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Diabetes The Leveler-Sweeping Across Nations

Diabetes seems more a leveler than any other disease. It strikes without any partiality- regardless of age, income, status, color or sex//.

When Shankar Vishwanath, 48, a team leader at a leading software company from Bangalore visited a diagnostic facility for his annual medical check-up, the doctors there could not but suspect him from inheriting the metabolic disease - diabetes. And they were right. Shankar weighs 110 kg, for his 5.93 feet height.

Yet what surprised the doctors was that his colleague Sai Sirish, who was at least 15 years younger, and lankier - 6 feet tall and weighing 68 kg, also had high sugar levels.

Medical records at many city hospitals show how myths about the sugar disease have been broken down in the last few years. ``It's no more the disease of the rich or the obese. We have gone much beyond that,'' says endocrinologist Dr Mala Dharmalingam, of Bangalore’s M S Ramaiah Memorial Hospital.

``The disease is now seen in large group of people in the rural areas in developing countries,'' she adds. Cutting across class, age, weight the disease seems to have spared none. As per the World Health Organization’s estimates it could rise to 333 million in 2025. Predictions also show that 70 percent of those affected will belong to the developing world.

Yet if there could be anything more alarming than this, it is the number of children who will be affected by the disease. An 11-year-old in Vietnam, a nine-year-old in China and an eight-year-old in India detected with type II may be exceptions now. Yet as pediatrician Dr P Maiya says: “We are beginning to see an increase in the number of diabetes cases, even among children.”

Presently there are an estimated 33 million diabetes cases in India, China, Japan and Pakistan. “With several people still not diagnosed there would be a rapid increase in associated problems like cardiac problems, stroke, renal failure and blindness, which either leaves people disabled or proves to be fatal disorders,'' says Dr Devi Shetty, Chairman, Narayana Hrudayalaya.

The rapid changing lifestyle -lack of adequate exercise and balanced diet – is an oft-quoted reason. And to justify this, the incidence of the disease has doubled with the launch of junk food and aerated drinks, according to consultant physician Dr Ramana Rao.

At the same time, doctors do not ignore the genetic ingredients. Studies show Indians carry certain genes that increase susceptibility to diabetes and lack genes that provide protection. According to a research by Chennai-based Dr V Mohan, director of the Madras Diabetes Research Foundation, the polymorphism of the PPAR gamma gene Pro12 ala, which protects Europeans from the disorder is missing in Indians, while another polymorphism of the same gene Thr Threonine, which triggers the disease, is present in Indians.

There are other studies that show that low fetal nutrition could also cause the problems. ``Most pregnant women probably did not have a balanced nutrition. This is probably one reason why thin people, both a mother and her child, have diabetes,'' says Dr Mohan.
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