November 12, 2005
By Syed Akbar
Fast changing food habits coupled with stress and increasing environment pollution is contributing to the spread of diabetes in the country. Andhra Pradesh is no exception. According to an estimate by the American Diabetes Association, there are at least 31.7 million diabetic patients in India and the number is expected to grow to 79.4 million by 2030. In Andhra Pradesh alone about 30 lakh people suffer from diabetes and Hyderabad with its fast food joints and the Nawabi lifestyle is fast emerging on the world map of diabetes with many people joining the list of patients.
As the World Diabetes Day is observed on November 14, the World Health Organisation cautions people that about 366 million people worldwide would be diabetic patients by 2030. A recent survey by the Diabetes Association of Andhra Pradesh showed that of the 12,000 people surveyed in rural areas, about two per cent or 240 people suffer from diabetes.
What is worrying doctors is that diabetes is also fast spreading in rural areas. It is also no longer a disease of the developed countries. The prevalence of diabetes in urban areas of Andhra Pradesh is estimated to be 10 per cent. As diabetes expert Dr PV Rao points out the prevalence rate in cities often touch 14 per cent. The increased prevalence of diabetes in India has a lot to do with a switch from a traditional to a Western diet.
“Diabetes is a major threat to global public health that is rapidly getting worse, and the biggest impact is on adults of working age in developing countries. At least 171 million people worldwide have diabetes. This figure is likely to more than double by 2030 to reach 366 million,” says a WHO report on diabetes. It has launched a mission programme for diabetes control to “prevent diabetes whenever possible and, where not possible, to minimize complications and maximize quality of life”.
Diabetes is fast emerging as the root cause of many complicated health diseases including cardiac problems. As senior interventional cardiologist Dr PC Rath points out, instances of coronary heart diseases are generally related to neglect of diabetes. “India has the highest incidence of diabetes. Diabetic patients are more prone to coronary heart diseases. The patient suffer from chest pain which he or she normally neglects. This causes silent heart attacks,” he points out. Dr Rath advises diabetic patients to undergo regular health check-up every year so prevent cardiac complications.
Ayurveda expert Dr Venugopal says that regular exercise will help in the management of diabetes. “We can prevent diabetes by regular exercises and controlling diet. Traditional Indian food is the best food. But our people have now taken to Western food habits which is one of the reasons for the fast spread of diabetes in India,” he feels.
According to him alternative system of medicine will go a long way in managing diabetes. The panchakarma therapy, a gift of Ayurveda, will not only stop complications but also prevent amputation of diabetic foot.
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Some startling facts and figures
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1. India currently has the world's largest diabetic population with an
estimated four crore people
2. Every sixth person is a diabetic in Hyderabad and other metropolitan cities
including Delhi, Mumbai and Chennai.
3. Every 15 minutes a legis lost to diabetes in India
4. In India 40,000 legs are amputed per year, most of them as a result of an
infection in the foot of someone with diabetes.
5. It is estimated that 1000 amputations take place in a year in Hyderabad,
3000 in Delhi and 4000 in Mumbai.
6. Eightyfive per cent of amputations can be prevented with early detection
and early interventions
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Early signs
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1. Increase in urine volume and frequency. It increases as the glucose levels in blood go up. Kidneys filter blood and try to rid it of excess glucose. Frequent urination means dehydration which seriously affects the health.
2. Increase in thirst. Since water is lost in excessive urination, the patient drinks more water. Excess sugar concentrates the blood and this also increases the thirst.
3. General weakness and fatigue.
4. Slow or rapid weight loss. Many patients with early diabetes notice they are actually eating more and yet losing weight.
5. Increased hunger and glucose though more in blood is not available for cells as fuel for energy.
6. Blurred vision may be noticed. This is because the fast increasing blood glucose levels can cause fluid shifts in the lens of the eye.
7. Infections of gums, bladder and skin. Women may notice recurrent urinary or vaginal infections.
8. Healing of wounds is slow in noninsulin-dependent cases.
9. Irritability; drowsiness, tingling or numbness in hands and feet, or itching.
10. Tingling or numbness in the hands or feet
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Diet Control
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Diabetic patients should follow a strict dietary system to keep the disease under check. They must avoid the following foods.
1. Salt since it aggravates the problem.
2. Sugar as it only adds to the calories and carbohydrates.
3. Foods containing fat or high fat content.
4. Control intake of red meat to the extent possible.
5. Whole milk or milk products. Low fat milk is sufficient.
6. Tea and coffee. Take just two cups of the conventional tea or decaffeinated coffee in a day.
7. White flour and its products.
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Diabetic patients may take the following items in sufficient quantities to keep their body in good condition.
1. Bitter gourd as it contains plant insulin which reduces blood sugar levels.
2. Fenugreek seeds.
3. Jamun or Indian black plum or berry.
3. Garlic.
4. Onions.
5. Vegetables and foods with high fibre content.
6. Cinnamon solution
7. Foods containing anti-oxidants like lemon.
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Types of Diabetes
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Diabetes is of two types. It is classified commonly as Type 1 and Type 2 diabetes. Type 1 diabetes or juvenile onset diabetes occurs mostly in children. Type 2 or adult onset diabetes occurs around 35-40 years of age.
Diabetes is a chronic disorder in which the body fails to convert sugars, starches and other foods into energy. Many of the foods are normally converted into a type of sugar called glucose during digestion. The bloodstream then carries glucose through the body. The hormone, insulin, then turns glucose into quick energy or is stored for further use.
In diabetic people, the body either does not make enough insulin or it cannot use the insulin correctly. This is why too much glucose builds in the bloodstream.
Diabetes in children: The body produces little or no insulin. It occurs most often in childhood or in the teens and could be inherited.
People with this type of diabetes need daily injections of insulin
Diabetes in adults: It is the most common diabetes. About 80 per cent of diabetic patients suffer from this. The pancreas produce enough insulin but the body cells
do not metabolise it. This type of diabetes is generally triggered by obesity.
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What causes diabetes
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In patients suffering from insulin-dependent diabetes the pancreas fail to make enough or stop making altogether insulin. Doctors believe that this type of diabetes is caused by an over-reactive immune system. A triggering factor confuses the body's defence system into attacking the beta cells of the pancreas and killing them. This autoimmune reaction may be triggered by a virus or by several viral infections.
Heredity and environment are other factors that cause insulin-dependent diabetes.
Diabetes is diagnosed when it is determined that a person's blood sugar is too high because of failure of insulin. The main effect of insulin is to regulate metabolism, the body's ability to utilize fuel. In diabetes, sugar metabolism is directly effected, however, the metabolism of our two other fuels, fat and protein is also effected.
Doctors use urine and blood tests to check for diabetes. In both, they are checking glucose levels. Glucose in the urine can be a sign of diabetes, although it is not always so. The doctor also may give a complete physical to check the heart, eyes and kidneys.
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How to manage diabetes
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Patients can help control their blood sugar and diabetes when they eat healthy, get enough exercise, and stay at a healthy weight. A healthy weight also helps patients control their blood fats and lower the blood pressure. Many people with diabetes also need to take medicine to help control their blood sugar.
Good food choices for diabetes are no different than what is recommended for all other people.
One can help control the blood sugar and diabetes by eating healthy, doing enough exercise, and staying at a healthy weight.
Doctors say that distributing meals and snacks throughout the day is important for people with diabetes. At least three meals are recommended.
Diet is a cornerstone of controlling diabetes. More than half of all adult diabetics manage their diabetes with diet rather than insulin or oral hypoglycemic agents.
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Panchakarma therapy for diabetes
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Ayurveda is highly effective in the treatment of diabetic foot, a dreadful
complication of diabetes. Almost 1.5 lakh people suffering from diabetes lose
their limbs every year due to non-healing of foot ulcers/wounds.
According to Dr NB Venugopala Rao, Nadisweda, a medical technique with
roots in Ayurveda, has been found to be useful in the treatment of diabetic
foot. "It helps in increasing the blood circulation in the peripheral blood
vessels thereby speeding up the recovery process. It prevents the formation of
gangrene," he points out.
In majority of cases, the blood vessels develop atherosclerosis, a condition
where the lumen of the blood vessels become narrow, decreasing the flow of
blood to a particular area or areas where the sensitivity of the skin decreases.
This condition is called diabetic neuropathy. It makes the foot susceptible to
injury. Ayurvedic drugs hold good for treatment of different types of chronic
ulcers like ischemic nature, deep vein thrombosis, occlusion of blood vessels.
Nadisweda is a modern adoption of age-old panchakarma technique, the
mainstay of many Ayurvedic therapies. "This is a combination of established
procedures in cleaning the wound by herbal decoction, administration of a set
of herbal drugs and application of steam to the injury," Dr Veugopala Rao
points out.
For washing, selective herbs are finely powdered, thoroughly mixed with
water and boiled. Medicated oil is applied on the affected part and exposed to
steam of a herbal mixture for about five minutes. The results have been 100
per cent successful, he claims.
