HEALTHWATCH
Prevent diabetes
DR SANJIVA WIJESINHA
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Diabetes may be in our genes but most people won’t develop the disease unless they allow it to do so.
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Simplest rule: Eat less and walk more.
Imprisoned in every fat man a thin one is wildly signalling to be let out
Cyril Vernon Connolly
A couple of months ago I met Professor Abubaker Suleiman, former Director General of Health Services in Malaysia. Before becoming the head of his country’s health department, Prof. Suleiman was a leading nephrologist in Kuala Lumpur. In the 197
0s, he had been responsible for starting renal dialysis and kidney transplantation programmes in Malaysia.
In the course of the conversation, Prof. Suleiman said that more than half the patients requiring kidney dialysis in Malaysia today are diabetics.
Diabetic nephropathy
In fact the commonest cause of kidney failure in his country — and in most developing countries — is Diabetic Nephropathy. Such damaged kidneys gradually lose their normal ability to get rid of the body’s unwanted chemicals and toxins.
When the kidneys finally fail to perform their function adequately, the patients will need regular dialysis. They have to be connected to an artificial kidney machine, which extracts the toxins from the circulation. Failure to remove these toxins regularly allows them to accumulate in the blood, leading to death from kidney failure. At present the only alternative to dialysis is a kidney transplant.
The biggest health threat facing Asia in the next decade is not Bird Flu or AIDS but Diabetes. The consequences of diabetic damage — to kidneys as well as hearts — are likely to cause massive problems for populations and health service providers in countries like India. .
Pragmatic approach
A more pragmatic long-term approach is to minimise the number of people who will develop diabetes.
Unfortunately Indians are very susceptible to diabetes. Many still have a mistaken belief that diabetes is caused by eating too much sugar. The truth is that diabetes is in our genes — but most people won’t develop the disease unless they allow it to develop.
Human beings were meant to use up the calories they consume in their food by their daily physical activities. After all, our ancestors started out living in caves, eating the roots and vegetables they foraged for and the flesh that they hunted.
These days we live in houses, and consume more than we need to of fried and sweet foods and sugary carbonated drinks (with or without cocaine derivatives). We walk very little and we all put on weight as we get older, especially around our waists.
The prevalence of obesity in our population is far too high and since being overweight and obese is one of the surest risk factors for developing diabetes, doctors have even coined a new word, Diabesity, to describe the new disease that is affecting the world.
Putting on weight and not exercising our muscles is a sure way to bring on diabetes as we get older. Having diabetes is not simply a question of taking tablets and pretending to avoid sweet foods at parties.
Diabetes is a damaging disease that makes one six times more likely to get a heart attack and puts one at risk of kidney failure.
Good precaution
It is a good precaution to get yourself checked for diabetes once a year, especially if you are over forty, overweight or your stomach protrudes over your belt. All that is needed is a simple blood test.
If you find that you haven’t yet got the disease, now is a good time to start taking steps, literally and metaphorically. to prevent yourself getting it.
The simplest rule to follow is to “Eat Less and Walk More”.
The writer is a surgeon and family physician based in Australia.
