Tuesday, June 22, 2021

‘50% Indians with diabetes not aware they have it’

India is home to 77 million people with diabetes and 80 million people with prediabetes. By 2030, the diabetic population in the country is close to hitting the mark of 101 million. Studies show that almost every Indian past the age of 50 is a diabetic unless proven otherwise, and at this rate it could become the next diabetes capital of the world soon, overtaking China. Dr V Mohan, who has done some stellar work over the last five decades in the field of diabetes care and research, says that half the afflicted population in India are not even aware that they suffer from the condition. In his recently-published memoir, ‘Making Excellence a Habit’, the Padma Shri winner recalls his experience of setting up one of the world’s largest chains of diabetes centres, Dr Mohan’s Group of Diabetes Institutions that began as a single clinic in 1991 and now has over 52 branches across 32 cities. For someone who began researching on diabetes with his father, Prof. M. Viswanathan (considered the ‘Father of Diabetology’ in India), when he was just 18, Dr Mohan has seen the evolution of the country;s healthcare system.Over the years he has also seen the transition of Indian lifestyle into a more affluent and sedentary, carbohydrate-rich and sugar-heavy one with the population doing very little physical exercise. In an e-mail interaction with Lopamudra Ghatak of the Economic Times Digital, the 67-year-old expert lists the warning signs that we cannot afford to ignore for too long, and recommends steps to prevent the “twin epidemics of diabetes and obesity.” And when asked to choose between instinct and intelligence, he quotes Malcolm Gladwell, for a reason. Excerpts:Lopamudra Ghatak: Your memoir - ‘Making Excellence a Habit’ - begins with wonderful lines by 3 great English poets - Shelley, Wordsworth & Tennyson, and the impact that their works had on you. Looking back, is there a tinge of regret, at all, at not having pursued English Literature?Dr V Mohan: To be honest, in the initial years, yes, because I felt I was moving away from the dreamy-eyed, idyllic life of a poet/English professor towards the harsh reality of a medical doctor. However, as I’ve mentioned in the book, since I converted my passion for writing poems and essays into writing scientific research articles,I’ve felt a good deal of satisfaction.LG: The book sees a non-linear narrative - and there are multiple personal nuggets of events that happened years ago. They all read as though it happened recently. How did you manage to remember (so much), and recreate as well for the readers?VM: Thank you! A lot of the events were recorded in my diary and calendar e.g.conference dates, visits to various countries and hence, I was able to accurately pin down the dates. Some of the feelings described in the book were so deep that they are lifelong impressions and unlikely to be erased from my memory. Of course, the recreating of those is the licence that the author takes when s/he writes their story.LG: In all the years of being a medical professional, what has been the biggest learning for you? And your biggest failure, if any?VM: The greatest learning for me personally is that a medical professional and a researcher never stops learning. Things get outdated so quickly in the kind of work that we do, that we have to remain a student throughout our lives.I have had many failures. The biggest regret is that I have not been able to find a cure for diabetes, despite working 50 years in this field.LG: You have received worldwide acclaim and fame for your stellar work in the field of treating diabetes. How does it feel to be counted among the world’s top few medical professionals in the field?VM: It’s always nice when one’s work is recognised, but in all humility, I would like to say that most of my achievements are due to teamwork. I am blessed to have a fabulous team of doctors, scientists, technicians and collaborators and it is our combined effort that has led to all our successes. Thus, I cannot take full credit for whatever I have achieved. 83767703LG: What are your views on the Indian healthcare system? What do you think can be done to produce more doctors and medicos in the country?VM: The Indian healthcare system is undoubtedly excellent. Our doctors are world class. By and large, they are ethical and show great empathy. There is still a shortage of good specialists in the country and hence we need to produce more doctors who are not only specialists in various fields, but also very good family doctors like we had in the past. One of the problems with Indian healthcare is that because 80 per cent of it is private (and therefore out-of-pocket),the rich and well-to-do can afford the best of treatments, while the poor tend to get left out. A more equitable distribution, perhaps through free insurance and other measures would make this more balanced. It is my dream that we will achieve this in my lifetime.LG: It’s alarming but India is considered as the world’s capital of diabetes. The diabetic population in the country is close to hitting the mark of 101 million by 2030. Where have we gone/going wrong? And how do you think we can fix it?VM: The huge number of people with diabetes in India is due to several factors: Our population itself is large. Very soon we will become the largest populated country in the world overtaking China in the next 4-5 years. When that happens, the maximum number of people with most diseases in the world, including diabetes, will be from IndiaAffluence, decreased physical activity, intake of foods which are high in calories, carbohydrates and unhealthy fats, all contribute to the diabetes epidemic. As the country progresses, we must prevent the twin epidemics of diabetes and obesity. We must encourage people to increase physical activity, to reduce stress by doing yoga and pranayama and to cut down on their carbohydrate intake (either rice or wheat) and increase the intake of vegetables and protein. With these, we can slow down the diabetes epidemic. Of course, as the life expectancy of the population is also increasing, we may not be able to cut down on the growing number of people with diabetes. It’ll be fine as long as we can help them live a long and healthy life, despite diabetes.LG: There seems to be a clear link between mucormycosis and uncontrolled diabetes - what can we do to control this?VM: The answer lies in the question itself. The most important cause of mucormycosis is uncontrolled diabetes. Hence, the first and the most obvious thing to do is to get the diabetes of everyone, under good control. For this reason, I just started a nationwide campaign by declaring June 2021 as ‘Diabetes Control Month’. If we try to control the diabetes of every one with the condition in India, I am confident that the incidence of mucormycosis can be drastically reduced. Also, we must remember the fact that 50 per cent of people with diabetes do not even know they have diabetes. Therefore, large scale screening of the population, to pick up those with undiagnosed diabetes, will also help to bring conditions like mucormycosis under control.LG: You’ve mentioned in a recent video that there are approximately 40m people walking around with diabetes who don’t even know they have it. How can this be addressed?VM: The one way in which undiagnosed diabetes can be detected is to do large-scale opportunistic screening. Luckily, to detect diabetes all you need is a simple hand-held glucometer and a blood glucose strip. This type of screening can be done wherever there are a large number of people. This includes schools, colleges, universities, offices, corporations, religious places like temples, churches, mosques, in parks, beaches, malls and any other place that people go to. Large-scale camps can be organised to detect people with diabetes. The other place where such detection can occur is in any doctor’s clinic, irrespective of which system of medicine is being practiced by the doctor. If any person goes to any doctor for any illness, the blood glucose can be tested as the fifth vital sign in addition to their pulse, BP, temperature and respiration. This will help to detect those with uncontrolled diabetes who canthen be referred for proper treatment.LG: Your memoir has a chapter titled ‘Combining Entrepreneurship with Ethics and Empathy’ in which you have highlighted the times when you had to strike a balance. The pandemic and the subsequent locked-down life that we are leading has made many of us realise the need for empathy in public and professional life. How can we, as a race, become more empathetic to others?VM: I think empathy is one of the most noble of all human virtues. You must be sensitive to the needs and hardships faced by others. If we are able to listen to their problems and help in whatever way, we can touch the lives of the people with whom we come into contact. The medical profession offers an excellent example of how this, not only can be done, but should be done.LG: What is next on your to-do list?VM: After Covid settles down, we have plans to expand all activities that we are currently engaged in. This includes expansion of our clinical facilities, taking up more research projects, educating more doctors and training them in diabetes, offering more free diabetes check-ups and treatment to those who cannot afford and finally, reaching out to people with positive messages and therefore giving them hope that diabetes is not a disease, but only a disorder.LG: Instinct, intuition or intelligence: which is your pick?VM: This is a tough one and you have cornered me! Obviously, all the three are gifts given by God. It’s nice if we can sharpen our intelligence as that will help us to think clearly. However instinct and intuition are also important. Most often than not, if we follow our intuition or ‘gut feeling’, we tend to be right. This is beautifully explained by Malcom Gladwell in his famous book ‘Blink’. Hence, I think these three are not mutually exclusive, but can be effectively combined. ‘Making Excellence a Habit’ has been published by Penguin Random House in India. 72003063

from Economic Times https://ift.tt/35M8Zxe

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