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The Rediff Special/ Shobha Warrier in Chennai
How to prevent and control diabetes
January 31, 2006
A study has been conducted on the causes and prevention of diabetes among the Indian population for the first time. Until now, such studies were conducted only on Western populations and the results of the study were not applicable to residents of South Asia.
The results of the study, conducted by the Chennai-based M V Hospital for Diabetes and Diabetes Research Centre (a World Health Organisation Collaborating Centre for Diabetes in India) under the guidance of scientist Dr A Ramachandran, were published in Diabetologia, the International Journal of Diabetes.
The study discovered that India has an estimated 35 million diabetics and worse, that nearly 13.3 million cases remain undiagnosed.
Various studies reveal that the high incidence of diabetes is mainly because of rapid urbanisation, decreased physical activity, obesity, stress and above all, the low threshold level among Indians to environmental risk factors.
Only 6 percent of the urban population in the West have diabetes. In contrast, the number is between 12 and 15 percent in the case of urban South Asians.
The incidence of diabetics in urban India has increased 20 times In the last 20 years!
After smoking, diabetes is the major cause of heart disease in urban India.
Another startling revelation is that over 50 percent cases of diabetes in rural India and 30 percent in urban areas go undiagnosed.
Undiagnosed diabetes can lead to long-term complications. "Early detection and proper treatment are very important," says Dr Ramachandran.
A question often asked is whether it is possible to prevent diabetes. Various studies and programmes in the West have shown that a modification in lifestyle and proper medication can delay and prevent diabetes in high-risk groups. Western studies showed reduction diabetes among obese people who reduced their weight.
But the results of those studies are not applicable to the Indian population because Indians differ in anthropometric (human body measurement) and biochemical features that increase the risk of diabetes.
Indians are also relatively non-obese but highly insulin resistant. The onset of diabetes in Indians is significantly at a young age compared to their Western counterparts.
It was important to find out how far a modification in lifestyle will benefit Indians who are not fat and mostly on vegetarian diets high in carbohydrate and fibre, Dr Ramachandran said.
The study, which began in July 2001 and completed recently, screened nearly 11,000 high-risk men and women. It also identified 531 people with Impaired Glucose Tolerance. Their lifestyle was monitored for three years.
The subjects were classified into four groups -- a control group who were under observation without any medicine or lifestyle modification; a lifestyle modification group (who walked for 30 minutes daily and followed a recommended diet); a group that was given metformin (a diabetes drug), and the fourth group which was given both medication and asked to follow lifestyle modification.
After three years, the study discovered that 55 percent of the control group had diabetes. 39.3 percent of those who followed a diet and exercise also had diabetes. 40.5 percent of those on medicine had the disease. 39.5 on medicine, diet and exercise were afflicted.
"Our study clearly shows that lifestyle modification and exercise are as effective as medication in reducing the risk of diabetes. This is a landmark study because it shows the most practical and cost effective way to fight diabetes and its complications especially in a developing country like India," says Dr Ramachandran.
"Our study shows primary prevention of diabetes is possible in non-obese people with pre-diabetes without weight reduction, but by dietary modification, enhanced physical activity and also by medication," Dr Ramachandran added.
So, if you belong to the high risk group with pre-diabetes with a blood glucose level of between 144 and 199, start walking for 30 minutes daily and follow the prescribed diet, you can reduce the risk of diabetes.
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