Diabetes Mellitus is the modern Black Plague sweeping its way like wildfire across continents and communities. Often thought of in the past as a disease of the Decadent West, it has come home to roost in our country and our state where its incidence has been increasing at an alarming rate.
From ancient days itself, Egyptians, Greeks, Chinese and Indians were aware of the existence of this disease. The sweetness of the urine (‘Madumeha’ in Sanskrit) was a characteristic of the disease and having diabetes over a century ago meant a shorter life full of pain and suffering.
Our understanding of Diabetes has increased by leaps and bounds but we still have a very long way to go in winning the war against this crippling and debilitating killer.
It is estimated that there are 60 plus million persons in India suffering from Diabetes Mellitus with the numbers expected to go up to 100 million by the year 2030. What is shocking and disheartening is that nearly half of these are unaware that they have the condition. India runs a close second to China in being the ‘Diabetic Capital of the World’ - something we should all be deeply ashamed and embarrassed about. While in the Western world, urban rates of Diabetes prevalence is far higher than in rural areas, in our country the rates are nearly equal especially in our state of Kerala where the urban and rural divide hardly exists.
Most diabetics do not have many symptoms and diabetes is discovered accidentally during a routine medical examination, during an inter current illness or when complications set in. In our country Diabetes sets in at younger ages but is diagnosed late and behaves more aggressively than in the developed world.
Diabetes is a disease of sugar metabolism, but modern medicine understands it as much more. It is also a disease of fat metabolism and affects practically every organ in the body. The main organs targeted by the disease are the kidneys, eyes, heart, blood vessels and nerves. The fact that both large and small blood vessels are involved would mean that vital organs are at risk when the disease is not adequately controlled.
Incidence of heart disease, kidney failure, blindness, gangrene leading to amputations is significantly higher in Diabetic populations. The rationale behind early detection of Diabetes is to control the blood sugars and prevent or postpone the complications.
Management of Diabetes Mellitus is an uphill task. We need to identify the diabetics in our population who are unaware that they are affected. For this we need mass screening programmes. We have to spread the message of prevention of diabetes to our young ones in schools and colleges where the importance of diet, exercise and weight control should be stressed. We need to spread awareness about the disease through education programmes both for patients and susceptible populations. Once the disease is diagnosed, importance must be given to giving the patient all possible information about the disease and its management. It is only by absolute cooperation between the medical community and the population at large that we can begin to combat this “health terrorist” which could lay waster to our future generations.
Dr Sujit Vasudevan, MD, Sr Consultant Physician, Ojus Clinic, Kochi