The diabetes story: Prevalence, diagnosis and ways to combat

November 14, 2013

(World Diabetes Day)

Fast growing life, work-place concerns and little time for recreation is killing us softly. As a nation, India is soon going to be the world’s diabetic capital. Those diagnosed with diabetes are only the tip of the iceberg. Those undiagnosed are like a ticking time bomb.

The word diabetes mellitus was originally coined by Apollonius in 230BC as Diabetes meaning honey and Mellitus meaning to pass through. However, the famous Indian physician Sushruta coined the word “Madhumeha” which means the passage of sweet urine after he had observed the attraction of ants over the urine of a patient with diabetes. Diabetes is a chronic disease caused by either insulin deficiency (Type 1) or a combination of insulin deficiency and insulin ineffectiveness which is called Type 2. Type 1 is commonly seen in children and young adults whilst Type 2 is commonly seen in older people. Type 2 diabetes comprises about 90% of people with diabetes worldwide. Diabetes as a disease is becoming increasingly common and it is increasing at an alarming rate amongst Indians. Today it is estimated that there are about 61-63 million people with Diabetes and it is estimated that this will rise to about 100 million by the year 2030. Originally it was thought that Diabetes was a disease of the rich but it is now found in everyone including children and young adults.

There are various reasons for the increasing prevalence of diabetes. There is certainly improved diagnosis of the disease due to raised awareness and improved diagnosis. The Indians have a particular genetic susceptibility to diabetes. However, increasing life expectancy, better economic conditions, a sedentary lifestyle and changes in nutritional habits of Indians have all led to the increase in diabetes. Diabetes can present with increased need to urinate, excess thirst, extreme tiredness and increased hunger, slow healing of wounds, irritability and blurred vision. But if you feel you have suddenly started drinking water more than usual, passing urine more than usual, then let the warning ring in your mind.

The diagnosis of Diabetes is a combination of patient history, clinical symptoms and blood tests. The diagnosis of diabetes is established when the fasting blood glucose is greater than 126mg/dl or the two hour post prandial blood glucose after a 75g glucose load is greater than 200 mg/dl or HBA1 is greater than 6.5% especially if this is repeated twice. A random blood glucose of greater than 200mg/dl is also strongly suggestive of diabetes.

People suffering from diabetes are susceptible to various complications. They are either due to damage to small blood vessels (microvascular) or due to damage to large blood vessels (macrovascular). Diabetes affects virtually every part of the body but the main complications are:

Diabetic retinopathy, when it affects the small blood vessels of the eyes. It is one of the most common causes of blindness in adults. Diabetics should have their eyes checked regularly as it does not produce symptoms in the early stages and can only be detected through check ups. Diabetic nephropathy is when it affects the kidneys. It starts with the leaking of minute quantities of protein (microalbuminuria) in the urine and if not treated may lead to renal failure. It is therefore important to check for microalbuminuria in the early stages. Diabetes is one of the commonest causes of dialysis in adults. Diabetic neuropathy is when diabetes affects the nerves. It affects about 70% of diabetics in some point in their lives. Sometimes it results in pain and on occasions no sensation at all. Diabetes also causes symptoms like erectile dysfunction, abnormal sweating and loss of control over the bladder.

Heart disease is one of the most important causes of death in diabetics. It is important to remember that in some diabetics it may not present with the classical symptoms of chest pain which may delay diagnosis and treatment. Strokes are at least three times commoner in diabetics leading to death or significant disability in those who survive. It is therefore important that good control of the blood glucose is maintained and regular check ups are undertaken to minimize the risk of complications.

Combating diabetes is a necessity and the patient himself is responsible for his well-being, a strict protocol diet in combination with what they are being maintained on either, oral drugs or insulin injections has to be followed with. It is important for every diabetic to look at their diet and nutritional requirements and their levels of physical activity such as exercise. Increasingly we have become used to a sedentary lifestyle and the eating of low fibre high fat diets.

Lifestyle management complemented by oral drugs and or insulin is the cornerstone of treatment of diabetes. Insulin and oral hupoglycaemic drugs should be started on the advice of a doctor. When it comes to food, Ideally the diet should be customized taking into account factors such as age, gender, weight, height, physical activity and the needs of the individual. However, foods with a low glycaemic index, high in fibre, low in fat are preferable. Animal protein such as meat often contains a higher quantity of saturated fat. Vegetable protein like beans, legumes, nuts and seeds are encouraged. Fish being a good source of omega 3 fatty acids is also good. It is important for diabetics to take meals/snacks at regular intervals avoiding both over eating and under eating. Smaller portions are always better than larger ones.

It is important to exercise as it helps in controlling the blood glucose. Regular exercise such as brisk walking, swimming, cycling or any other forms of exercise that keeps you moving for at least 30 minutes of moderate intensity five times a week is ideal. It is important that if you have not done any exercise in the past you start gently and build up gradually. There is no particular time of doing the work-out, you can do it when you are comfortable, either in the mornings or during the evenings.

The moral of the story is simple, we live in times where we do have treatment options for diabetes to maintain you for life. There are now newer drugs and different types of insulin available. But we do not have a cure for Diabetes. To what extent the disease progresses or to what extent you remain healthy is a question best you can answer. Proper control of blood glucose with lifestyle modifications and regular check ups is important. Patients with diabetes should be empowered to take control of their management of diabetes with the help of health professionals. Always remember to have a personal life untouched by work-place concerns. When the workload increases, see that you prioritize what you need from what you want. In that way you can not only add years to life but life to years.



By Dr Sushil Jathanna and Dr Edmond Fernandes
Dr Sushil Jathanna (MBBS, MSc, MRCP, MFPHM, FFPHM, DGM, DMS) is Director, Global Hospital & Athena Hospital, Mangalore and Former CEO of NHS Cambridgeshire, UK; and Dr Edmond is Chief Executive Officer, Health Concern Foundation- A Health Organization exempt under Section 80G of Income Tax.
To submit your article / poem / short story to Daijiworld, please email it to mentioning 'Article/poem submission for daijiworld' in the subject line. Please note the following:

  • The article / poem / short story should be original and previously unpublished in other websites except in the personal blog of the author. We will cross-check the originality of the article, and if found to be copied from another source in whole or in parts without appropriate acknowledgment, the submission will be rejected.
  • The author of the poem / article / short story should include a brief self-introduction limited to 500 characters and his/her recent picture (optional). Pictures relevant to the article may also be sent (optional), provided they are not bound by copyright. Travelogues should be sent along with relevant pictures not sourced from the Internet. Travelogues without relevant pictures will be rejected.
  • In case of a short story / article, the write-up should be at least one-and-a-half pages in word document in Times New Roman font 12 (or, about 700-800 words). Contributors are requested to keep their write-ups limited to a maximum of four pages. Longer write-ups may be sent in parts to publish in installments. Each installment should be sent within a week of the previous installment. A single poem sent for publication should be at least 3/4th of a page in length. Multiple short poems may be submitted for single publication.
  • All submissions should be in Microsoft Word format or text file. Pictures should not be larger than 1000 pixels in width, and of good resolution. Pictures should be attached separately in the mail and may be numbered if the author wants them to be placed in order.
  • Submission of the article / poem / short story does not automatically entail that it would be published. Daijiworld editors will examine each submission and decide on its acceptance/rejection purely based on merit.
  • Daijiworld reserves the right to edit the submission if necessary for grammar and spelling, without compromising on the author's tone and message.
  • Daijiworld reserves the right to reject submissions without prior notice. Mails/calls on the status of the submission will not be entertained. Contributors are requested to be patient.
  • The article / poem / short story should not be targeted directly or indirectly at any individual/group/community. Daijiworld will not assume responsibility for factual errors in the submission.
  • Once accepted, the article / poem / short story will be published as and when we have space. Publication may take up to four weeks from the date of submission of the write-up, depending on the number of submissions we receive. No author will be published twice in succession or twice within a fortnight.
  • Time-bound articles (example, on Mother's Day) should be sent at least a week in advance. Please specify the occasion as well as the date on which you would like it published while sending the write-up.

Comment on this article

  • Rob Stan, Los Angeles

    Fri, Nov 15 2013

    I had been to India a few months back & used to walk whenever possible for day to day work & people used to tease me indirectly. Here in US it's not possible to usually walk for day to day work as people usually live in outskirts & commute involves long distances & only way to walk is for doing exercise.

  • Peter Lewis, Kalmady/k s a

    Thu, Nov 14 2013

    Francis, Mangalore Rightly said.

  • Francis, Mangalore

    Thu, Nov 14 2013

    Exercise is the best medicine to prevent Diabetic. Now in villages also nobody do work. Every home owns a four wheeler and two wheeler. Short distance also people use vehicles. Most of the time sit in front TV, Computers, Mobiles. No time to play, or do housework. All
    Schools and college should introduce compulsory Physical Training and also counseling about
    Benefit of exercise

  • vgb, mangalore

    Thu, Nov 14 2013

    No medicine can bring about entire cure. However, there are very good allopathic medicines which help in tight control.

  • valerian rodrigues, ujire

    Thu, Nov 14 2013



    Thu, Nov 14 2013

    GURMAR powder Curry leaves, Methi seeeds, Amla juice and cinammom is highly effective in controlling Sugar levels.Low GI food with daily walking is very beneficial.

  • Joseph F. Gonsalves, Bannur, Puttur / Mangalore

    Thu, Nov 14 2013

    1) The most deadly disease Malaria’s proven vaccine is ready in 2014 to the market - Happy to note medical success.
    2) HIV also is not a deadly disease now and people are living with medicines. – Entire cure also may be ready.
    3) Cancer cure is almost ready 90 proven medicine is ready they found the Gene - Happy to note Medical success.


  • arun, udupi

    Thu, Nov 14 2013

    the allopathic medicines for diabetes can control it but have many side effects!. no wonder these medicines show path to other diseases in bonus!
    Regular exercises & walking,use of methi & karela will contribute much!

  • Vincent Rodrigues, Katapadi/Bangalore

    Thu, Nov 14 2013

    Superb educative article on Diabetes indeed. Thanks to the doctor and we wll be grateful if he continues tips to maintain well this disease ,it will be very useful to the public. All the best. Thanq.


    Thu, Nov 14 2013

    @ Bhandarkar Maam

    aaz sanjer(evening) Gandhi park, mannagudda meltha ve?

  • R.Bhandarkar, M'lore

    Thu, Nov 14 2013

    Asked the Pundit , Sir. He says there are varieties of Ants , and only some are capable of this test.
    Will take you to him, if you want after getting an appointment...

  • Rudolf Rodrigues, Mumbai/Mangalore

    Thu, Nov 14 2013

    Very informative article on World Diabetes Day especially when India has become the diabetes capital of the world!!!

    More awareness should be created on how to prevent or delay the onset of diabetes!!

    The main culprit is our diet with the overload of simple, highly processed carbohydrates (sugar, flour and all the products made from them) and the excess consumption of omega-6 vegetable oils like soybean, corn and sunflower that are found in many processed foods. Our predecessors who used coconut oil and unprocessed/natural foods liberally never had such high incidence of diabetes and lived a long healthy life!!!

  • For Justice, Abu Dhabi / Ubar

    Thu, Nov 14 2013

    Thanks a lot to daiji as well as the doctors for providing us these advises...



    Thu, Nov 14 2013

    Thanks for publishing a very useful article for the benefit of diabetics. I feel all Diabetics should try to cure themselves by changing their diet habits. A balanced diet is vital to healthy lifestyle & do regular exercise it will do wonders.

  • Harold Pais, Udupi/Bangalore

    Thu, Nov 14 2013

    Hi Mr Bhandarkar,
    One can have diabetes without any trace of sugar in the urine. Ask your Pandit not to disturb the Ant Hill by urinating and the leave the ants alone. I fully agree with your laughter comments.

  • Surendra Poojari, Mangalore

    Thu, Nov 14 2013

    As you said..Laughter is the best medicine Bhandarkar Maaam..And you always make us laugh. Keep up the good work.

  • vgb, mangalore

    Thu, Nov 14 2013

    very Informative article ,people in rural areas need to be educated.

  • R.Bhandarkar, M'lore

    Thu, Nov 14 2013

    I do not know how many of you will like this 'test' or not...
    1.Three ants, once it seems kept away from a pile of sugar while their counterparts were flocking it...Reason?
    It was later discovered that the ants had 'diabetes'......
    2. Some Pundit , the other day was advocating a novel method of 'diabetes test'..How you ask?
    Step1: Urinate near an 'Ant Hill'
    Step 2: Observe carefully. If ants flock then 'Positive', if not, Negative....
    Have Sugar or not I think 'Laughter is always the best Medicine...Agree or Disagree?

Leave a Comment

Title: The diabetes story: Prevalence, diagnosis and ways to combat

You have 2000 characters left.


Please write your correct name and email address. Kindly do not post any personal, abusive, defamatory, infringing, obscene, indecent, discriminatory or unlawful or similar comments. will not be responsible for any defamatory message posted under this article.

Please note that sending false messages to insult, defame, intimidate, mislead or deceive people or to intentionally cause public disorder is punishable under law. It is obligatory on Daijiworld to provide the IP address and other details of senders of such comments, to the authority concerned upon request.

Hence, sending offensive comments using daijiworld will be purely at your own risk, and in no way will be held responsible.