Lifestyle change is best remedy to diabetes: Prof. Abdul Basit

• Globally, over 1.1 million children and adolescents are living with type 1 diabetes, while three in every four people with diabetes (352 million) are of working age (20-64 years).
• Pakistan ranks 4th in the list who has largest number of diabetes patients.
• The IDF Diabetes Atlas 9th Edition reports that the prevalence of diabetes in Pakistan has reached 17.1%, now 148% higher than previously reported.

KARACHI:  Diabetes is a serious threat to global health that respects neither socioeconomic status nor national boundaries hence its best to prevent diabetes in early stages. These views were expressed by Prof. Abul Basit, Director, Baqai Institute of Diabetology & Endocrinology (BIDE), Karachi, and member of the IDF Diabetes Atlas Committee while talking to Business Recorder.

The increasing prevalence of diabetes in Pakistan is a wake-up call. We must do more to prevent type-two diabetes, diagnose all forms of diabetes early and prevent complications. We must also ensure that every person with diabetes has affordable and uninterrupted access to the care they need.

Prof Basit while clarifying the misconception that Diabetes is just the problem of developed countries said that recently published IDF Atlas 9th Editions shows that the Pakistan ranks 4th in the list who has largest number of diabetes patients. Top three are India, China and America respectively. These ranking were given due to the proportion of the population, otherwise I think ratio of diabetes patients in Pakistan may be more than USA or China. So, it is clear that diabetes is not only the problem of developed countries but it is also becoming a huge problem in under developed countries now.

In Ancient times people used to say, it’s a disease of rich people,  to some extent it was true as people used to say Mercedez and diabetes goes hand in hand but science has now proved its not only the disease of rich people but it’s a disease of lifestyle now. Earlier, in big cities the markets used to open at 7 or 8’o clock, in villages, people / farmer would wake up at 5 and go to work, but now even farmers go to work at 10 am and our markets open at 1 pm.

In our childhood we used to have dinner right after Maghrib, now we eat dinner sometimes after Isha, or between 10 pm to 12 am. Kids used to walk to schools, there was no fast food, dependencies on meat was less, people used to have ice cream or colas once in a blue moon. Now we eat less vegetables and more meat, we eat fast food more than the home cooked food, we eat ice cream and drink colas more often. Kids now going to schools either in school van or private cars. So, this is the problem of lifestyle.

On World Diabetes Day, the International Diabetes Federation (IDF) is releasing new figures that highlight the alarming growth in the prevalence of diabetes around the world. 38 million more adults are now estimated to be living with diabetes globally compared to the results published in 2017. New findings published today in the 9th Edition of the IDF Diabetes Atlas, show that Pakistan is now in the top 10 countries for absolute increase in diabetes prevalence.

The IDF Diabetes Atlas 9th Edition reports that the prevalence of diabetes in Pakistan has reached 17.1%, now 148% higher than previously reported. In 2019, over 19 million adults in Pakistan are estimated to be living with diabetes – putting them at risk of life-threatening complications. 8.5 million of these 19 million, are undiagnosed and, as a result, may be particularly at risk.

We have so far talked about type-2 diabetes. Type-1 diabetes is found more in developing countries like Sweden, Finland, Norway, Denmark, and Iceland etc, this is because of environmental problem or genetic inheritance. Type-1 diabetes is very rare in Pakistan. For example, if we examine 10 patients daily, only one or two are found with type-1 diabetes. So type1- diabetes is only 2 pc in the country.

So now let’s come to your third question what is diabetes. See type-1 and type-2 diabetes are two different diseases. What happens in type-1, when a human pancreas stops working for any unknown reason it stops producing insulin so the only remedy is insulin. It is very common in children and occur due to viral infection and there are few more reasons which science is unable to understand.

The best of example is Pakistani cricket super star Waseem Akram, who is the fittest type-1 diabetes patient. One day during practice he was unable to bowl and felt frequent urination. Upon checking his sugar level was at 300-400. Doctor advises him to immediately take insulin, now he is still fit. Its like when you are hungry you eat food, when you feel thirsty you drink water, if you are habitual of tea you drink tea, similarly, we have to teach people and families to take insulin because diabetes is not a disease. And diabetic patients are as same as a normal person.

Type-2 diabetes is the biggest problem in Pakistan. When people become victim of type-2 diabetes at the age of 40 or after 40 they are at life risk. Their pancreas becomes obstinate and insulin resistant it has insulin in it but it stops accepting it. Body doesn’t accept insulin’s action and we have to give them medicines. It happens because of obesity, fat that accumulates in stomach it becomes the most obstinate organ of the body that doesn’t obey insulin. People are advised to reduce their fat if they want to get rid of diabetes.

Now let’s talk about big diabetes surgeries, there is new method of treatment has been introduced called Bariatric Surgery. In Bariatric Surgery, we cut reduce the size of stomach and diabetes will be removed completely. But it’s an expensive mothed that cost 5-6 lac rupees. So, I would like to convey this message to people to reduce your weight by changing your lifestyle. Reduce your diet, walk daily at least half an hour, eat more vegetables. We should take daily 2000 calories, take 1000 in breakfast, 700 hundred in lunch and 300 in dinner but we do otherwise, we take three 300 hundred in breakfast, 700 hundred in lunch and 1000 in dinner. Please change this routine. It has scientifically proved now that people who maintain 2000 calories in above mentioned method their chances of heart attack and other chronic disease are less.

The problem is over 190 million people are diabetic half of which doesn’t know they are diabetic. They get to know about diabetic they suffer with heart attack, stroke or kidney failure.

Replying to a question about how Diabetes is affecting organs like heart, lungs and kidneys Prof. Basit said that the major role in diabetes is sugar control. If you control sugar you will avoid the odds and complications. But this is not 100% that you will not face sugar complications, you will have to do several things simultaneously like, control your cholesterol, blood pressure, daily walk, proper medicine and reduce to half weight then hopefully you may avoid the complications.

Globally, an estimated 463 million adults are living with diabetes and 55 million are in the Middle East and North Africa Region alone. Type 2 diabetes accounts for up to 90% of the total.

The rise in the number of people with type-two diabetes is driven by a complex interplay of socio-economic, demographic, environmental and genetic factors. Key contributors include urbanisation, an ageing population, decreasing levels of physical activity and increasing levels of overweight and obesity. For reasons which are unknown, type 1 diabetes is also on the rise.

Diabetes has an impact on all age groups, regardless of geography and income. Globally, over 1.1 million children and adolescents are living with type 1 diabetes, while three in every four people with diabetes (352 million) are of working age (20-64 years). The rise in prevalence is putting a strain on the capacity of countries to guarantee regular and affordable access to essential medicines and appropriate care. This leaves many struggling to manage their diabetes, placing their health at serious risk.