Sugar Coated ill
One in eight people with diabetes in Delhi are at risk of a heart attack within the next 10 years, and another five per cent are likely to suffer a stroke. A study of people with diabetes in 30 upmarket and middle class neighbourhoods in Delhi — Defence Colony, East of Kailash, Vasant Vihar, Gulmohar Park, Civil Lines, R. K. Puram, Mayur Vihar, Punjabi Bagh and Rajouri Garden, to name a few — showed that people with diabetes do little to lower cardiovascular risk factors. The study — done by researchers at the Sitaram Bhartia Institute of Science and
Research and published in the international medical journal, Diabetic Medicine — surprised the investigators as they expected better health-seeking behaviour in educated people.
Wealth not health
Says lead author Dr Jitendra Nagpal, senior epidomologist at Sitaram Bhartia Research Institute, “We chose upmarket areas because it is assumed that the people in the lower socio-economic sections neglect their health far more than those who are educated. We were shocked when we discovered that even the educated did not appear to take preventive measures to protect their health.”
For the near 1,000 people who were diagnosed with diabetes, 819 agreed to a blood test. The mean age was 53.6 years (35-65 years) and on an average, they had been diagnosed with diabetes 8.1 years ago. “As many as 41.8 per cent had poorly controlled blood sugar levels, 75.1 per cent had abnormal cholesterol and triglyceride levels, and 74.3 per cent had hypertension,” says Nagpal. Risk engines used to assess future probability of disease showed a 10-year heart risk among 12.6-13.6 per cent and a stroke risk of 5.1-5.7 per cent.
“Heart attacks are the leading cause of death among people with diabetes, with the risk of heart disease and stroke being two to four times higher for people with diabetes,” according to the American Heart Association. Women with diabetes are at greater risk, with a study showing that women over 55 years with diabetes are seven times more likely to have heart disease.
“People with diabetes are often overweight, have high blood pressure, high triglycerides and high bad cholesterol and low good cholesterol, all factors that make their arteries more prone to clogging,” says Dr J. N. Pande, former head of medicine at the All India Institute of Medical Sciences.
Heart disease is more diffused in diabetics — who are also more prone to silent heart attacks, as they experience no pain associated with an attack because of diabetic naturopathy.
About 40 million people have diabetes in India, and another 40 million are at risk of it if they do not eat healthier food, get more active and lose weight. Initially, the patient develops insulin resistance, a condition in which fat, muscle and liver cells do not use insulin properly.
At first, the pancreas works harder to produce more insulin — to keep up with the added demand, but over time it loses its ability to secrete the required insulin, and the person becomes unable to metabolise he blood sugar. On an average, insulin resistance begins about a decade before a person is diagnosed with diabetes.
Diabetes, however, can be controlled, and a person can lead a productive life for decades even after being diagnosed. Uncontrolled diabetes, however, increases the risk of many diseases like heart attacks, stroke, kidney failure, blindness and even gangrene — with 40 per cent non-traumatic amputations being caused by it.
While medicines can help you control and keep the related complications at bay, only lifestyle modifications such as losing weight, exercising and controlling your diet can help you control it.