Saturday, November 14, 2009


Indians feel proud by the achievements in many spheres during the last six decades of independence. The farmers of this country have brought laurels for this country, even if the agriculture is a losing proposition for most of them. The impoverished farming population which constitutes more than 90% of the agriculturists in India catapulted the country into top position with respect to production of many crops on the global scale and if India is a major producer of milk, sugarcane, fruits and vegetables, cereals, cotton, tea etc the credit goes to the subsistence farmers of this country. Of course, the nuclear bombs, rocketry and IT industry have made India a world force to reckon with though their percolation effect is far and few..

Against such a background, Indian record in many other areas is dismal. It is supposed to be one of the most corrupt countries in the world, has highest number of poor, hungry and malnourished population, has very poor record in the sphere of sports and athletics and is considered to have a soft belly when it comes to aggressive diplomacy. On a day when the whole world is observing the ritual of "Diabetes Day", India has been declared the "Diabetes Capital of the World", probably because it boasts of the highest population afflicted with this metabolic disease. The current estimate is that there are 50 million plus diabetic persons in the country which is projected to reach a staggering figure of 75 million. It is scary to note that seven out of 100 Indian adults suffer from diabetes disorder. 

Earlier perception that diabetes is a rich man's disease has taken a knock on on its head because compared to the per capita income in First World countries, corresponding figure in India is a pittance. Still diabetes seems to have developed an affinity for Indians, though their food consumption pattern is no where near that in most of the developed countries. One of the parents being diabetic poses a 20% risk for the children to inherit it, while a diabetic couple can increase the risk to 50%. With each passing generation the age at which diabetes develops gets lowered by 5-10 years. The relation between diabetes and obesity is well established and uncontrolled BMI can be a sure sign of potential development of diabetes. Here lies the paradox! Obesity is not known to be prevalent in India but diabetes is still a predominant disease. It is a complex question to which ready answers may not be forth coming.

There is a misconception that as India is a land of "mithais" (sweetmeats) with hundreds of variations, popular amongst all people across the country, there could be a connection between consumption of sweets and development of diabetes. Possibly such a connection may be through excess calorie consumption and higher BMI but cannot be through any effect on pancreas or insulin production. A recent report from the US blames sugar for reducing the life span based on studies on some worms which have similarities with humans in the insulin signaling pathways. A lot more needs to be done to unravel the real reason as to why Indians are more prone to diabetes without being unduly overweight.

If adequate insight on the above phenomenon is not gained quickly, diabetes may spread in geometrical progression with each passing generation becoming more vulnerable to it because of their diabetic parents. While diet modification can help to arrest the progress of diabetes in those already affected, lacking the wherewithal to reverse the disease, based on current knowledge, will hamper global efforts to checkmate it effectively. Diet and exercise seem to be the only tools available to fight diabetes to day and more people realize this truth better will be the future of this planet. 

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