Living with diabetes: some sweet truths and bitter realities

Educationist SV Chittibabu turned 100 just days ago. A remarkable milestone that gets better when you are told that he’s had diabetes for close to 60 years now, 56 to be precise.

His family and doctor vouch that he has lived a life without major health complications, with just the required discipline to keep Type 2 diabetes in check.

“He has had no heart or blood pressure problems,” says son C Mohankumar, a consultant physician, adding that his father lived an active life, having been Vice-Chancellor of Madurai Kamaraj University and Annamalai University (Chidamabaram). He did not stay away from official functions and the delicacies that may have come with them, or a non-vegetarian diet, which he discontinued just 10 years ago. “He used to go walking,” says the son, when asked about his father’s exercise regimen, when he was younger.

Diabetologist Dr V Mohan, doctor to the educationist, explains why the 100th birthday is a milestone of sorts. “Awareness, better and early diagnosis and treatment, regular check-ups and a little discipline are seeing more people live longer with diabetes without associated health complications.”

“Studies have shown that the first 10 years are the most important. If you control your diabetes well during the first 10 years, you can almost be assured that in your lifetime, it will not trouble you with its dreaded complications,” he says, adding that lack of attention in the first 10 precious years will mean precious time lost and “no amount of control after that” seems to help as people develop complications.

Alongside the success of a well-managed disease, diabetologists are also seeing the other side of the coin. Young people who get diabetes earlier in life are seen developing complications by the time they reach 40 or 50 years, says Dr Mohan, referring to diabetes-related complications including kidney failure, needing dialysis or renal transplantation, severe coronary artery disease, often with a heart attack, which needs bypass surgery, or blindness due to diabetic retinopathy or loss of limbs due to gangrene, and diabetic peripheral vascular disease in neuropathy.

Pointing out that early diagnosis and proper management of the disease are critical, he says, “If anyone in your family has diabetes, please ensure that all members of the family are checked up for diabetes, so that it can be detected at an earlier stage,” since at a pre-diabetic stage it is completely reversible. And for those already diagnosed, keep it under control from the beginning, he stresses.

Gadget-driven illness

Diabetologist Shashank Joshi points to the troubling fact that “every seven seconds a person dies of diabetes, globally.”

Disquieting trends cited in the International Diabetes Federation (IDF) report (2017) seem to continue to prevail, says Joshi, the IDF’s South East Asia Chair-elect. “In India, we are seeing the second peak of diabetes in the youth (16 to 30 years),” caused by sedentary lives, unhealthy diet and too much screen time, be it the mobile phone, television or computer. And this is becoming evident in rural areas as well, he adds.

This is a completely lifestyle and modern gadget-driven peak, he says, and young people come to know of their diabetes only when they develop a health complication or heart attack. Diabetes can bankrupt economies, as it strikes people in the most productive time of their life, he says, apprehending that village residents may catch up with their city counterparts (in terms of diabetes prevalence) 10 years before it is projected to happen.

The 2019 map on the prevalence of diabetes across the world will be released next week on World Diabetes Day (See ‘Coming Up’ column in Pulse). Presently, India is reported to have over 70 million people with diabetes, after China with over 100 million. And as prosperity and the population grow in India, and as China stabilises its population, diabetologists caution that India is headed for pole position, if it is not there already.

Joshi says that India needs to become the “diabetes-care capital of the world” and not the “diabetes capital”. And for that, along with affordable medicines and insulin, policymakers need to take steps to encourage people to eat right and stay fit, he says, lauding the Government messaging on fitness and efforts to get healthy food in school and office canteens. On an individual front, people need to eat less, eat on time and eat slowly, besides getting seven hours of sleep, says Joshi. And importantly, he adds, “don’t give stress, don’t take stress”. Sage advice, for those without diabetes as well.