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New-age lifestyle hurts
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Fallout of a faulty lifestyle, type 2 diabetes is on the rise. AJAY MENON finds that by and large people ignore the advice of doctors to modify their lifestyle.
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A MODERN day lifestyle disease, type 2 diabetes lies undetected in many adults and children, not to speak of the increasing numbers of diagnosed cases.
"There is a tremendous increase in the number of people with type 2 diabetes''
"Sedentary lifestyles have contributed immeasurably''
"The only way out seems to be a drastic modification of lifestyles''
A clear, powerful message is coming out of the mouths of doctors and experts in the city. Although panic is certainly not the right response, it is vital that people in the city begin to re-evaluate their lifestyles and take a hard, close look at the truly sinister enemy in their midst.
Preliminary results from a survey conducted by the Endocrinology Department at the Amrita Institute of Medical Sciences and Research Centre, indicate that nearly 14 per cent of the adult population in Kochi has type 2 diabetes. Out of this, a shocking 40 per cent may be undiagnosed, says the study.
Let's take a moment to find out a little more. This is what doctors say: In type 2 diabetes, it could either be that the body doesn't produce enough insulin, or it may be that the cells in the body fail to recognise the insulin that is present. This results in high levels of sugar (glucose) in your blood. It is seen that almost one-third of people with type 2 diabetes also have high blood pressure (hypertension) and perhaps "disordered levels of fats in their blood,'' called dyslipidaemia. The "metabolic syndrome'' or "syndrome X" that you have heard of is this combination of diabetes with hypertension and dyslipidaemia. The connection between "metabolic syndrome" and obesity is well known to doctors.
It must be noted here that the UKPDS (United Kingdom Prospective Diabetes Study), done over 20 years and perhaps the most comprehensive of its type has shown that "diabetes therapy is no longer mainly about glucose lowering per se, but about overall reduction in the risk factors for diabetic complications."
Dr. Harish Kumar, Consultant Endocrinologist at Amrita says, " It is very hard to get the message of lifestyle modification across to people. I cannot stress enough the importance of exercise and a sound diet.'' Unfortunately, more and more people show the results of erratic lifestyles on their bodies. And this only exacerbates the situation for those with a genetic predisposition toward diabetes. The bulging stomach and severe complications are interrelated and the consequences can be quite deadly, literally.
"There is a smouldering problem of epidemic-like proportions in the sub-continent as far as type 2 diabetes is concerned," says Dr. A. G. Unnikrishnan, Endocrinologist at the Amrita Institute. He points out that increasingly; there is the risk of children developing type 2 diabetes, thanks to poor lifestyles.
"Eating extremely refined foods and exercising minimally if at all is an important cause," he says and describes how childhood obesity in Japanese children has resulted in type 2 diabetes becoming almost as common as type 1 there. "Lifestyles here are similar to those in advanced countries, so the dangers are real," says Dr. Unnikrishnan. He also cautions people to be wary about their BMI (Body Mass Index, a number that shows body weight adjusted for height). "Here, people are susceptible to type 2 diabetes and ischaemic heart disease at lower levels of BMI."
Dr. Sujit Vasudevan, Consultant Physician, Ojus Clinic and Nursing Home says, "Despite the high incidence of type 2 diabetes, awareness about its complications and the need for monitoring is dismal." Relating how a good number of people check for blood sugar very infrequently and that too only during complications, he says, "Patients must be educated about what is normal blood sugar, why levels remain normal and how often blood sugar must be checked." Preventive checkups that cover lipids, cholesterol and the eyes must be done regularly, he adds. " I suggest that patients use a glucometer as is done in the West. Although it costs around Rs. 3,000, it is well worth it when you consider the physical and economic costs that can be avoided," says Dr. Vasudevan.
Dr. Harish Kumar asserts that chronic stress constitutes a great danger. Diabetes seems "to come out" during the periods when people undergo great stress. Needless to say, most of this has to do with faulty lifestyles. "It is necessary to teach children about lifestyle modification through the school curriculum as they are the most receptive to such advice," avers Dr. Harish.
" I would urge town-planners to set up good playgrounds and wide pavements so that children and adults play, walk and exercise," says Dr. Unnikrishnan. "Parents should buy bicycles for their children rather than allow them to spend time only in front of television sets," he exhorts.
The golden rules that govern a reasonable lifestyle are simple enough and can be adopted by anyone. Dr. Sujit Vasudevan lists his rules:
Exercise on a regular basis.
Eat wisely.
Maintain your ideal body weight.
See the doctor regularly and follow his/her instructions.
That seems to be simple enough but even those in the know are loath to follow them, say doctors. That perhaps explains the reasons for the scourge.
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