India is home to some 70 million diabetic patients and the disease is fast gaining the status of a potential epidemic. Some 1 million Indians die every year because of this disease.
The question is, can there be new, simpler ways to cure diabetes ?
Some 75% of the 415 million people with diabetes worldwide come from low or middle-income countries. Incidentally, India ranks second only to China, home to 92.3 million diabetics.
Neuropathy- dysfunction of one or more peripheral nerves is the most common complication of diabetes followed by cardiovascular complications, renal issues, retinopathy and foot ulcers.
Why are Indians highly susceptible to diabetes?
For one, genetic outlook alone makes Indians four times more likely to develop diabetes than Europeans.
Second is diet. The food consumed by an average Indian is rich in carbohydrates and fats which adds more calories to the body than what is required. This leads to obesity which in turn leads to diabetes. By extension, changing lifestyle contributes to this as well.
Awareness is a bigger problem.
Estimates suggest that around 50% of diabetics in India, mostly in rural areas, are not aware of their condition, despite the fact that every adult over the age of 40 is at risk. This lack of awareness about the complexity of this illness prevents people from taking treatments.
Diabetes can be classified in to two-Type 1 and Type 2 Diabetes. The most prevalent one is Type 2 diabetes which can be controlled by taking measured diet, oral medication and proper exercise. Type 1 diabetes which is insulin dependent though not preventable can be kept at bay by following a balanced diet and lifestyle.
How Can We Solve The Diabetes Problem ?
The answer apparently lies in taking matters into your own hands, according to a study by leading researchers at the Public Health Foundation of India, All India Institute of Medical Sciences, and Emory University.
The study points the way to developing a low-cost care model to treat diabetic patients.
The target group for this study included 1,146 patients (575 in the intervention group and 571 in the usual care group) with type 2 diabetes and poor cardio-metabolic profiles.
While usual care participants continued to be treated at the discretion of physicians, the intervention participants were supported by non-physician care coordinators in addition to their usual physicians. The key takeaways from the finding are follows:
- The intervention employed in the study is a detour from new or expensive drugs. Instead it helps the patients manage disease on their own by providing individualized support and enhancing the physician’s likelihood of being responsive.
- The study showed that identical benefits were noticed in public and private diabetes clinics. This proves the larger point that health inequalities that are prevalent globally, cutting through age, sex, caste and other parameters can be narrowed down with structured care.
- These findings are relevant for the U.S., India, Pakistan, and many other low-, middle-, and high-income countries alike where achievement of diabetes care goals is suboptimal and where health disparities are common.
The multifaceted quality-improvement (QI) program for diabetes management in India and Pakistan resulted in twice the probability of achieving diabetes-care goals compared with usual care over the course of 2.5 years.
This approach might help change perceptions in India.
India faces significant barriers in reducing the huge numbers of diabetic patients. There is a section of the population that still doubts the efficacy and safety of insulin. The ease of administration and flexibility of use is an important factor affecting the acceptance of treatment recommendations.
Kerala recently imposed a ‘fat tax’ of 14.5% on junk food which has been hailed as a start in the right direction to keep diabetes under control. With lifestyle diseases on a rise and diabetes being a chief one, the Kerala government’s move would reap benefits if executed as intended.
With government coming forward with programmes for diabetes management and partnerships between various stakeholders, new ways of diabetics care process must be explored. The biggest challenge however would be to dispel myths surrounding the diet and medication and ensuring compliance to the medical regime.