A RECENT study conducted by PGIMER Chandigarh found about 36 per cent of residents in the “pre-diabetic” stage even as 1.6 per cent were diagnosed with diabetes. This was the result of a random survey of all “healthy” individuals, read people without diabetes, carried out in four sectors.
Professor Sanjay Bhadada from the department of endocrinology, PGIMER, who carried out this study with his team said they tested as many as 911 people in the four sectors of 15, 22, 38 and Indira Colony. Their HB1AC — Hemoglobin A1c, often abbreviated HbA1c, is a form of hemoglobin that is bound to glucose — an average of three months of blood glucose (blood sugar), was checked and it was found that a good percentage of individuals were in the pre-diabetic stage.
While 328 people (36 per cent) were found pre-diabetic, 566 (62 per cent) were certified healthy and 15 (1.6 per cent) were diagnosed with diabetes.
In Sector 15, almost 40 per cent of people tested were found pre-diabetic. Out of 349 residents, 146 were found in the pre-diabetic stage while three had diabetes.
An HBA1C of less than 5.7 is considered normal. However, a score of 5.7 to 6.4 means the person is in the pre-diabetic stage and at the risk of developing diabetes. A patient of diabetes has a score of more than 6.4.
In Sector 38, of the 287 healthy individuals studied, 178 were found normal but 101 were found in the pre-diabetic stage and eight were diabetic. In Sector 22 as well, of the 91 healthy individuals, 33 were found to be pre-diabetic and two were diagnosed with diabetes.
Chandigarh, the diabetes capital of India
A survey by the ICMR-INDIAB last year showed that the city had a diabetes prevalence of around 15 per cent, which was the highest among any states and UTs in the country. The survey had concluded that 14 out of every 100 persons in the city are diabetic and 14 are pre-diabetic.
The doctors had attributed the high incidence of diabetes to increased urbanisation, consumption of calorie-dense food, adaptation of sedentary lifestyle and rising obesity. It was stated that the economic transition from lower to higher socio-economic strata has also contributed to the increased burden of diabetes.
Anatomy of diabetes
It is a condition when the body has fluctuating or elevated blood sugar levels. There is alteration in the carbohydrate, protein and fat metabolism. As the body does not produce any or the right amount of insulin, glucose remains in the blood and is not utilised properly by body cells.
In some cases, the autoimmune system destroys the pancreatic cells leading to insulin deficiency (LADA or Latent Autoimmune Diabetes).
Although diabetes is considered a chronic condition, it can be managed and regulated with the right lifestyle changes and diet.
Not managing it well can lead to severe life-threatening complications like glaucoma (a condition wherein there is increased intraocular (or eyeball pressure leading in permanent vision loss) and diabetic foot. In the latter condition, cuts, blisters and injuries do not get cured quickly. In its extreme manifestation, gangrene or infection in lower extremities could necessitate foot or leg amputation. Diabetes also leads to cardiovascular diseases, diabetic dephropathy and various other complications.
The main types of diabetes are
Type 1 diabetes: It is due to the body’s malfunction to produce insulin in the body, and requires the person to inject insulin. This form was previously referred to as “Insulin-Dependent Diabetes Mellitus” (IDDM) or “Juvenile Diabetes”.
Type 2 diabetes: It is due to insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency. This form was previously referred to as non-insulin-dependent diabetes mellitus (NIDDM) or “adult-onset diabetes”.
Type 2 diabetes can be prevented with lifestyle changes such as healthy diet, proper exercise and the right body weight.
The third main form, gestational diabetes, occurs when pregnant women without a previous history of diabetes develop a high-blood glucose level.
Early diagnosis the key
Professor Sanjay Bhadada says that with people adopting an increasingly sedentary lifestyle, it has become vital to get yourself checked for diabetes routinely.
“Weight reduction is really important because obesity is also one of the leading causes of diabetes. There are some studies where intermittent fasting has led to reversal of the disease and improvement in blood glucose levels,” he said.
Bhadada recommends an hour of exercise every day to prevent this disease. “Even in children, late-night eating, junk food, high-calorie diet, and stress is leading to this disease. But I will say prevention is better than cure so we must exercise restraint instead of falling prey to it,” he stated.
Diabetes registration in Chandigarh
A cursory look at statistics shows that the number of locals suffering from diabetes is rising with every passing year. The number of children who were diagnosed with diabetes in 2009 was just 549 as compared to 1,382 in the first 10 months of 2019.
Among the adults, the number of new patients of diabetes at PGIMER stands at 9,948. On average, around 10,000 new patients are added to the institute’s diabetes registry every year.
Healthily ever with diabetes
While Chandigarh may have the dubious distinction of being the diabetes capital of India, it’s also home to a large number of people with this disease who have learnt to overcome it with a mix of physical activity and the right diet.
Former railway minister Pawan Kumar Bansal, who always finds himself getting compliments for his fit frame, youthful demeanour and the spring in his stride, has been living with the disease for almost 29 years now. “You can say that I am living happily with diabetes,” he beams, adding, “It is not a disease if you manage it well but it is the mother of all diseases if you don’t regulate it.”
Bansal was an MP when a doctor friend diagnosed him with diabetes one fine afternoon. His blood sugar levels were almost 350. Bansal recalls taking a deep breath before taking the disease head-on by making enduring lifestyle changes. He says he has been managing diabetes so well that it is almost ‘insignificant’ in his life.
Though with time, doctors increase the daily dose of insulin, the former minister, who is known for his daily walk at the Sukhna Lake, takes it just once a day and keeps his blood sugar in control.
The former railway minister says the genes play only a small role in age condition. “Hereditary factors account for just 20 per cent, but physical inactivity and improper diet can play havoc,” he surmises.
“When I was diagnosed with this disease, my physical activity was zero. I brought it back into my life. Initially, I started playing badminton and other games. Now I go for a daily walk without any breaks and do yoga three times a week for an hour each,” he said.
His diet, he says, is frugal. “I have completely banished wheat and sugar from my kitchen.’’
“We have multigrain chappati, which is a mix of jowar, bajra, ragi and other grains. We also eat a lot of amla (gooseberry), sometimes even going to the extent of cooking a vegetable from it. When I speak of not taking wheat, it is also includes all types of breads, even the brown bread,” he adds.
Bansal makes sure that the diet in the house is healthy even when it comes to his grandchildren.
“Nowadays you see children being diagnosed with diabetes. We ensure there is a healthy diet at home and there is no fuss about it. Even my five-year-old grandson knows that junk food is not good for your health,” he says.
One lifestyle change that really hurt this lawyer was tea. “There was a time when I would have 14-15 cups of tea a day; now I have scaled back my consumption to four or five times a day. Even when I attend wedding functions, I stick to simple chapati and daal,” says Bansal.
RAHUL (name changed), 12
Rahul, a 12-year-old, was diagnosed with diabetes in September this year. Rahul was tested for diabetes when he started experiencing frequent thirst and urination. Upon testing, his blood sugar levels were found to be really high.
Though doctors advised the family to put the child on insulin, he has been managing this disease really well with the right diet. “We haven’t given him insulin even once, and hope he will not require any,” says his mother.
Patients who have been keeping this disease at bay also swear by bitter gourd (karela). It contains an insulin-like compound which has been shown to control diabetes naturally.
While many go off sugar only to replace it with sugar-free sweeteners, clinical nutritionist Shreya says it is even more dangerous than sugar. “Instead go in for brown stevia – it is just like a tulsi plant and you can add it to your tea or coffee for natural sweetness,” she said.
Shreya says diet plays a very important role in curbing this disease. “You can even reverse this disease if you alter your diet,” she claims.
Former Union Minister Harmohan Dhawan
Former Union Minister Harmohan Dhawan says he is a “living example of someone who reversed diabetes” 15 years ago with a combination of physical activity and right diet. The former minister recounts how he was put on medication 35 years ago. “It’s been fifteen years and I have not taken any medicine for this disease,’’ he claims.
Dhawan believes the cure lies in “modification in the lifestyle”.
“About 35 years back, I was in Los Angeles when I was diagnosed with diabetes. I experienced frequent thirst and urination. Doctors in India put me on medication,” he said.
Dhawan stated that he conducted a research on the topic and found that 30 grams of normal atta chapati that people eat leads to an increase of 55 mg/dl blood sugar level while wholegrains with a mix of jowar, bajra, ragi, gram, jau increases the blood sugar level by a mere 25 mg/dl. Also, cutting down on carbohydrates, consuming nuts, fruits and vegetables and avoiding packaged foods also helps in regulating the disease.
Today, the former minister counsels diabetics. Talk about the patient becoming the doctor.
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