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Diabetic Tsunami is going to hit ..! (January, 2007)

The alarming incidence and galloping jumps in numbers of new victims of Diabetes Mellitus (D.M.) particularly attacking the youngsters in India is a matter of serious concern! The diabetic census for India was 19.4 millions in 1995 and the projection for 2025 is 75 to 80 millions. This Diabetic Tsunami will possibly hit not only the coasts but also the hinterland, urban and rural, much earlier than predicted. India is the proud holder of the title of “Diabetic Capital” of the world; and Chennai has the distinction of being D. Capital for India! To treat this huge sea of Diabetics, we need more and more specialists in this disease; medical colleges should introduce a postgraduate diplomas and degrees in Diabetes; more specialist Hospitals for treating this disease are needed. But the better option is to explore into and analyse causes for the impending epidemic and take proactive preventive measures.

Some studies conducted so far give a fair picture of Diabetic scenario in India. One in every five diabetics in the world is an Indian. A recent report in Lancet medical journal reported incidence of diabetes in India as 12 % in the age group 30 to 50 years, compared to 8% in U.S.A. Also among Indians, possibly as a result of some genetic predisposition, D.M develops much faster in younger age, even in those with minimal obesity. Obesity, which is a risk factor, affects 22-24 % of children in elite schools in Delhi, as per recent study conducted by AIIMS and Defense Research & Development Organization. In another group of 600 children, 400 were found to be obese, 3 diabetics and 15 prediabetics. Many of these over weight youngsters may in fact be harboring a condition called ”Syndrome X”, described by researchers of Stanford University as early as 1988. Unrecognized and uncontrolled, this condition leads to frank D.M.and several diseases of the heart and blood vessels, in later life.

In early stages of “Syndrome X”, evaluation and some corrective measures makes all its harmful metabolic and other features completely reversible! Diabetes in this large group is totally preventable. Our people – Parents, Doctors, Diabetologists and the Public in general should gear themselves up and face head-on the impending Diabetic Tsunami!

What is Syndrome X?
Externally children and youngsters belonging to the present “technologically switched-on generation”(Dilip Bobb, I.T, Dt, 20.11.06) look healthy and well fed; they have a very good appetite for all kinds of food and junk food with a wonderful gift of doing multi tasking in their studies or profession. Their talents and intellectual capabilities are to be seen to be believed. But many of these plumpish, over weight or obviously obese may be harboring the stealthy Syndrome X. Parents and medical personnel should have a high degree of suspicion in their healthy looking, but plumpy children to take a medical test. You have to Sherlock Holmes’ it out by a medical check up. Elementary clues to Dr Watson are a slight rise in B.P; cholesterol and lipid profile showing abnormalities; abnormal blood coagulation profile and blood glucose estimation showing “glucose intolerance” or frank diabetic state. This is the classical Syndrome X and if left unchecked leads to high B.P., heart disease and Diabetes too, all at a much younger age, a decade or two before even fifty!

Syndrome X – how to fight it out?
Many of us, especially those brought up in an urban milieu, tend to partake in rich food – food rich in various kinds of fat and carbohydrates, highly tasty and mouth watering! They are freely available in fashionable modern eateries which attract the young and fashionable and the rich class. These kind of “fast foods” or “junk foods” as they are called tend to get absorbed quickly from intestinal tracts and raise the blood sugar steeply (called as ‘High Glycaemic food’) as a result. The response to keep blood sugar in check is to produce more insulin in the Pancreas. More insulin results in bringing sugar in control, which however quickly falls too. The resulting sensation of “hunger” in such an individual makes him crave for more food and the cycle goes on. Prolonged overproduction of insulin produces resistance to its action and causes further demand for insulin. The excess insulin production and the “insulin resistance“ cause other side effects on other systems in the body which gradually lead on to “Syndrome X”. The following are the typical features of “Insulin resistence”manifesting as Syndrome X.

  • Significant inflammation of arteries and this in due course will result in “heart attack” and “Stroke”.
  • Increasing Blood Pressure.
  • Elevated “Triglycerides” ( a form of fat/”cholesterol”) in the blood.
  • Lower HDL (good) cholesterol in the blood.
  • Elevated LDL (bad) cholesterol.
  • Increased tendency to form “blood clots” (heart attack & stroke).
  • Significant uncontrolled weight gain, usually around the middle of the body, called “ Central Obesity”. The waistline increases dramatically.
  • Ratio of Triglyceride/HDL, if greater than 2 is an indication of impending/early syndrome X.
  • Post prandial blood sugar shows borderline increase (130 to 190 mgs) also called as glucose intolerance” or “preclinical diabetes”. More than 200 mgs PP Blood sugar

indicates established Diabetes.

It may take several years for a syndrome X initiate to develop full fledged Diabetes and other cardio vascular effects.

In the relatively early stages, effects of Syndrome X are entirely reversible.
Reversal and control is possible by permanent lifestyle changes in the form of:
1) A sensible diet plan, balanced diet planned for weight balancing and containing generous servings of fresh vegetables, fruits and fibers.
2) Moderate but regular exercises to be done daily or 5/7 weekly; an exercise regime consisting of aerobics, muscle building and/or games – all of which you should enjoy doing and hence continue on long term basis or life long.
3) A regulated and disciplined life style with sufficient time allotted for sleep and ideally incorporating some Yoga methods like Meditation, Relaxation, Pranayama, with or without some Asanas and some spiritual or religious reading.
4) Also recommended to take nutritional supplements, essential vitamins, minerals and some anti oxidant combinations.
5) Regularly monitoring medical parameters and periodical preventive medical check up.

These are general guidelines; you should directly consult with your family physician for details regarding diet, exercise and suitable supplements and medications if needed.

And remember, your child’s future health and happiness depends on your proactive action, when your active “healthy looking” bright and brilliant child may in fact be carrying the seeds of Diabetes and Heart Disease in the form of Syndrome X!

Take care and be a responsible health conscious member of Society!
Dr. M.Mohan Rao,
Director and Senior Surgeon (Retired).

References:
1. Ray D Strand, MD; What your Doctor doesn’t know about Nutritional Medicine may be killing you.
2. Damayanti Datta, Killing you sweetly, India Today, Nov., 20, 2006.
3. Dilip Bobb Wired Generation, India Today, Nov., 20, 2006.
4. Vijay Times, Daily Newspaper, Dt. 20.11.06


Dr. M.Mohan Rao, MBBS,MS,FICS,MCH,

Director & Senior Surgeon (Retired but not tired),
Dr. U Mohan Rau Memorial Hospital.
Email: mmr@mohanraohospital.com


 


 

Updated on 01.01.2007.
 

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