Tamil Nadu   

Watch your sugar level closely

WITH MORE and more people in the 30-plus group being diagnosed with diabetes, India is heading for a situation wherein its population in the productive age group will be debilitated by a series of attendant problems that affect vision, kidneys and the heart. Harold E. Lebovitz, Professor of Medicine in the Division of Endocrinology at The State University of New York Health Science Centre at Brooklyn, talks to K. V. Prasad.

THE CONCEPT of self-monitoring of sugar level has to catch on, he points out.

"Indians have a very high likelihood of diabetes owing to a genetic predisposition and also high calorie food. I have been coming to India for the last 15 years and I see a tremendous increase in Type 2 diabetes cases. Everybody I talk to says he or she is a diabetic." He says a conservative estimate puts the diabetic population in the country at 35 million. With the cases increasing in large numbers every year, this will double in 20 years. (In Type 2 cases the body does not produce enough insulin or the cells ignore it. Type 1 is juvenile diabetes.)

Dr. Lebovitz says the dietary habits that invite trouble are not peculiar to India. Things are as bad in the United States too. Diabetes has reached epidemic proportions in the U.S. And, fingers point at high calorie food, obesity and lack of exercise.

Dr. Lebovitz has served on numerous review committees for the American Diabetes Association, the National Institutes of Health and the Veterans Administration. He is a recipient of many awards including The Albert E. Renold Medal of the American Diabetes Association, The Samuel Moses oration award of the Research Society for Study of Diabetes in India and The Charles Best

Type II diabetes does not present many symptoms other than probably frequent urination during night. And that is dangerous. Unless diagnosed, the symptoms cannot get related to diabetes. And it takes five to 15 years for the complications to show up. While problems to the kidney happen 10 years since the onset of diabetes, cardio-vascular disease occurrence depends on the age of the patient.

But what is more alarming in India is that there are children in the 12-13 age group diagnosed with Type II diabetes. Dr. Lebovitz deplores the rising number of children confined to their houses, glued to the television or the computer screen. And eat high calorie food all the while. This is where education plays a vital role in prevention. As for adults "treat as soon as you detect diabetes and treat aggressively," he says.

Self-monitoring at home is vital, he says and even family physicians must encourage this. At the same time, measuring the average sugar level (for the last three months) is very important to ascertain the level of control (both in the form of diet and exercise). The message is clear: "If you do not watch your sugar level closely, you are deceiving yourself, not the doctor."

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