The Silent Epidemic of Diabetes in India

In the middle of March earlier this year, while the work stress peaked in line with the coming closure of the financial year, a few colleagues and I decided to undergo a preventive health-check. It was one of those things that came about after a postprandial discussion over cigarettes, where someone casually mentioned that with most of us well in our middle age and it might be a good idea to check out the state of our health. None of us had any symptoms of any disease, however we certainly had risks, some of us were heavy smokers, lead sedentary lifestyles filled with high levels of stress, and some had a family history of various lifestyle diseases. Lest, we forget our discussions, I quickly booked ourselves to undergo a preventive health check at the Max Medcentre, the coming Saturday.

Finally Vinay, who is the programming director of the radio station, where I worked than and I underwent the Health Check. Max is familiar territory for me, the entire experience was wonderful. A couple of days later we turned up for our review with the internist. As I walked into the office of the doctor, I did not have any inkling of what lay in store. Dr. Kalra made me feel comfortable and then gently dropped the bombshell, my blood sugar levels and lipids were way too high. I had diabetes and it was totally out of control, the liver function was impaired and the metabolism of the lipids was extremely poor. He was alarmed enough to ask me to consider starting on insulin forthwith.

When I looked at the test results, I too found them hard to believe. I sought advise from friends who were doctors, immediately set up a meeting with Dr. Sandeep Buddhiraja presently the Director of Internal Medicine at Max Healthcare and who has been a colleague and a friend. Sandeep, asked me to repeat the tests and put me on statins as well as metformin, apparently disagreeing with Dr. Kalra on the use of insulin. He asked me to make serious lifestyle changes and consoled me by saying that the good thing was that I need not give up smoking or reduce alcohol consumption!!! (I am a non-smoker and a teetotaler)

For the past 7 months now I am learning to live with diabetes. The good thing is that I have no symptoms, don’t feel ill or constrained in any manner. I have made significant lifestyle changes, which I believe would help me live healthier. I have lost more than 10 kgs in these months, feel a lot lighter and younger than earlier, watch what I eat, regularly take my medicines and check my blood sugar using a home kit. The blood sugars and the lipids are now in control and my regular bi-monthly meetings with Dr. Buddhiraja are a great help.

I do not know why I have diabetes, we have no family history of the disease, I have always lived a fairly active life and have never smoked. I had a BMI of 27, a little more than what it should be but certainly not very high. Now that I keep an eye on the latest research on diabetes, I realize that the day is not far off, when we will have a cure for diabetes. However, awareness about the disease, its prevention and management are our best bets in combating diabetes for now.

This is also a great opportunity for healthcare and pharmaceutical companies. I now spend close to Rs. 3000 per month on medicines, tests and consultation fee for managing my disease. Last year itself India had close to 48 mn diabetics under active management. There are millions more who are not aware that they are diabetics. The total direct cost last year on the management of diabetes in India was estimated to be USD 31.9 bn. This includes the massive cost incurred on hospitalization and treatment of complications resulting from diabetes. Yet, we do not have a single chain in the organised healthcare space, which is focused on the prevention and management of diabetes. In large metropolitan cities like Delhi, there are super specialists, who are experts in managing diabetes, but in most of the country it is the general physicians or cardiologists who take care of diabetics.

The management and treatment of diabetes requires long-term and finely calibrated care, which can only be provided by trained experts. More importantly, awareness needs to be created so that people at risk, can undergo regular screening to diagnose the disease. From personal experience, I can easily say that it is completely silent and catches one totally unawares.

From the perspective of healthcare entrepreneurs there can hardly be a greater opportunity in stepping in and setting up professionally run Diabetes Management Centres, which can effectively combat the disease before and after it strikes. Presently, there are no such chains and all we have are mom and pop clinics run by individual doctors. We need an organised effort to combat Diabetes and we need it right now.