Lifestyle modifications will keep diabetes at bay

November 14 once used to be, in India, at least, Children's Day. No longer so. Diabetologists have usurped the day now known globally as World Diabetes Day. And perhaps, rightly so, as projections emerging with regard to the growing number of diabetics in the nation are enough to stop you in your tracks.

As World Diabetes Day is nigh upon us, here is yet another study to underline the enormity of the problem. The results of the research indicate that about 19 per cent of the study population in the State suffers from the twin conditions of diabetes and hypertension; while about 40 per cent surveyed had diabetes, and another 40 per cent suffered from hypertension only.

It was conducted by Sanofi, provider of health care therapeutics, including pharmaceutics.

The SITE (Screening India's Twin Epidemic) study was conducted in eight States – Tamil Nadu, Karnataka, Andhra Pradesh, Maharashtra, New Delhi, West Bengal, Gujarat and Madhya Pradesh. In Tamil Nadu, close to 2000 patients from Chennai, Coimbatore and Madurai were studied.

One of SITE's co-ordinators for the State, Vijay Viswanathan, says, “The data reveals that diabetes and hypertension are indeed becoming a twin epidemic in the State. Furthermore, 9 per cent were newly diagnosed cases of diabetes. Shockingly, even amongst the diabetics undergoing treatment, 71 per cent were ‘uncontrolled' thereby emphasising the need not only for regular testing but also for greater awareness about the correct treatment regime.”

Talking about the hypertension aspect, another SITE co-ordinator N. Sivakadaksham adds, “The Sanofi SITE Tamil Nadu study shows that of the patients who were hypertensive, 84 per cent did not have their hypertension under control. The data further reveals that 32 per cent of the hypertensive patients have albumin in the urine. 23 per cent were newly diagnosed.”

Diabetologists once again emphasise the concept of bringing in lifestyle modifications to prevent non-communicable diseases and/or complications. V. Mohan, chairman, Dr. Mohan's Diabetes Specialties Centre, said Diabetes Prevention

Studies in the US and Finland have shown that with lifestyle moderations, about 58 per cent of persons with pre-diabetes stop their progression into diabetes. The Indian equivalent is about 30 per cent.

There is no doubt that this intervention is most effective. A minimum of 30 minutes exercise per day, preferably going up to one hour, cutting down on high calorific white rice (for the majority of the South Indian population), substituting it with brown rice or adding a lot of pulses and legumes, avoiding fatty foods, and cutting down on at least 5 per cent of body weight have shown significant results, he says.

R.Karunanidhi, diabetologist, Jain Diabetes Centre, Mylapore, says that diabetes should also be made ‘notifiable', as it is as much a social and economic problem as it is a medical issue.

One key way to bring in awareness is to make calorie notification mandatory on all food stuffs sold.

This strategy introduced by New York Mayor Bloomberg had a great impact on weight reduction in the specific population group in the US, he says. “All our scientific research must be translated into community action, for unless the community steps in, this situation is not likely to be controlled.”

A mantra worth marketing?

A mantra worth marketing?
A first-ever status report on Indian medicine and folk healing suggests a high-level commission to globalise Ayurveda

It is common knowledge that Ayurveda has been in practice in India for the last 3000 years. Yet, the popular mode of diagnosis in this country is generally allopathic. However, with growing awareness about the benefits of alternative medicine and possible side effects of allopathic drugs in more and more people, one sees a renewed interest in our traditional methods of treatment and healing. It is then at an opportune time that the Government has commissioned a first-ever status report on Indian medicine and folk healing. The report, funded by the Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH) under the Ministry of Health and Family Welfare, has recently been submitted to the Union Health Minister Ghulam Nabi Azad, strongly suggesting the establishment of a high-level commission to propagate and globalise Ayurveda. The report, over 300 pages long gives the example of China suggesting our Government “study and document” how China has succeeded in doing so with their traditional medicine.

To drive home the point, the report compiler, Shailaja Chandra, former Secretary, Department of AYUSH, and former Chief Secretary of Delhi Government, has called for “establishing a high-level Commission like the L.M. Singhvi Commission, which addressed issues related to NRI/PIOs.” The mandate should be to follow a promotional plan for our traditional medicines akin to that of Traditional Chinese Medicine (TCM), charted out by China since 1972, primarily for Acupuncture and herbal medicine.

“The website of the U.S. National Institute of Health (NIH) and the National Center for Complementary and Alternative Medicine (NCCAM) indicate that TCM is widely used in the United States. According to the 2007 National Health Interview Survey, which included questions on the use of various Complementary and Alternative (CAM) therapies, an estimated 3.1 million U.S. adults had used Acupuncture in the previous year,” says the report, a copy of which is with The Hindu Metro Plus. Chandra, in the report, also mentions that the U.S. Government-recognised Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM) accredits schools that teach Acupuncture and TCM. “About a third of the U.S. states that license acupuncture require graduation from an ACAOM-accredited school.”

Panchakarma

The status report has particularly called for positioning Panchakarma like Acupuncture. “There is a need to reposition Panchkarma as a recognised therapy for muskulo-skeletal and neurological problems including rheumatoid arthritis, Parkinsonianism and in Behavioural Science. A beginning could be made by demonstrating Panchakarma procedures on veterans suffering from post-trauma stress disorder to be observed by Veteran Affairs Department of U.S. Defence. Were a high-level policy decision to be announced — for example if Indian Railways as the biggest employer in the public sector recognised Ayurvedic treatment for insuring accident cases, it would instil confidence,” it says.

“Our missions abroad stock few CDs and leaflets here and there but efforts to market Indian medicine have been lack-lustre and unconvincing.”

Among other suggestions, the report, compiled after an exhaustive research spanning close to a year, puts the thrust on research in Ayurveda. “Only clinical outcomes published in international journals would lead to recognition of Ayurveda. The ground reality is that there is no legal scope to practice Ayurveda in most countries, primarily because of a lack of credible research.” This has necessitated the need to study and document the policies and strategies that China adopted over the years for globalisation of TCM.

Significantly, the report calls for the need to offer postgraduate interdisciplinary training to modern scientists to increase the dialogue between Ayurveda and modern science. While lauding the efforts of the Kerala Government in promoting Ayurvedic Tourism, Chandra also highlights the fact that the influential American Medical Association is “hugely exercised about heavy metal content in Ayurvedic formulations.”

“The issue alone is enough to distort the globalisation discourse for a very long time. It already occupies centre-stage on the NCCAM's website on Ayurveda. The situation demands that massive attention be paid to GMP (Good Manufacturing Practice) and testing for heavy metals and impurities, without which few will take us seriously.”

The report, made with “a focus on benefits that the systems have given to the public”, ends with the submission, “The 12th Five year Plan is on the anvil. The time is to act now.”