Tuesday, 9 December 2014

KSS on the Occasion of World Diabetes day

On the occasion of the world diabetes day, our chief medical officer Dr Kumaran offered to do a knowledge sharing session on the "Diabetes Awareness & Education". World Diabetes Day (WDD) is observed every year on November 14 and  the campaign is led by the International Diabetes Federation (IDF) and its member associations. It engages millions of people worldwide in diabetes advocacy and awareness.

We in the learning & development department jumped at the offer of the  CMO, given the fact that  one cannot know too much about a disease that is constantly growing and affecting all  sections of the population without any bias of age, sex or colour! Dr Kumaran described  diabetes as  a chronic  disease that "follows you like a shadow". He revealed that  by the year 2025,  six crore Indians are expected to be in the grip of this disease! Yet,with proper education & awareness one can lead a long life without complications.

Normally, in a talk of this nature many people may  assume that they already know most of what is required to be known about the disease as it is often discussed under the life style diseases along with hyper tension and obesity. Yet Dr Kumaran's presentation was not only informative but fine tuned for the audience - employees working in an Indian manufacturing industry. After the talk, there was opportunity for interaction & clarification by the audience.

At the outset, doctor  explained that diabetes is caused due to either the pancreas not producing enough insulin or the cells of the body not responding properly to the insulin produced. There are three main types of diabetes mellitus:
  • Type 1 DM results from the body's failure to produce enough insulin. This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes". The cause is unknown.
  • Type 2 DM begins with insulin resistance, a condition in which cells fail to respond to insulin properly. As the disease progresses a lack of insulin may also develop. This form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes". The primary cause is excessive body weight and not enough exercise.
  • Gestational diabetes, is the third main form and occurs when pregnant women without a previous history of diabetes develop a high blood glucose level
Prevention and treatment involves a healthy diet, physical exercise, not using tobacco and maintaining   a normal body weight. Blood pressure control and proper foot care are also important for people with the disease. In this connection the doctor advised  weight control, restricting the  BMI to 23- 24 ( Normal is 18-25, over weight- 26 to 30 and obese 30 to 39 and  a BMI of more than 40 being classified as morbid obesity ) . He also warned that a waist line of more than 40 inches is dangerous.  Apple obesity ie obesity above the waste is a matter of concern as against pear obesity( below the waste).According to him an increased waist line denotes  a decreased life line.

Dr Kumaran underscored the importance of education in arresting diabetes and opined that each patient or potential patient should assume the role of a medical student .  With respect to diet & nutrition, he suggested that 50% of a meal consist of vegetables ( 5 varieties of rainbow coloured vegetables that include yellow,orange,green & purple colours), 25% carbohydrates and 25% protiens.He advised to consume more of fibre based food to reduce the absorbtion of sugar and to restrict oil consumption to three spoons per day.Although olive oil is the best, it is advisable to consume a mix of different oils to get maximum benefits over a period.  In this connection, I liked the novel suggestions given by him for modyfying the food regularly used by us, instead of advising some fancy food from abroad  viz  adding vegetables & pulses to your dosas, adding to your rotis various types of dhals/pulses, adding tomato & vegetables to  Samba wheat upuma and prefering vegetable chutneys to coconut or peanut chutneys.He suggested taking food in smaller quantity more number of times( morning,mid morn, Noon, Evening, night and bed time (milk,marie bicuits).

75%  of  dealing with diabetes rests with the patient. Apart from the focus on what one eats, attention should be given to the following:-
  • Regular exercise of 45 minutes per day that includes stretch exercise, aerobic (walking, jogging,swimming) and anaerobic (weights)  exercises.
  • Regular health check ups -once in three months to check  bloood sugar viz fasting, post food consumption(PP) and HBA1c (an average in 3 month period). For diabetic patients, the fasting levels should be within 100 and 126, PP between 140 and 160  and a HBA1c of below 7%.
  • Checking blood pressure periodically (120/80  is normal) as also cholesterol( total cholesterol < 200)
  • An eye check up at least once in a year (17-18 maximum eye pressure)
  • visit to dentist once a month
  • Brushing teeth with fluoride tooth paste twice a day
  • Dental floss instead of using tooth pick
  • kidney function check once in six months
  • Avoid tobacco- A single cigarette is known to contain 7000 chemicals!
  • Keep the feet as clean as your face to avoid possibility of any infection entering
  • Not cut the toe nails too deep
  • Wear comfortable foot wear- Micro cellular (MCR) sandals with buckle
  • Tread mill check  once in a year (by pass surgery would be required if  block in  3 vessels)
  • Drink 5 litres of water per day
  • Sleep 7 to 8 hours a day.
  • Practice yoga & meditation
  • Carry an ID card with you indicating the diabetic condition
Dr Kumaran concluded the session reminding the participants that  accepting responsibility & following the tips as above, can keep the five dreaded Pathys at bay ( Cardiomyopathy affecting heart, neuropathy affecting nerves, retinopathy affecting the eye, nephropathy affecting kidneys & dermopathy, affecting skin). He suggested utilizing the services of a comprehensive diabetic clinic so that all aspects of diabetes are addressed at a single window.The guidelines also ensure the health of your feet,teeth & other parts of the body which can be adversely affected  by uncontrolled diabetes.With that, it was curtains for a very informative & enlightening session and all the participants joined learning & Development in thanking the speaker for the kind and timely gesture!


  1. Thank you Rajeev, this is a very detailed and an informative post. Much needed content on diabetes and its constant presence.

  2. Thank you Vinay for your appreciation.Diabetes is one disease that is growing at a very fast pace & targeting younger and younger people! Hence no amount of education on it is too much..