May 24, 2022
The pollution is one of the bad effects of unplanned industrialization & urbanization. Both industrialization & urbanization along with sedentary life style are also spreading epidemic of diabetes mellitus in India. India is regarded as diabetes capital of world as it has highest number of diabetic patients. India will have about 8 crore diabetic patients by 2025.
The number of diabetic patients is not high because of our higher population but due to the fact that firstly, Indian are more prone to have diabetes and secondly rapid transition from rural to semi-urban to urban area causing rapid change in eating habits along with adoption of sedentary life style are responsible for the increasing number of diabetics patients. The other most important fact is that incidence of diabetes in urban population is 2-4 times of rural population in different parts of the country. But the incidence of pre-diabetes is almost same in urban & rural population hence there is urgent need to target pre-diabetics or who are at risk of developing diabetes to contain the epidemic.
Obesity especially central, high intake of refined carbohydrates, aerated drinks, fast & deep fried foods, increased total fat intake, increased saturated fat intake, low fibre intake and less physical activity or sedentary life style are risk factor for rapid conversion of pre-diabetes to diabetes. This rate of conversion is very high amongst Indian & it is around 20% per year in some parts of India.
Person who have family history of diabetes, pre-diabetes, obesity/over weight (more than 20% of ideal body weight), central obesity, increased body mass index (BMI) & waist hip ratio (WHR), heart disease & high blood pressure or cataract at young age, diabetes during pregnancy or repeated infection are candidates at risk of developing diabetes.
Those above persons at risk should get tested for diabetes. Ideally they should get tested by 75 gm oral glucose tolerance test. If not possible, should get fasting plasma glucose done after 10 hours of overnight fasting. Fasting sugar should be less than 100 mg% & 2 hours after 75 glucose should be less than 140 mg%. If fasting is more than 126 or 2 hours PP is more than 200, it labeled as diabetes mellitus. If fasting is more than 100 but less than 126 & or 2 hours plasma sugar more than 140 but less than 200 is labeled as pre-diabetes.
As the rate of conversion for pre-diabetes to diabetes is very high in India hence there is very urgent need to target this high risk population. Indian & International studies have shown that pre-diabetes to diabetes conversion can be prevented or postponed by adapting healthy life style. This can be achieved by reducing 5-10% of body weight by reducing total calorie intake by 500 calories per day, avoiding sugar & fine carbohydrates, avoid fast & deep fried food, aerated drinks, reduce total fat intake, reduce saturated fat intake, increase fibre intake, leafy vegetables & fruits.
The physical activity should be at least 150 minutes of brisk walking or similar activity per week or 30-45 minutes of brisk walking or at least 5 days in a week. There should not be gap of more than 48 hours in the exercise schedule.
It has been observed that adopting above healthy diet & life style provides long term benefits in preventing development of diabetes in