Categories
Public Health

Diabetes levels drop marginally in India as per Novo Nordisk Foundation Study

Diabetes is a cause for greatest concern in India. The reason for that is many fold. But the most prominent among them is that diabetes is the foundation on which many other diseases come into play. As you know, diabetes is a condition and not a disease, and usually starts with the body’s inability to maintain the insulin level in the blood. As you know, diabetes is a condition and not a disease and usually starts with the body’s inability to maintain the sugar levels in the blood.

This could be a result of genetic makeup or also from the pancreas inability to produce insulin. But the most common co factor is stress. In 2018 Novo Nordisk had launched a diabetes impact challenge, in which they wanted to maintain a diabetes index to measure the HPA one c levels in the body.

HbA1C measures the Association of the glucose molecule with the red blood cell. As a red blood cell has a life of 120 days. This measure gives us an average of the sugar levels in the body for 120 days, and it’s a much better, and reliable measure of the sugar levels as compared to fasting, and post prandial blood sugar levels that were used earlier. In its recent finding the Novo Nordisk Foundation which produces this result figured out that from October 2019 to September 2020. The HbA1C levels have marginally dropped in India. Currently they are at 8.48 per cent. They ideally should be below 6.

By, the average HbA1C once he level was recorded at 8.48% for the year from October 2019 to 20. But this collection happened over 30 Indian cities with a vast average respondent rate of 55 years, or which of the 57% were men and 43% were women. Again you can see the testing levels among women are less and this is another area of concern.

The Indian diabetes care index which was also launched in 2018, to improve the diabetes care in the country has been providing a real time view of the average HbA1C levels in India.

According to the Novo Nordisk foundation, there are more than 77 million diabetics in the country. And the country, the total spend on diabetes is around INR 64,000 crores.

The second issue that comes up is that with COVID-19, it is clearly proven that anybody with comorbidity or with underlying conditions like diabetes, was more predisposed to, you know, to health issues. And it is clearly established that diabetes affects a lot of body parts, especially extremities like hands and feet, heart, circulatory system, and your kidneys. Your eyes, and overall suppresses your immune system.

I have written about diabetes and its implications on health, many times earlier, including these articles which you can refer to help you get a better understanding of what can be done.

What does this mean for you?

1)      Monitor-  I think 55 is a bit too late to check what your sugar levels are. The most important thing is to start monitoring it from the mid-30’s onwards. If India has risen to 71 million diabetics overnight. It is primarily because the awareness has increased. And the constant checking is possible.

2)      Detect- Get a blood sugar monitor machine. I think it’s very important, a very good investment, along with a Blood Pressure machine. I think these are solid investments that you should make, whether you have an HDTV or the latest Apple gadget. It doesn’t matter but these schedules can really save your life.

3)      Reduce Stress- Diabetes is related to stress to great extent, higher stress higher sugar levels, and higher and lower the body’s ability to deal with the sugar let’s see where is it that is causing stress for you and how you can mitigate it, you might do yoga and meditation to manage the stress, but the ultimate aim should be eliminate the source of stress.

4)      Watch out for added sugar- Last but not the least, which is sugar intake added sugar is the biggest reason why insulin intolerance is happening in the body. So, it is important to figure out if there is added sugar that you are eating which you are not aware of, which could have been causing this problem.

5)      Exercise if your medicine- Workout in the open for 150 minutes a week. This could be a simple walk or cycling or swimming.

As always, it is important for you to stay healthy. Stay safe. Own your health. You have to do it; nobody else will take care of.

Sources: https://www.biospectrumindia.com/news/79/17555/average-hba1c-level-registers-marginal-improvement-in-india.html

Categories
Wellness

Sugar is the new health threat : Findings from Credit Suisse Study

Last week I had written a piece informing people about the dangers of sugar and given them 4 reasons to cut it out of the diet. I received a lot of criticism and some feedback on the piece. I do acknowledge that I am not an endocrinologist and have not conducted any independent study on this topic.

But last week while watching a documentary on sugar consumption from New Zealand, I came across references to a report from Credit Suisse “Sugar: Consumption at Crossroads”

Findings from the Credit Suisse report is more validation of my earlier article. The truth is that the processed food industry has been using sugar in large quantities. In addition to taste, sugar is also a good preservative. And last but not the least I feel Sugar is very addictive, more addictive than cigarettes or alcohol.

Sugar is the new threat to our health

There were three findings from the report that were eye openers. These were

  1. Global Consumption- The global per capita consumption of sugar is up 46% from 48 grams a day to 70 grams a day. This is the addition of 280 calories daily. 70 grams is around 16-18 teaspoons. While this is the average, the US leads the world with 40 teaspoons a day while China has the least which is around 7 teaspoons a day. Picture an American and a Chinese. Now you would know where obesity is coming from….need I say more.
  1. Sugar link with Obesity- While medical research has not been conclusive to link Sugar with Obesity, there are indications that the link will be established soon. Today we have enough indicators putting sugars and carbohydrates as creating a greater risk for Type 2 Diabetes and Heart Attacks. While Insulin resistance is genetically determined, it is established that more than 7 teaspoons for women and more than 9 for men is way above the insulin tolerance levels. This is the amount of sugar found in a single bottle of coca-cola.
  1. Medical Practitioners Agree- While a large scale trial or study keeping a control and a trial group across many years have not been organised as yet, the surveys across medical practitioners across the glove have agreed that sugar is the causative elements for the increase in hearts diseases. The concurrence was as high as 80%. Interestingly the consumption of sugar has declined in the upper strata of the society specially among educated individuals. But sugar finds a way to sneak in through processes food.

So what does all this mean for India?

Well in India the number of deaths in India due to heart diseases stood at 15% in 1990 and now it is up to 28%. The main factor for this has been diet. While factors like hypertension are a direct result of obesity, other factors like environmental pollution and tobacco usage also contributed to this number. In other words, our sugar consumption is killing us faster than we think.

What can we do ?

Here are three steps that I want all my readers to take immediately

  1. Educate yourself- There is enough literature available on the net and as well on research sites. Spend some time reading this and take charge of your health.
  2. Watch Documentaries- There are enough documentaries on channels like Discovery and Amazon Prime. This gives you a sense of the research and though process on this issue across the globe.
  3. Read Nutrition Facts- At the back of all food articles in India, there is a table that indicates the amount of sugar that have been added to the product. Read that carefully. Remember WHO prescribes only 9 teaspoons per male per day and 7 per female. Anything above that is very dangerous.

In conclusion, take charge of your health. If you don’t no one else will. As always comments and suggestions are welcome.

Categories
Public Health

The real cost of obesity in India

India has always been a land of plenty. Historically it was a land that controlled almost 25-30% of global GDP. It is no surprise then that ancient texts write about obesity in uncertain terms. As a matter of fact practices like Yoga developed in India as a holistic system for physical and mental wellbeing.

During the colonial rule India suffered and so did the health of its citizens. Obesity was replaced with starvation. The Bengal famine during 1943 was the epitome of what all was wrong with the colonial rule and administration. The situation continued after independence, the PDS and rationing system ensured that food was available but in limits.

But 1991 changed all that. With global liberalisation India was an active market to many of the food companies. Nestle, Unilever, General Mills, among others introduced many of their global successes in the country. The net result combined with the growing purchasing power of the middle class has resulted in an epidemic that affects 5% of the population today. It also lays the foundation for systemic conditions like Diabetes and circulatory conditions like cardiovascular diseases.

According to reports from the Indian Heart Association India carries almost 60 % of the cardiovascular disease burden of the world. In terms of obesity again India sees more instances of abdominal obesity. During research on 22 different SNPs near to MC4-R gene, scientists have identified an SNP (single nucleotide polymorphism) named rs12970134 to be mostly associated with waist circumference. In this study, more than two thousand individuals of Indian origin participated and the aforementioned SNP is highly prevalent in this group. Also, obesity seems to affect women more than men in India. According to research done by CADI Research, Obesity among women seems to go higher with increasing BMI.

So what’s the real economic cost of obesity?

  1. For starters, I think it is not necessary for people to spend to consume more if they are already obese. Consumption of food should be “means to an end” and not the other way around.
  2. Obesity forms the basis of the other two lifestyle diseases killing India- Hypertension, and Diabetes. Just last week a very serious colleague from my office had a stroke, his condition was exasperated due to diabetes and obesity.
  3. Studies in India estimate that, for a low-income Indian family with an adult with diabetes, as much as 20 percent of family income may be devoted to diabetes care. For families with a diabetic child, up to 35 percent of income is spent on diabetes care.
  4. If you have Diabetes for five years you would have spent around Rs 1,50,000 on diabetes treatment only. After 10 years you would have spent Rs 4,00,000 and after 20 years you would have spent Rs 15,00,000. The increase in cost with time is due to the increase in complications.
  5. To add this the direct cost of diabetes is around Rs 1,00,000 which includes the cost of direct consultation with doctors and the numerous tests that have to be performed.
  6. Then there is the opportunity cost. Is it estimated that a loss of Rs 50,000 per annum per individual due to sick leaves?

So essentially we have a interesting situation, where we spend money to consume and then spend again on healthcare services.

So how can we change this around

  1. Get aware of the disease burden. If overweight then start, looking at dedicating 1 hour per day on exercises. Something as simple as walking daily is a good start.
  2. Lose the habits, drinking, smoking, junk food is again adding to the costs.
  3. Get regular tests done, this avoids surprises and helps you plan to cover for the disease burden. At a minimum, you should get HB1ac test done quarterly.
  4. Pick up Yoga, I have been practicing Yoga for the last 5 years and have immensely benefited from the practice

The cost of healthcare is only going to go up. Just remember that steps taken today can reduce the cost tomorrow, whether to act or not is totally upto you.

Sources

  1. https://cadiresearch.org/topic/obesity/global-obesity/obesity-in-india
  2. https://edition.cnn.com/interactive/2017/10/health/i-on-india-childhood-obesity/
  3. https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/What-is-the-cost-of-diabetes-care/articleshow/49843288.cms

Categories
Healthcare Delivery

Thoughts on #WorldDiabetesDay

India continues to deal with a unique mix of communicable and non-communicable diseases. As we continue to grapple with communicable diseases in the form of Dengue and Malaria; lifestyle led noncommunicable diseases like Diabetes are also spreading across the country.

Categories
Healthcare Delivery

How to take charge of your health for increasing quality of life

We have made tremendous progress in our understanding of healthcare patterns in India. This understanding has been employed in improving certain key parameters. A good example is life expectancy at birth for the Indians.