Detect diabetes on time

9 Nov 2008, 0256 hrs IST, Amitabh Baxi, ET Bureau

November 14. The day is celebrated in India as Pandit Jawaharlal Nehru’s birth anniversary and Children’s Day. November 14 is also, incidentally,
World Diabetes Day. I will take the liberty of yoking together these two disparate events to drive home a simple message — November 14 is not only about revellery and gaiety which mark Children’s Day. Take out time, this day, to educate your children about the disease called diabetes and that they should take precautions to nip the problem in the bud.

Let’s understand why? Today, India is called the ‘Diabetes Capital’ of the world, with more than 8% of the population affected by the pandemic. This equates to 41 million people. And frighteningly, more than 50% of people with diabetes are unaware of their condition, costing society millions of rupees in treating the many serious complications that arise from undiagnosed or poorly treated diabetes — blindness, kidney failure, nerve diseases, limb amputations and cardiovascular diseases, to name a few.

Importantly, in some countries, as many as 80% may not know they have the condition. Diabetes caused 3.8 million deaths globally in 2007, more than 6% of total world mortality and similar in magnitude to that reported for HIV/AIDS in the year 2002. Every 10 seconds, a person dies of a diabetes-related illness, and it is the fourth leading cause of death by disease globally.

That said, I would now turn to the growing problem of obesity among children and how many of them may actually be showing signs of auto immune disorders without even knowing about it. In fact, diabetes in a child is often completely overlooked: it is often misdiagnosed as the flu or it is not diagnosed at all. But the fact is that diabetes is one of the most common chronic diseases to affect children. It can strike children of any age, even toddlers and babies. If not detected early enough in a child, the disease can be fatal or result in serious brain damage.

Concurs Dr Ambrish Mithal, senior consultant, endocrinology, Indraprastha Apollo Hospitals, New Delhi: “Type 1 diabetes is a clearly localised genetic defect, while type 2 diabetes has a strong inheritance factor but the defect is not localised. In fact, there’s a strong possibility that obese children of diabetic parents will develop the disease after 10 years of age.

The other triggers are environmental factors and physical inactivity. While type 2 diabetes can be managed by a dose of metformin and insulin shots, and in some cases only with oral drugs, the problem comes in type 1 diabetes children who can be treated only with insulin shots. We even see a lack of parental and societal acceptance for such patients and many of them lose their lives because of sheer ignorance.”

Learn and live. Diabetes is a chronic, potentially debilitating and often fatal disease. It occurs as a result of problems with the production and supply of the hormone insulin in the body. The body needs insulin to use the energy stored in food. When someone has diabetes they produce no or insufficient insulin (type 1 diabetes), or their body cannot use effectively the insulin they produce (type 2 diabetes).

Doctors say type 1 diabetes is an auto-immune disease that cannot be prevented. Globally, it is the most common form of diabetes in children, affecting around 5 lakh children under 15. However, as a result of increasing childhood obesity and sedentary lifestyles, type 2 diabetes is also increasing fast in children and adolescents. In some countries (for instance, Japan), type 2 diabetes has become the most common form of the disease in children.

Ishi Khosla, clinical nutritionist and director, Whole Food, who sees an increase in the number of children visiting her clinic with diabetes, blames it on changing lifestyle with less physical activity. “While type 1 diabetes in children is an auto immune disorder, what worries me is the rise in number of children reporting early onset of type 2 diabetes. This is a condition in which kids develop insulin resistance and is mainly triggered by environmental factors and to an extent, genetic predisposition. Surprisingly, even slightly obese children are reporting symptoms of diabetes,” she says.

Khosla advises parents to get their children moving and regulate their indoor activities such as TV viewing and computer games. Underscoring the need for increasing awareness levels and better supervision, she feels parents should be role models so that healthy food alternatives and are given to children.

In fact, that’s why the World Diabetes Day campaign in 2008 aims to raise awareness of the warning signs of diabetes; encourage initiatives to reduce diabetic ketoacidosis and distribute materials to support these initiatives; and promote healthy lifestyles to help prevent type 2 diabetes in children. Sedentary lifestyle, dietary indiscretion, physical inactivity...are you passing on the perils of modern life to your children as well? Think about it.