Pre-diabetes on the rise in undivided Andhra Pradesh

Hyderabad: As India inches closer to becoming the diabetes capital of the world, a mammoth task for health care professionals is to identify people who are pre-diabetic. The Indian Council of Medical Research and the Ministry of Health published a report in the medical journal Lancet which mapped diabetic and pre-diabetic situation of 15 states.

A large number of the subjects who were interviewed were pre-diabetic. In undivided Andhra Pradesh, there were a whopping 11.1% pre-diabetics and 12.6% confirmed diabetics. The research categorises them as those with Implied Fasting Glucose, which shows insulin levels before fasting, and Improved Glucose Tolerant, which shows insulin levels after the two hour fasting. In AP, about 7.4% showed high insulin levels before fasting and 2% showed the same after fasting.

“People who have high insulin levels before fasting are more susceptible to getting diabetes than those who do so after fasting. But if insulin remains high in both stages, the progression to diabetes will be much faster,” says Dr M. Anjana, who was the first author of the research. Timely identification of patients as pre-diabetic can eliminate the risk of diabetes entirely. “If regular exercise is done and dietary habits are changed and weight is reduced by 4-5 kg, we can expect diabetes to never develop in patients; otherwise, even pre-diabetics could develop heart disorders,” says Dr Mohan, chairman of Dr Mohan’s Diabetes Specialties Centre.

A 2016 research on diabetes prevention amongst 600 obese Indians showed that change in exercise and dietary habits benefited about 36% of people with insulin levels that were high before and after fasting. The group which has an almost irreversible chance of diabetes is the one with high insulin levels before fasting, with only 12% having any chance of preventing diabetes.

The Lancet report highlights that this would be a tough task as diabetes being a lifestyle disease is linked to better incomes and sedentary lives. “We have seen states with high GDP may have high diabetes but they are more aware of how to tackle it. Urban poor are at higher risk,” says the report. Full blown diabetes often goes unrecognised in our country. “Type II diabetes is a silent killer unlike Type I where the manifestation of the disease is obvious, with frequent urination and thirst. People only realise that they are with Type II diabetes during dental or cataract surgeries, which is dangerous because they would have already reached an advanced stage that can lead to foot ulcers, retina damage, says Dr Vijay Vishwanathan.  and even heart attacks,” says Dr Vijay Vishwanathan.

"The government must initiate mass awareness programmes for diabetes as it can easily be controlled and prevented. Insulin and tablets must also be made free for those who can't afford them," said Dr Mohan.