Diabetics must focus on preventing complications: Top diabetologist

New Delhi: Amid spiralling cases of diabetes in India, a top diabetologist on Thursday said preventing the myriad and dreaded complications of the blood sugar disease is important to help people affected to lead a healthy and long life, while also reducing the economic burden of the country.

According to the latest Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study, a tenth of all Indians have diabetes, and high levels of other non communicable diseases like hypertension and cholesterol, which not only raise mortality risk but also increase economic burden.

Speaking to IANS, Dr V Mohan, chairman of Dr Mohan's Diabetes Specialities Centre and one of the authors of the study, said that one should try to prevent diabetes, but among those already diagnosed, disease progression must be controlled so as to prevent severe complications, because "just like diabetes is silent, the complication around it is silent".

"Diabetes will keep on increasing not only in India but in the world. Because there are modifying risk factors and non-modifiable risk factors. If diabetes cannot be prevented because of genetics or ageing, one thing you can do is to prevent the complications of diabetes.

"People with uncontrolled diabetes can suffer from kidney problems -- failure, dialysis, transplantation -- blindness, amputation, heart attacks, strokes, dementia, nerve problems, gangrene. Even their sex life gets affected due to diabetes.

"If you control your diabetes well, none of these complications need to occur," said Dr Mohan.

The alarming ICMR-INDIAB study, published in the journal The Lancet Diabetes and Endocrinology, showed that a whopping 101 million Indians live with diabetes. This is 1.68 times higher than the previously estimated 60 million diabetics in India and a previously known 7.84 per cent national prevalence rate of diabetes. Increases in weight, eating junk food, not exercising, disturbed sleep patterns all pave the wave for diabetes, said Dr Mohan.

In addition, increase in carbohydrates, combined with a sedentary lifestyle, as well as rising pollution levels, adulteration of food and their contamination with pesticides, also contribute to the diabetes epidemic in the country, he said.

The ICMR-INDIAB study also showed that 136 million Indians are pre-diabetic, or in other words, these people are waiting to convert into diabetics soon. Dr Mohan said, although the figures are alarming, it gives us a good opportunity to tell people that you are diagnosed at a stage of prediabetes, where you can reverse the condition and become normal.

"In the stage of pre-diabetes, the beta cell function in the pancreas is not completely gone but starts overworking. Reducing the load on beta cells by exercising and decreasing weight, cutting down fat in the liver, and abdomen will help prevent progression to diabetes. All this is possible," he explained.

Further, Dr Mohan noted that diabetes can be avoided as well as reversed with several measures such as keeping abdominal fat in check. "Your waist plays a very important role. Simple waist measurement will tell you that obesity, abdominal obesity is a definite sign of some future diabetes," he told IANS.

"If you can maintain a thin base, by exercise and by eating the right food, you're taking 10 steps forward to prevent diabetes," he added.

Moreover, to prevent the risk of diabetes the top diabetologist explained the "ABCD principle", where A stands for A1C levels, that is three months glucose average should be below 7 per cent; B stands for maintaining blood pressure at least below 140/90; C is called a stop cholesterol where the low-density lipoproteins (LDL) also called the "bad" cholesterol should be below 100. And D is for discipline and explains diet, exercise, stress reduction, not smoking, alcohol moderation.

"Diet, high calories, weight, increase in obesity are the major drivers, and there is a small genetic factor, which makes Indians a little bit more prone. And therefore we need to do more exercise than even the white man to prevent diabetes. So if you don't do it at all, then we will end up very fast as diabetic," Dr Mohan said.