Recent figures released by IDF paint a scary picture of the diabetes epidemic showing no signs of abatement. 366 million people worldwide are now living with the disease and many more are at risk; diabetes is responsible for 4.6 million deaths a year; it is among the top ten causes of disability resulting in devastating complications such as blindness and lower limb amputations; all nations- rich and poor- are suffering its impact, and the disease is hitting the poorest hardest. It is an increasing burden on global health system with an estimated $500 billion spent a year on it.
Keeping in mind this dismal scenario, the IDF and WHO are calling upon thousands of people from over 170 countries to join together to Act On Diabetes Now –the theme of this year’s World Diabetes Day—with a view to put diabetes firmly in the public spot light and take corrective action. The reasons for this almost four times rise in the incidence in diabetes over a period of 21 years could be manifold. According to Mr Lorenzo Piemonte, Communications Coordinator at IDF, “Diabetes is strongly linked to urbanization, which is the case in many developing countries where 80% of the new diabetes cases are happening. As people have access to more wealth they adopt more western lifestyles, which results in an increased risk to developing type 2 diabetes, the most common form of the disease. It is often still considered the rich man’s disease, but the numbers show that it hits the poor man the hardest even in developed countries, and is increasing in every country of the world with a disproportionate impact on the developing countries.”Dr Gourdas Choudhuri, Professor and Head, Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), also agrees that Type2 diabetes (commonly called adult onset diabetes), is spiralling mainly because of unhealthy lifestyles. According to him, “Type2 diabetes has a very strong genetic component and the genes of this have been passed down for over generations in us Indians. Yet it was not as common in our forefathers as it is in us now. The reason for this is the changing environment and life style. If we have the genes, it definitely makes us more prone to diabetes, but it does not mean that we will necessarily develop the disease. But a very high consumption of high sugar and fat—much more than what the body needs – makes our bodies fertile ground for diabetes. A high Bone Mass Index (above 25) means that there are excess fat cells in the body, and fat cells are natural antagonism reaction of insulin. Therefore their presence contributes to insulin deficiency, which is the underlying cause of diabetes. Another reason is lack of exercise and sedentary life habits both in adults and children.”
So what is the best step forward, to counteract the onslaught of diabetes? Dr Choudhuri firmly believes that, “We need to exercise well, and eat healthy. Exercise not only brings the body weight down, it also improves glucose metabolism. It is also absolutely necessary to have healthy food options available in the market. It is a good sign that multinational fast food chains, which used to sell only calorie loaded dishes like burgers and pizzas, are slowly succumbing to the demands of health conscious people, and have started selling salads too, especially in the west. In India, as of now, that level of awareness is not there. But it is just a question of mindset. Once we perceive it is as a necessity, we are bound to consume healthier and low calorie foods. A positive start in this direction is the availability of sugar free ice creams and sweets, which are safer options for people living with diabetes. Again, ‘Subway’ outlets in India are selling a variety of healthy food options of brown bread, greens and salads.”
Dr Choudhuri further stresses: “I cannot overemphasize the importance of schools in inculcating good eating habits and healthy life styles in students. Several things need to change at the school level. Firstly, school timings are getting shorter, and the whole emphasis is on academics and scholastic achievements. A comprehensive development of the child is taking a back seat. Secondly, the extent of games and sports activities has come down sharply, probably because of lack of available time in school. This needs to be dealt with on a serious footing. We need a more inclusive approach to physical activities, and regular use of the games field should be made compulsory for all, and not just for those who are good at sport/athletics. The other issue is that schools need to play an active part in deciding what is sold in the school canteen, as is already happening in many developed countries. One of the good things that have started in the US and other countries is the ban on sale of cola drinks in and around the schools (not just in the canteen). Sugared soft drinks with empty calories are one of the major causes of obesity. We need to do that in India too. The canteen food in Indian schools is not healthy. It is generally deep fried stuff like samosas, bread pakoras and chhola bhaturas. School authorities have to be more sensitive to these issues, and ensure that healthy (and not junk) food is sold in the canteens. Also there should be no fast food shops located in the vicinity of schools. Healthy food does not mean boring and unpalatable food. In my own hospital here we coaxed our cafeteria guy to sell at least 5 food items which were very healthy and yet tasty. One is puffed rice with baked peas, which is a legume and has fibre and protein. Another option was to make a roll of roti instead of paratha stuffed with boiled vegetables which were tastily flavoured with different types of sauces. This became a huge success with the hospital staff. Such options should be made available in schools too.”
In September this year, the UN High Level Summit on Non Communicable Diseases, held in New York, brought diabetes to the attention of world leaders and put it on the global health agenda. Mr Piemonte rightly feels that, “14th November, this year, presents the perfect opportunity to build on the momentum generated by the Summit and produce a powerful and united voice calling on governments and decision makers to deliver on their commitments, which they made in September, to tackle the epidemic.”
If nothing is done to prevent a further rise, we would be looking at over half a billion people living with diabetes within a generation. So let us all join hands to help make a difference and achieve a healthy future. On the eve of this world diabetes day, the famous Taj Mahal of India will, for the first time, bathe in blue light, joining scores of other monuments worldwide, to show solidarity in the fight against diabetes.
Shobha Shukla - CNS
(The author is the Managing Editor of Citizen News Service (CNS). She is a J2J Fellow of National Press Foundation (NPF) USA. She has worked earlier with State Planning Institute, UP and taught Physics at India's prestigious Loreto Convent for over three decades. Email: shobha@citizen-news.org, website: http://www.citizen-news.org)
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