Dr. Aswin Mukundan, MD, Consultant, Dr. Mohan’s Diabetes Speciality Centre, Calicut

Diabetes is one such disease which was studied thoroughly and received revolutionary changes since its discovery. The scientific world is making a big leap in the treatment for diabetes, every decade that passes by. It is very significant in India as we stand second in the number of diabetic patients in the world. Most of us are not aware that treatment modalities once thought to be available only in developed countries like America and England are available in our country too.

The other name of diabetes in medical field is “silent killer”. It comes silently, attacks us silently and take us away silently. Usually we tend to ignore the symptoms of diabetes such as tiredness, fatigability, sleep disorders, increased thirst, increased hunger, increased urine output, sexual problems, weight loss etc. We don’t understand that if detected and treated as early as possible, the complications of diabetes can be prevented. Even when we identify the symptoms we tend to ignore it.

For justifying all the ignorance people tend to raise some questions such as, wasn’t diabetes present in older times? Our ancestors has lived a healthy life even then? To those who ask such questions I have two things to convey

1. Yes, diabetes was present since time immemorial. Most of it went undiagnosed or ignored. That’s why there were several unexplained deaths in the past.
2. You can never ever compare the older lifestyle with present day lifestyle. We use our bikes today even to go to a nearby shop. We eat outside from hotels at least once in a week, especially processed foods. Then adulterants, fertilisers etc etc.

That’s why diabetes is aptly called a lifestyle disorder. It’s disheartening that even after knowing all this, many among us tend to avoid modern medicine and run behind alternatives. In my own experience such people end up in our clinics in 5-10 years with all the disease complications. It is such outdated thoughts which push them into a stage and come to us when the disease process has gone beyond the irreversible stage.

Most of the Keralites have a fair idea of the older treatment methods of diabetes. But, what are the changes in this field? Which all are available to us? 90% can’t answer these.

1. Why should we know about it?

We have a habit of presuming that anything newer is costlier. I have only one thing to tell them, it is costlier not to treat diabetes than treating diabetes. We have access to world-class treatment facilities here. These new treatment modalities taught us that even people with diabetes can live a long and healthy normal life.

• What was old: a preview and what are all the changes from it?

Diabetes can also be called an “iceberg disease” for a reason. Because the older methods of treatment for diabetes trust on only fasting and postprandial values of blood sugar to treat. Drastic changes has occurred. It is just the tip of an iceberg. There are more important things deeper to it, to test, and to give individualised treatment for every patient accordingly. Every patient is treated differently according to the disease state and his body conditions. One size doesn’t fit all. Every single person is different from each other.

There were only two types of diabetes in the past, type 1 who needs insulin from beginning, and type 2 who can be managed with tablets. Now modern medicine has discovered more than 20 types of diabetes and each type is treated in a unique way. Previously three drugs were only mainly used to treat diabetes, Metformin, Sulfonylureas, and insulin. We have more than 10 classes of drugs today which are far better.

• What’s new?

As I have mentioned earlier a lot of new tests have come which changed the way doctors are treating diabetes. hbA1c , to calculate 3 months average blood sugar.  Insulin levels in our body can be measured, and if normal, patients can be managed with tablets who are unnecessarily put on insulin. Genetic tests to determine the types of diabetes such as MODY, LADA etc are important as treatment depends on the type of diabetes. One among the latest invention is AGP (Ambulatory Glucose Profile). One coin shaped chip if pasted on your body can give us 14 days blood sugar readings in a graph as report. Don’t get scared that the name chip itself sound too technologically advanced, it hardly costs around 2-3k INR. Another most important invention are the insulin pumps. It is considered equal to God for those who were tired of taking 4-5 injections of insulin daily. It’s a small device that can be attached to our body and the doses can be adjusted according to the blood sugar values easily. Last but not the least is about bariatric surgery. This was an easy way to tackle obesity since the scientists found out the relation between obesity and lifestyle disorders. It brought revolutionary changes.

• Is everything available in our Kerala?

100% yes! Nobody even heard about such stuffs till yesterday but all such latest technologies and world class treatment facilities are available in our small Kerala too.

One word to end with:

Let’s defeat diabetes, lets join hands together to bring up a healthier society !