Medindia spoke to Dr. Vijay Viswanathan, MD, Ph.D, MNAMS, Managing Director of M.V. Hospital for Diabetes and Diabetes Research Center at Chennai, Tamil Nadu, India, a WHO Collaborating Center for Education, Research and Training in Diabetes. M.V. Hospital for Diabetes is one of the largest referrals for diabetic patients requiring super-specialist opinion and management of the disease. The WHO Collaborative Center’s plan of action for the control and prevention of diabetes mellitus includes evolving appropriate programs at country, inter-country, regional, inter-regional and global levels. Medindia heard the doctor’s views on the awareness, prevalence and management of diabetes in this part of the world.

The alarming rise of diabetes around the world is causing great concern and every country across the globe is devising ways and means to explore newer strategies to control the disease.

Alarming Diabetes Facts –

Findings released by the International Diabetes Federation recently are shocking:

• Diabetes affects 240 million people worldwide currently and is expected to affect 380 million by 2025
• In 2007, five countries with the highest numbers of people with diabetes were India (40.9 million), China (38.9 million), US (19.2 million), Russia (9.6 million), Germany (7.4 million)
• In 2007, five countries with the highest diabetes prevalence in the adult population were Nauru (30.7%), United Arab Emirates (19.5%), Saudi Arabia (16.7%), Bahrain (15.2%), and Kuwait (14.4%)
• Every 10 seconds 1 person dies from diabetes-related causes
• Every 10 seconds 2 people develop diabetes
• Cardiovascular disease accounts for 50% of all diabetes fatalities
• 10% to 20% of people with diabetes die of renal failure
• At least 50% of people with diabetes don’t know their diabetic condition. In some countries this may be 80%



Interview

How do Indians compare with others in the world in terms of cardio-vascular risk profile that could be aggravated by the onset of diabetes?

Indians have a higher cardio-vascular risk profile among both diabetics and non-diabetics than the white Caucasians. For instance, even within the UK, it is seen that the Indian population is more prone to diabetes and cardio-vascular diseases. So it is not just food and lifestyle but also genetic factors that are behind the high incidence of diabetes among Indians. India is called the world’s Diabetes capital in terms of numbers. Considering India’s overall population of a billion plus people, the number of diabetics does seem huge. Seen in percentages, India has 16-17% diabetics among the urban adult population, whereas in some places such as in the Gulf countries it is above 20%.

According to recent studies, mortality due to heart disease in diabetics is coming down in the West because of vigorous treatment of high BP, cholesterol and glucose. Is it true of India too? With increasing awareness is the incidence coming down?

Unfortunately, no. It is true diabetic awareness is picking up in India. Some people are switching to healthier lifestyles - exercising their body more and choosing lighter diets. But the prevalence is not coming down as much as it has in the West. Roughly speaking, if 10%-30% of the US population has cardiovascular risk profile, it is 50- 60% in India. Taking statins to control lipid levels and even an aspirin as a preventive measure is not done seriously by most people in India.