The growing urbanisation has brought a lot of wealth and improved our lifestyle but it has come at a cost. We are now the diabetes capital of the world. But there is a ray of hope. Diabetes can be defeated with simple yet effective changes in lifestyle.
Dr Rakesh Kumar, Resident, RBTB Hospital, New Delhi shares his views and some useful tips to keep diabetes away from our lives. Here are the excerpts of our interview with him –
Question-1: Growing urbanisation is considered as one of the biggest contributor to the growth of diabetes among the masses. Do you think that time has come when we really need to apply a thoughtful approach to fight this disease which is likely to destroy a whole generation?
Answer-1: Yes, growing urbanization is one of the biggest contributors to the growth of diabetes. Now, India is known to be a global hub for diabetes, diseases can be broadly classified as communicable disease and non communicable disease.
Diabetes comes under non communicable disease among non-communicable diseases. It accounts for 25% alone and if we combine diabetes and hypertension, it accounts for nearly 40% of non communicable disease.
If we are talking about health burden we should never forget about economical burden and diabetes results in decrease in productivity, absence from work, dropout and premature mortality. Then what is urbanization? See, urbanization refers to transformation of village to cities. Urbanization has two angles one is developmental angle and other is health angle.
Developmental angle as we all know, it looks very fine, very good. On the other hand health angle is growing challenge for all of us.
Overcrowding which leads to communicable disease like COVID-19 as we are seeing today, since last one and a half years.
Non communicable disease incidence prevalence is increasing like cardiovascular disease, diabetes.
Scarcity of water and sanitization problem fourth is high pollution rate and its consequences like respiratory disease, lung cancer and all. See as we are discussing here only diabetes and urbanization that is increase in incidence and prevalence in non-communicable disease.
So, what is the risk factor for diabetes? One is low physical activity, second is low intake and intake of fruits and vegetables. Third is stress, pollution, high consumption of alcohol, carbonated water, sugar soft drinks and all. Low physical activity contributes nearly 38% in diabetes, low intake of fruits and vegetable contribute nearly 28%.
Question-2: There is a growing culture specially in the metro cities of not cooking at home and ordering food from outside which is mostly junk food. Do you think it is a serious issue that need to be highlighted and people should be sensitised against the harms of eating outside food.
Answer-2: See in urban areas large number of people living in small area that is more of more in densities there. Good healthy food is available to only few people. Many people do not have sufficient time to prepare food and those people undergo dietary dietary transformation that is shifting from healthy food to fast food that is chappati made from millet to Pizza burger box and people started depending upon processed food that is fast food which having high calorie and less nutritive value. I call it blank energy. In addition to this, lack of privacy in urban area lead to stress, anxiety, depression, these all contribute to diabetes too. As we talk about urbanization and diabetes, highest prevalence we can see in Southern estate including Puducherry, Kerala, Tamil Nadu, Andhra Pradesh. I can say we are getting late to sensitize people to not to take junk food and embrace a healthy lifestyle.
Question-3: Very young people between the age group of 21-25 are also getting diabetic. What is your advice to them?
Answer-3: We should take food which contain fiber and protein. Simple diabetes is carbohydrate intolerance.
Nowadays, very young people between age of 20-25 years are also getting diabetes. What is that we called as MODY means Maturity Onset Diabetes in Young.
Scientifically it is a trans Krypton factor defect. It has very strong association with family history. I mean healthy lifestyle they can retard the diabetes. See there is evidence why such a group of people are suffering more and more now. So, there is direct correlation in direct correlation is with diabetes during pregnancy that is gestational diabetes. Other is if the baby born newborn baby weight is more than 3.5 Kg. There is much more chances for having early or early onset diabetes mellitus. So, proper anti natal checkup should be there and other advice is that adopt healthy lifestyle avoid junk food.
Question-4: How big is this issue is in rural India? Do you think urban India can learn something from rural India?
Answer-4: If we compare rural population from urban population, whether the prevalence of diabetes is less or equal it is very known. Earlier, urban population used to have more incidence and prevalence of diabetes as compared to rural population, but, nowadays, we can see that the urban ruler gap and narrowed and prevalence of diabetes has increased in both rural and urban India, but still there is less prevalence of diabetes among rural population as compared to urban population. There is a reason – rural people have a healthier lifestyle and they do not consume processed food. They have physically very active
Question-5: What are your top tips to those who are fighting diabetes?
Answer-5: So, at last what is the conclusive statement, my conclusion statement is that in urban population people are getting married very late which contribute to diabetes and hypertension and other non communicable diseases. So, at last take home message is lifestyle modification like weight reduction, adopt DASH (Dietary Approach To Stop Hypertension) diet and go for daily aerobic exercise for at least one hour. Moderation of alcohol consumption is also required and one should also stop smoking and seek medical advice if required.