Diabetes spells India’s new challenge as it adopts western ways
ndia’s march to wealth and prosperity also brought along diabetes as an uninvited guest. India is radically changing its traditional ways and adopting the west as a model. The result is a course collision with one of the deadliest and most deceiving diseases of our time. The poor is affected but the wealthy are too; diabetes in India is a status symbol for those lucky enough to enter the middle class. In a country with little or no health insurance, many have decimated their accumulated new wealth to pay for diabetes treatment.
India and its 1,252 billion inhabitants have experienced a 10 fold increase in diabetes between 1971 and 2000. Now 61.3 million are affected, and young people seem to be more affected then world averages which is unfortunate. Diabetes does not only strike the obese; skinny people get it too. Diabetes in India became the disease of the poor and the wealthy alike; living in the city or in the country.
India’s government faces enormous challenges trying to manage diabetes. The fast modernization brings a set of problems never confronted before. Lack of health care providers specially in the rural areas; lack of infra structure; a socially fractured cast system and the sheer large number of people creates a perfect storm. Diabetes is a condition needing intense one on one supervision, education and individualized care all difficult in India.
India’s health care system have adopted to a great extent, the American health care model. There are several partnerships with American institutions including the American Diabetes Association (ADA). Initially this seem to be a good idea but the ADA choices for care might be inadequate to India’s problems. An intense reliance on expensive drugs and an outdated diet recommendation based on carbohydrates control rather then low carbohydrate, high fat diet to a culture that is already carbohydrate intensive.
Indians have a high ethnic background and a susceptibility to the disease. The most plausible theory is that Indians carry the thrifty gene. Indians in ancient history must have had many periods of famine and certainly not the abundance of food they have today. Western ways have brought fast food and a sugar overindulgence. Other negative factor is the genetic predisposition for gestational diabetes. As many have pre diabetes and diabetes the disease can go for years without being noticed.
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Delayed diagnosis is a serious problem but a common occurrence among new affluent Indians. Unchecked, diabetes progresses to levels that are practically impossible to revert. By the time a person begins to address it, is either too late or more difficult to treat. Amputations, blindness, feet sores become the norm to an already stressed and precarious health care delivery system.
Vascular complications begin to take hold as diabetes is unchecked. India’s large population make it difficult for mass screening, and large numbers of people go un diagnosed. Early diagnosis of diabetes is critical because it prompts early initiation of treatment. Early intervention can also prevent other conditions to take hold such, cardiovascular disease and obesity which will further complicate diabetes in later stages.
Disparities in social economic and educational levels contribute to the difficulties in managing diabetes then any other disease in India. In addition there is a mismatch of health care burden with health care budget as most funds traditionally have been allocated to communicable diseases and diabetes fall off this category. For the first time in our history non communicable diseases have surpassed transmissible ones. The barriers to care are threefold: there are patient, societal, and medical barriers.
There is a urgent need for recognition and lifestyle change in India. The traditional models of care for diabetes might not work for a large and socially fragmented country like India. Pharmaceutical industry take advantage of the complexities of diabetes and lobby for their drugs which only control the disease temporarily without offering a chance for reversal. Ironically India is home of the largest collection of medicinal plants with anti diabetic properties. The implementation of these herbs might be highly overlooked in face of western medicine dominance. Because of the difficulty in controlling diabetes a further investigation an inclusion of medicinal plants and diet changes could be of help. The search to control diabetes could lead to a cultural and social introspection into India’s traditional ways.
- Epidemiology of type 2 diabetes: Indian scenario
- Hints of Unique Genetic Effects for Type 2 Diabetes in India
- The current state of diabetes mellitus in India
- Type 2 Diabetes in India: Challenges and Possible Solutions
- TYPE 2 DIABETES MELLITUS IN INDIA
- Averting Obesity and Type 2 Diabetes in India through Sugar-Sweetened Beverage Taxation: An EconomicEpidemiologic Modeling Study
- High Prevalence of Type 2 Diabetes Mellitus and Other Metabolic Disorders in Rural Central Kerala
- Organization of diabetes health care in Indian rural areas
- TRADITIONAL INDIAN HERBAL MEDICINE USED AS ANTIPYRETIC, ANTIULCER, ANTI-DIABETIC AND ANTICANCER: A REVIEW
- Trends in the Prevalence of Type 2 Diabetes in Asians Versus Whites
- Diabetes Atlas
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