LDL cholesterol and blood pressure under control. They may also take aspirins to prevent blood clots that cause heart attacks.
After reading the article, I wondered how many people in India must be getting this complete treatment, if only 7 percent currently get it in US. My brother for sure isn’t getting it, despite our family being pretty well informed (I have a brother-in-law who is a doctor) and we having gone to the most renowned specialist in Orissa for treating the diabetes of my brother.
The scenario is especially dreadful because diabetes has already reached epidemic proportions in India in the last couple of decades. It is estimated that there are more than 35 million people with diabetes currently in India, and the numbers are increasing. I don't know specifically about India, but diabetes is already among the leading causes of death in many countries. There was a time in India, when diabetes was a rich man’s disease but now with the increased urbanization, sedentary lifestyles and our appetite for sweets, the numbers are growing in the middle class. In addition, Indians have a strong genetic vulnerability to the disease. This summer I was joking with my sisters that prevalence of diabetes in India would reduce by half if people stopped gifting each other sweets. Sweets are our most common gift; we gift sweets almost everywhere, when we visit somebody, on festivals, on family and official celebrations. The other half of diabetics would disappear if people started moving their butts. I think we are among the least exercising nations in the world. My solutions were surely a bit exaggerated and are probably more suitable as preventive measures, but a stronger health consciousness is certainly needed in India. While in western countries, people are moving to diet versions of Coke and Pepsi, and are starting to avoid junk food, we are getting more and more hooked to it in India. Fortunately, with efforts of the likes of Swami Ramdev there appears to be a rising interest in yoga, however the majority of the youngsters in urban areas rarely get to play any outdoor sports. Many of those who were physically active till they were in college develop huge bulges by the time they finish their second anniversary on job. We Indians are fond of whining and giving excuses about the lack of facilities. However, at my university in US where there is a huge population of Indian students, I rarely see Indians jogging, or at the gym, swimming pool, or other sports facilities. From this I suspect the problem is more at a cognitive level than political or social level. We are either ignorant of the ways to manage our health, or just give the least priority to it. This means there are no quick solutions for our diabetic nation.
Coming back to my brother, I know the way forward is even more difficult because of his intellectual disability and the fact that he already has developed diabetes. It is difficult enough for a normal person to go through the regimen of keeping the blood sugar levels under control, so you can imagine how difficult it must be for my parents to regulate his food, exercise habits and insulin shots. And now, they also have to make sure that his LDL cholesterol and blood pressure are within the recommended limits. My brother doesn’t have the intelligence to make the right choices about his health but people with normal intelligence do. I hope more people actually start doing it.