Says, Dr. Anil Bhoraskar, Diabetologist at Fortis SL Raheja Hospital in an email interaction with Ekta Srivastava, Health Technology
Current state of diabetes in India and how it needs to be tackled
At the moment Diabetes is like an epidemic or Tsunami affecting all the classes of people. The worst thing about this pandemic is that it is affecting young people. India is already suffering from various communicable diseases and the burden of this type of non communicable diseases which leads to severe complications thereby increasing the cost of the treatment which is just enormous. Unfortunately diabetes is not taken seriously in early stages because it may not have any symptoms. People develop symptoms only when they develop complications and the treatment of complications is not easy. Unless the community has a high index of priority of perception of this treacherous disease, we will not be able to overcome the problems associated with diabetes.
Emphasis on type-2 diabetes and issues related
Type 2 diabetes is the most common variety (90% of the people with diabetes in India has this form of disease) . Type 2 diabetes produces complications related to blood vessels of the heart, limbs, kidney, eyes and the brain. Coronary artery diseases (CHD) is 4 times more common amongst people suffering with diabetes and is seen prematurely.
Is diabetology a specialty in itself?
Diabetology is a specific specialty focused on problems particularly seen in people suffering from diabetes. It cannot be considered as a pure sub -specialty of endocrinology because it deals with nephrology, neurology cardiology and diabetic foot. Hence it is possibly a branch of internal medicine which deals with more severe conditions.
What are the recent advances in diabetes?
Recent advances in diabetes are many. Right from primary prevention to the treatment of tertiary complications. There are many new drugs which are quite efficacious in bringing down the elevated blood sugar, lipids and effective in controlling hypertension. Early interventions in vascular disease of the limbs and the heart have saved many lives. Coronary heart disease which was thought to be the number one killer is now managed very efficiently by immediate revascularization procedures, early detection of renal disease by detecting the presence of micro proteins in the urine and effective treatment using modern drugs have now started delaying the progression in nephropathy. Early detection of retinopathy has saved many diabetic patients becoming visually impaired with the help of laser machines. There are now many new drugs such as Gliptins, SGLT 2 inhibitors and GLP-1 analogues are extremely beneficial in not only controlling the sugar but also the weight of the diabetic patients.
To what extent is it preventable?
At least 50% of pre-diabetics can be prevented from getting into full fledged diabetes by having simple lifestyle changes.
Steps the government can take to curb the rising issue of diabetes
First of all the government must realize that diabetes needs priority in any national program on health. The prevention is far more cost effective which can begin in early childhood hence the importance of school education on nutrition and physical exercise which should be made compulsory as a part of syllabus. There should be serious regulations on advertisements and sales of harmful food products. All medical centers run by government must have adequate facilities for early diagnosis of diabetes. The drug therapy of diabetes and its complications should be regulated by the price control so that the treatment becomes affordable to practically every member of the community.
