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Is bariatric procedure the solution to diabetes?

There's mounting evidence to suggest it can though doctors advise extreme caution.

As part of the recently concluded three-day conference, Metasurg 2008, bariatic surgery was performed upon nine patients and relayed live to the delegate doctors. The procedure has been known for over 30 years as the most effective and long-lasting treatment for morbid obesity. But, surprisingly, none of these nine patients, weighing in the range of 100 kg to 200 kg, were seeking weight reduction. Instead, they were looking for a cure for diabetes.

"I have been suffering from diabetes and high-blood pressure for the past six years. My body mass indes(BMI) is 45, putting me in the morbidly obese category. No amount of medication, care, and caution seems to bring my diabetes under control," said Arvind Kalekar (name changed) from Aurangabd. "I hope this surgery will cure my diabetes."Kalekar weighed 160kg when he was wheeled in to the operation theatre.

The new-found use for the procedure was at the core of a heated international debate, which was conducted live during the conference. Bariatric surgeons swear by mounting evidence that suggests that the surgery might be the most effective treatment for metabolic diseases and conditions, includingType-2 diabetes, hypertension, high cholesterol, and sleep apnea. Endocrinologists and diabetologists,though, say it is a drastic measure fraught with risks.

Dr. Shanshank Shah, Consultant bariatric surgeon at Wockhardt Hospital, is confident that the procedure will resolve Kalekar's diabetic condition. "He won't have to take any medication for diabetes," said Shah, who claimed to have performed the surgery on 300 patients. Of them, 175 were rid of their diabetic condition.

Over 300 bariatric surgeons from across the world, who attended Metasurg 2008, agreed that surgery for obsity goes way beyond weight loss and can effect a complete remission of Type 2 diabetes and other life threatening diseases in most patients.

With mounting evidence, endocrinologists too are slowly changing their views. Dr. Udaya Phadke, who was among a group of 25 endocrinologists who participated in the debate, said,"So far, diabetes only had medical treatment. But now, evidence of a surgical option is emerging.

"But there is a catch- the surgery is advisable only for people who are grossly obese and whose diabetic condition is uncontrolled despite conventional medication. But if case selection is done properly, the procedure can be very usefull." Phadke's view was endorsed by leading city diabetologists like Dr Shanshank Joshi and Dr. Manoj Chaddha.

Diabetes under attack

The Amercian Association of clinical Endocrinologists (AACE), in its recently published guidelines, says the surgery can be a valid oiption in therapy for morbidly obese patients(with a BMI over 35).Professor Nicola Scorpinaro known as the 'father of bariatric surgery' for pioneering it more than 30 years ago, is currently engaged in clinical research to prove that bariatric surgery may also be useful to control severe diabetes in moderately obese and even non-obese patients(with a BMI between 20-35).

As India debates the Nikita Mehta judgment..

Mumbai docs want to try alternative therapy to ensure healthy babies.EVEN as the HC denied Nikita Mehta permission to abort her 25-week-old foetus, two Mumbai doctors are hoping to use alternative therapy that will ensure healthy babies. This treatment can be used when allopathic medicines fail to provide the desired results. Dr. H S Palep of integrative medicine and Dr. Geeta Niyogi of obstetrics, head of their respective departments at K J Somaiya Medical college, are in talks with the Boston University of Medicine to rest the success of an ayurvedic drug on 300 pregnant women aged 18-44 for healthy babies. The drug called Sujat (See box) claims to strengthen the placenta that supports the foetus. The research will follow a 'double-blind system where a placebo will be given to 150 expectant mothers and Sujat to the rest. The women will then be tracked for the entire term of their pregnancy. 'The average birth weight for an Indian is unable to significantly raise this weight, why, not try alternative medicine,' said palep who proposed the same to Dr. Robert Saper of Boston University last year. The initial reaction was skeptical. 'Alternative medicine is an important part of the course for medical students in USA, while in India it’s virtually ignored,' said Palap. The investigators are now waiting for approval from the Indian Council of medical Research and Us NIH/NICHD health authorities to start research.

What is Sujat?

A combination of nine different ayurvedic ingredients designed to strengthen the placenta of an expecting mother and improve general health.

Steam Cell cure on cards for rural diabetes.

The government is contemplating the use of stem cells for treatment of diabetes, especially in rural area. "Stem cells can now be grown and transferred into specialised medical therapies and this can be an answer to diabetes treatment," Union health minister Ghulam nabi Azad said on Sunday. Azad, while speaking at a diabetes conference in Delhi. Said it is important to take care of the rural population and help them to keep a check on the growing menace of the lifestyle disease. "We are formulating a scheme to facilitate mandatory check-up of the rural population above the age of 40 years for diabetes. if diabetes cases could be easily detected awareness created among them about its implications, then a substantial dent can be made to this disease," he said. The minster added that health workers in rural areas with be trained and provided with a diagnostic kit to detect diabetes. "Simultaneously a programme for diabetes control can be launched," he said, Azad also said marginal cases of diabetes can be easily tackled through yoga, naturopathy, exercise and correct eating habits. There is also a need to develop diagnostic kits within the country to substantially bring down the cost of diabetes detection and treatment, Azad said. A bitter-sweet truthDiabetes can make you feel helpless. But there are ways to manage this conditionDiabetes is a life-long condition which you need to take it seriously. Managing your diabetes well is a balancing act where you have to manage your medication with a healthy diet and physical activity. The management of diabetes most importantly involves self-care.

REGULAR CHECK UPS

Check your blood glucose levels regularly in order to preserve your health. Keeping tabs on your sugar level will help you to prevent complications from your diabetes. Your blood glucose levels should be below 120 mg/dl before meals and 180 mg/dl after meals. This shows that it is under proper control.

TIMELY MEDICATION

Medications are of utmost importance. If your doctor has prescribed medications you need to take them as directed. Take them at the same time each day and try to take them close to your regular meal times. Don't try and change the dosage all the time.

WATER POWER

Water is essential for the human body under all circumstances. It is important that you drink at least eight litres of plain water every day.

HEALTHY DIET

You must ensure that your diet includes fresh vegetables, carbs, good fats and some lean protein. This diet will help you and will also help decrease your risk of cardiovascular disease.

VITAMIN SUPPLEMENTS

Since your body doesn't receive much nutrition, it is important you provide it with the required supplements. Take amultivitamin every day. FOOT CARE Take good care of your feet. Wear shoes and socks that fir your feet well. While it may seem that this would not be a big problem, it can become one if there are sores on your feet that become infected. Check your feet after you bathe and before you go to sleep. Check the soles of your feet regularly. Don't use location between your toes. Dry between your toes thoroughly and make sure that you wash your feet carefully.

DENTAL CARE

Gum disease can be prevented with brushing and flossing your teeth. Diabetic patients are at a higher risk of gum disease, so take care to help prevent it.

SLEEP WELL

Have adequate hours of sleep. Sleeping seven to eight hours a night can make a difference in your diabetes and your overall well being. Go to bed and wake up at a regular time every day.

DAILY EXERCISE

Exercise your body. Moving your body helps you relieve stress, reduce blood sugar levels and can generally lift your spirits. Your can do regular walking, or spirits. You can do regular walking, or take up yoga for some light stretching.

UPDATE YOURSELF

Keep yourself updated on diabetes news. Research all the latest treatments and learn to live with diabetes. Who knows, you might just get lucky and find a cure for this condition.

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Diabetes. Some useful Tips

How does Exercise help?

1. Lowers blood glucose levels quickly improves the body's ability to use insulin

2. Reduces insulin requirement

3. Better control of diabetes

4. Reduces the risk of heart diseases

Primary preventionMaintaining of normal body weight Healthy nutritional Practice Regular Physical ExerciseSuch as Brisk walking / jogging Avoiding-alcohol & smoking Periodic health check up

Diet and diabetes

a. 30% of the disease can be controlled with proper diet

b. Proper Diet is vital in the treatment of diabetes

c. Diet for the diabetic person need not be completely different from a non-diabetic person.

Foods you should avoid

a. Sugar in any form-Sweets, ice creams Chocolates, Candies Etc.

b. High carbohydrate foods like Potatoes Sweet potatoes etc.

c. Fried items like Puri and Chat items

d. Fruits high in sugar content like Banana Sp ota, Grapes, Mango etc.

Secondary Prevention

It means control of diabetes and its complication It is possible by maintaining Normal blood glucose levels, ideal body weight and blood pressure, Normal blood cholesterol and fats.

All diabetes persons should regularly get their blood glucose estimation, kidney function test eye check up and foot examination done.

Foods you should eat more often

1. Take a balanced Diet

2. All green and leafy vegetables like Bitterrgoud, Lettuce leaves, Brinjal, ladies finger, cabbage. Cauliflower, carrot, Soya beans, Drumstick is good.

Remember.

1. It is not only important what you eat but also how much you eat.

'UN-SURGARY' FACTS

A. Currently about 26-27 million Indians are known to be suffering from one of the other form of diabetes.

B. About 16 per cent of the metro population in India above the age of 20 is diabetic (Type 2) as against an average of 12.1 percent for urban India.

C. Of the rural population comprising 70 per cent of India's one billion people, about 2-3 per cent suffer from diabetes.

D. 14 per cent of urban Indian also suffer from a pre-diabetic condition called the impaired glucose tolerance (IGT), which is a precursor to diabetes.

E. Almost 26 per cent, or more than a quarter of India's adult urban population, have some form of glucose intolerance.

F. Epidemiological studies have revealed that Indians are genetically pre-disposed to getting diabetes.

Diabetes successfully treated by ear acupuncture

GOT a sweet tooth, but can't indulge in it because of diabetes? Dr. Jay Kumar Deeksshit has a cue for you. November 14 was World Diabetes day and Dr. Deeksshit takes the opportunity to tell you how ear acupuncture help cure diabetes.

Auricular therapy

Auricular acupuncture may be used in conjunction with body acupuncture, but it tends to be used on its own. During treatment, a tingling sensation or slight dull ache may be felt, as well as some sensation in the related part of the body.

Ear acupuncture is based on the idea that each part of the ear is a mirror of the body as a whole. There are, for example, kidney meridian points on the ear. As a result, almost any ailment can be treated with ear acupuncture. Sometimes it is used together with body acupuncture, but some practitioners, use ear acupuncture on its won for diagnosis and treatment. There are two points in the ear, by giving acupuncture on one point; the B cell of pancreas gets reactivated. As a result, the resistance of insulin decreases and finally diabetes can be cured.

Dr. Jay Kumar Deeksshit is an eminent acupuncture practitioner since 30 years and his work has been recognised by the Government of India. He is the only acupuncturist to have received this recognition, and after 12 years of research work in diabetics mellitus, he has successfully treated it by ear acupuncture.

Dr. Deeksshit explains that there are mainly two types of diabetes-Type 1 and Type 2 Type 1: IDDM (Insulin dependent diabetes mellitus) Type 2: NIDDM (non insulin dependent diabetes mellitus)Both type of diabetes is incurable by any type of existing system of medicines like allopathy, ayurveda, homeopathy, etc. Nowadays, the modern lifestyle and stress have become to diabetes cause that leads to diabetes. Another type of diabetes is the one that woman develop during pregnancy. Obesity also one of the common causes that leads to diabetes.

Diabetes is also hereditary.

1.Whatever may be the reason, once a person gets detected with diabetes, it cannot be cured by means of any type of medicine or insulin, but it can be successfully treated by ear acupuncture.

2.Natural insulin can be produced through ear acupuncture. And when sufficient quantity of insulin gets stored into the pancreas, only then can diabetes be cured.

3.The body needs only 20 units of glucose into glycogen, which gets deposited in the liver. This is why the liver is known as the bank of sugar. So taking 30 units of insulin injection cannot control the sugar level because external insulin is not acceptable to our human body. The spleen reacts and produces anti-Insulin and anti-bodies and therefore diabetes is incurable. But with ear acupuncture, diabetes can not only be successfully controlled, but can also be cured completely.

Hold that sugar!

India is diabetes capital of the world. Do you do enough to manage your blood sugar?Currently, India has about 41 million diabetics and the number is likely to go up to 69.9 million by 2025. Lifestyle modification is what will prevent and control the disease. It's important to have a healthy diet and complement it with regular exercise and stress management.

EAT RIGHT

Having a healthy diet helps in achieving sugar levels and desirable lipid levels, which in turn help even prevent diabetes.

An ideal intake should be 500 Kcal/day of which,55-60 percent should come from carbohydrate. Proteins should provide 10 to 15 percent of calorie and the rest can come from fat. Saturated fats should provide less than 7 per cent of total daily calories and cholesterol intake should be less than 300 mg per day.

Eat high-fibre food, salads and fruits, though juices should be avoided. Alcohol, if consumed, should be in moderation. However, some foods are a total no-simple sugars (all kinds of sweets process food and red meat.

For pregnant women, artificial sweeteners and tobacco in any form must be avoided

A LITTLE WORKOUT PLAN

Like diets, exercise regimes are also individualized. The best is a stepwise incremental aerobic exercise . A 30-60 minute walk is recommended. Yoga can be useful if done under guidance. However, strenuous exercise must be avoided in patients with heart disease, retinopathy and autonomic neuropathy.

Footwear

Particularly important to diabetics, a patients should not walk bare foot: wear cotton socks and sneakers.

Toe webs should be kept clean and dry. Cracks in the heels are to be avoided. Toe-nails must be trimmed slightly away fromthe skin. For any minor foot injuries immediate medical attention is a requisite.www.keralaayurvedashram.com

DIBETIC EYE PROBLEM

DIBETIC RETIONPATHY

Eye is the window of Brain & organ of sight, which is our most precious sense organ and many people fear Blindness more than any other disability. There are Thousands of Diabetic patients who become blind every year because of Diabetic retinopathy. There is no curative treatment for Diabetic Retinopathy in Allopathic system of medicine.

World's Fastest & safest Ayurvedic O2 Treatment for Diabetic Retinopathy Indian Ayurveda is a very old medical science which has many treasures hidden in it which cures various diseases. Our treatment is one of them which has opened the doors for patients of the whole World looking for the treatment of Diabetic retinopathy. After continuous research for a long time by Ayurvedic Experts from Sanjeevan Ayurvedic Superspeciality clinic & research centre in association with experienced Ophthalmologists, have developed and achieved surest treatment for Diabetic Retinopathy.

ABOUT US:

We provide Ayurvedic treatment to cure diabetic Retinopathy under the supervision of experienced and well qualified Ophthalmologists.

MEDICOS (Faculties)

Experienced Ayurvedic Doctors, Ophthalmologists & Allopathic physicians.

INVESTIGATION FACILITIES

Thorough Ophthalmic checkup by experienced Ophthalmogists with special stress on indirect opthalmoscope and digital funds petrography to detect the exact condition of the disease for actual record of funds. This helps to compare the results on Retinopathy before and after our treatment and also as a permanent record.

RESEARCH

We are also carrying on research for Ayurvedic treatment for diploma (Double Vision),Glaucoma and allied condition for which trails are underway and results are quite encouraging.

DIBETIC RETIONPATHY

Diabetic Retinopathy is a complication of diabetes, which affects the Retina of the eye. In some of the Diabetic patients blood vessels of retina get damaged, due to which the retina does not receive enough amounts of oxygen & glucose. This results in ischemic (deficiency for nourishment. These new blood vessels are weak , fragile and cause recurrent bleeding in Retina and Vitreous ( the clear jelly substance inside the Eyeball). This makes the Vitreous opaque, causing Black-spots or floaters in the vision, blurring of vision or complete loss of vision (blindness).Diabetic Retinopathy as four stages:

1. Mild Nonproliferative Retinopathy: At this earliest stage, micro aneurysms occurs. They are small areas of balloon-like swelling in the retina's tiny blood vessels.

2. Moderate Nonproliferative Retinopathy: As the disease progress, some blood vessels that nourish the Retina are blocked.

3. Severe Nonproliferative Retinopathy: Many more blood vessels are blocked depriving several areas of the Retina with their blood supply. These areas of the retina send signals to the body to grow new blood vessles for nourishment.

4.Proliferative retinopathy: At this advanced stage, the signals sent by the Retina for nourishment trigger the growth of new blood vessels. This condition is called Proliferative retinopathy. These new blood vessels are abnormal and fragile. They grow along the retina and along the surface of the clear, vitreous gel that fills the inside of the eye. By themselves, these blood vessels do not cause symptoms or vision loss. However, they have thin, fragile walls. If they leak blood, server vision loss and even blindness can result.

TREATMENT

We cure diabetic retinopathy by Ayurvedic treatment.

By our Ayurvedic treatment, the leaked blood (hemorrhage) in retina and vitreous (inside the eyeball) gets cleared (quickly absorbed ) within a period of 2 to 8 weeks working and Retina receives sufficient amount of oxygen and nutrients. Formation of new abnormal blood vessels stops as well as the already present abnormal leaking blood vessels shrink, thus the further bleeding stops. Diabetic retinopathy is not only cured but also maintained by our treatment. This treatment, unlike laser surgery, doesn't damage the Retina. It not only restores the damaged retina to great extent but also makes it healthier and protects it from further damages due to Diabetes and saves the Eye from permanent damage.

Why our Ayurvedic treatment is best for DIBETIC RETIONPATHY, why not LASER TREATMENT & VITRECTOMY (OPERATION).

The difference between both the treatments:-

Advantages & disadvantages of Ayurvedic treatment:

1. Ayurvedic treatment does not have any disadvantage:

2. Any stage of the disease ( diabetic Retinopathy) can be treated successfully by Ayurvedic Treatment.

3. Restoration of the Vision is faster ( 2 to 8 weeks approx)

4. No additional damage to Retina.

5. No need of admission in hospital

6. There is no need for bed rest; patients can continue their day to day work & activities.

No surgical intervention.

7. Diabetic Retinopathy is not only cured but is also maintained by our treatment in addition it helps in overall well being ofthe patient.

Advantages & disadvantages of laser treatment & vitrectomy operation:

1. Laser treatment & Vitrectomy operation have many disadvantages.

2. Laser treatment causes permanent damages to retina. The vision in the laser treated part of Retina is permanently lost.

3. There is no treatment in Allopathic system of medicine to cure diabetic Retinopathy, only n the advanced 4th stage of the disease: to avoid further compactions Laser Treatment can be advised.

4. In the advanced stage of Retinopathy patients require 1000-2000 Laser burns on Retina, to just try to preserve the centralvision & night vision.

5. Surgical intervention in vitrectomy(operation) requires skilled surgeon.

6. Admission to the hospital is required & rest for at least 6 weeks after surgery is required. And also you will need to wear an eye patch for a few days or weeks to protect your eye.

7. Recurrent bleeding required recurrent Vitrectomy (operations ) and Laser treatments in addition and repeated follow-up visits to the Eye clinic.

8. Complications of Vitrectomy (operations ) like infections, loss of Vision and loss of whole Eye in few percent of cases are unavoidable.

9. Main thing is that Laser treatment and Vitrectomy (operation) do not cure Diabetic Retinopathy. They only cure the symptoms temporarily caused by Diabetic Retinopathy and even they do not guarantee results.

ASSURANCE : complete Money back Guarantee if no improvement I n Diabetic Retinopathy within TWO months.

DIABETIES AND TREATMENT

Increase in blood sugar level is a disease known as diabetes. If it is not controlled in time it damages the blood vessels which lead to Eye & Nerve problems.

We have specialized Ayurvedic Treatment for controlling diabetes. There is no side effect to a patient even if the medicine is taken for a longer period. It also prevents from the future complications like above mentioned. Our treatment not only controls the blood sugar but also improves the blood circulation and supplies sufficient amount of oxygen and nutrients to the organs of the body die to which the life of the patients become more comfortable and they .live healthy for a longer period.

Diabetes at Heart of cardiac trouble

Sion Koliwada resident Shakuntala is to undergo a cardiac bypass surgery next week,. Even though the 56-year-old fisher woman is scared about the operation, doctors feel it might be her only option.

What Shakuntala doesn't know is that her uncontrolled diabetes is the main reason of her heart problems. For three monts now, Shakuntala complained of a recurrent pain in her body. It was only when she went for a free check-up that she got to know that she had a heart problem.

"Shakuntala has had uncontrolled diabetes for the last six years. And in the past few months, she has started complaining of convulsions with mild exertions, even while sleeping. Her tests showed that three of her vessels are blocked. So the only treatment is a bypass surgery," said Dr.Ameya Udyavar, consultant cardiologist with Hinduja Hospital.

Cardiologists say that those suffering from diabetes are moresusceptible to cardiovascular problems as compared to those who don't. Statistics show that 65% patients with diabetes die from cardiovascular disease, 20-35% of patients with heart disease have diabetes and 55-60% patients undergoing bypass surgery are diabetics. Dr.Hasmukh Ravat, head of cardiology department in Wockhardt Hospital in Muluand, says that one out of the ten people in India suffer from diabetes."Because of the high blood sugar level, the artery becomes thicker and may even lose its elasticity. In such a case, if the fatty materials deposit on the inner walls of the arteries, the blood flow towards the heart will be affected, leading to an attack,"said Dr.Ravat. Cardiologists also believe that silent attacks are more common with diabetics. "Since the arteries get clogged, it causes pain in the chest. But with diabetic patients, these arteries also cause loss of the nerve function, because of which, the patient might not experience pain while getting an attack," said Dr.Udyavar. Doctors say that a treatment might not always be possible as the patient might not come to know that there is a heart problem if not for ECG tests. It is thus better for all diabetics to take precautionary measures. "It might not be possible for a diabetic to prevent an attack. But precautionary measures can ensure decreased succeptibility of heart problems," said Dr.N.Bansal, cardiologist from state government run JJ Hospital in Byculla. "People tend to gain weight in their mid 30s and 40s. If diabetics keep a check on their diet, exercise regularly, avoid gaining weight, keep the sugar levels in control, there is no reason why they cannot live a healthy life," he said.

PLATE FULL OF PROPER FOOD

High blood sugar or glucose level over time can lead to deposits of fatty materials on the insides of blood vessel walls. This may affect blood flow, increase the chance of clogging, or cause arteries to narrow or lose elasticity ( atherosclerosis)

DIETARY GUIDELINES

Carbohydrates

Daily carbohydrate intake should be approximately 50-60% of total calorie intake. Low Glycemic Index carbohydrate foods like oats, unpolished rice, whole pulses, beans and legumes, whole fruits like guava, apple and the like are preferred.

Fats

Fat(both visible in the form of oil, butter, ghee etc and invisible fat from cereals and pulses) should provide not more than 30% of total energy. This could be obtained by 4-5 tsp of oil and cereals and pulses in a 1600 Kcal diet.

Proteins

Protein intake should be as per body weight. A 60-kg man needs 60 gm of protein daily, provided by 9 servings of whole wheat flour, 2 bowls of dal or 2 pieces of lean meat like chicken or fish and 500 ml of double toned milk.

Salt

Have less than 5 g of sodium chloride per day.

Sugar and Artificial Sweeteners

Free sugars should be less than 19% of total calories. This includes all added sugars and sugars present in honey, syrups and fruit juices. Artificial sweeteners can be used in moderation.

Alcohol

Regular excessive intake of alcohol is harmful.

Water

Drink 1.5-2 litres (8-10 glasses) of water everyday.

Eating Out

Have healthy snacks. Avoid aerated and high calorie drinks, have buttermilk, coconut water or fresh lime water instead.

Regular Breakfast

Have a healthy breakfast daily, according to guidelines.

Cooking Methods

Boiled/steamed/roasted/grilled/sauted/poached/broiled/pan-broiled/stewed food is recommended over frying as it reduces the fat content in the food.

Meal Portions and Times

Eat small, frequent meals at regular intervals, keeping 3-4 hours gap between 2 meals.

Diabetes In S.Asia

Prevalence(%)

7.0

8.4

Number of people with diabetes(m)

58.7

101.0

Diabetes in India

Prevalence(%)

7.1

9

Number of people with diabetes(m)

50.8

87

Year

2010

2030 Half of India is too undernourished, the other half is eating the wrong food leading to a spurt in diseases like diabetes. We have to guide them on the right diet.

'Diabetes, hypertension deal twin blows to citizens'

Mumbai: India is not only the diabetes capital of the world, a new survey also shows that Mumbaikars have something to worry about the galloping twin epidemics of diabetes and hypertension.The study- Screening India's Twin Epidemic (SITE)-conducted for the first time on the two diseases at general physicians' clinics across the state revealed that almost a third of the surveyed patients had both the ailments, "About 25% of those who walked into the clinics had undiagnosed hypertension, while an other 5% had undiagnosed diabetes. Worse, almost 30% of those surveyed suffered from both diabetes and hypertension," saidendocrionalogist Shashank Joshi, principal investigator for the study on the epidemic of the twin diseases, which is being conducted by pharmaceutical giant Sanofi Aventis. SITE, which convered 1,842 people in Mumbai, Pune and Nagpur, will study 20,000 patients in the next one year."For two days, we screened the first 10 patients walking into the clinics of 100 GPs," said a company official.

India is infamous as the diabetes capital of the world, with 50.8 million people suffering from the disorder."But the real problem before India is the masked population that is unaware about the disease. This ignorance leads to the onset of co-morbidities, such as heart and kidney ailments,"Joshi said.

The SITE study's Maharashtras section also showed that 73% of diabetic patients did not have their counts in control, while the figure stood at around 64% with those suffering from hypertension."As a result of the uncontrolled disease, 32% of these patients have kidney problems, 18% altered lipid levels and 72% are overweight," stated the study.

However, Dr.S.Sadikot of Jaslok Hospital does not find the findings of the survey surprising at all. "Nine years ago, we realised that India had relatively high incidence of both diabetes and hypertension. This is all due to lifestyle changes. We no longer follow the old diet, and to top it all, we have become too sedentary for our own good. People use the lift when it comes to climbing up even two flights of stairs," he said.

DOUBLE TROUBLE

WHAT IS DIABETES?

Diabetes is the inability of the human body to produce insulin. It is believed that 7% of the general population suffers from diabetes, but a Chennai study pegs it at 19%

WHAT IS HYPERTENSTION?

In this condition, blood pressure remains abnormally high ( a reading of 140/90 mm Hg or greater). Around 25% of Indians suffer from this ailment.

SALIENT POINTS OF THE STUDY OF 1,842 PATIENTS

39.8% of the patients visiting clinics are diabetic and 54.6% hypertensive.

29% has both diabetes and hyptension

5% has undiagnosed diabetes and 25% hypertension

32% hypertensive patients has kidney problems

20% has altered lipids, indicating heart problems

72% are overweight or obese and 82.8% has central obesity

KNOW WHAT COUNTS

Wait Circumference:Less than 80 cm (31 inches) for women Less than 90 cm (36 inches) for men

Body Mass Index: Less than 23 kg/m2 for women and men

Blood Pressure: Less than 130/85 mm Hg Less than 120/80mm Hg for diabetes/ heart failure

Total Cholesterol:Less than 160 mg/dl

Retinal Diseases

Normal Vision:

The Retina is the nerve cell layer of the eye and acts much like film in a Camera. When light enters the eye it passes through the Cornea an dLens and is focused onto the Retina. The Retina transforms the light energy into vision and sends the information back to the brain through the optic nerve. The macula is the sensitive, central part of the retina and is responsible for sharp, detailed vision.

DIABETIC RETINOPATHY

Diabetic Retinopathy results from the effects of the diabetes on blood vessels that nourish the Retina tissue, which is the innermost layer of the eye wall. It is mainly associated with diabetes and is caused by the blockage of tiny blood vessels in the retina, causing hemorrhages on or in the retina. Diabetes causes retinal blood vessels to leak an dgrow abnormally. Untreated diabetes or poor disease maintenance greatly increases the risk of diabetic retinopathy. Depending on the severity of the disease, sight can remain near normal or may be lost entirely. Remaining vision may be blurred or distorted or the hemorrhage may cause a deep reddish veil to form over the field of vision.

Types of diabetic Retinopathy:

There are two main types of Diabetic Retinopathy:

A.Non-Proliferative

B.Proferative

In Non-Prolifeative or Background Diabetic Retinopathy , patients may have normal vision. The damaged retinal vessels leak fluid. Fat and protein particules may leak from these vessels and become deposited in the retina in patches know and Retinal Exudates.The retinal blood vessels may bleed into the retina and result in tiny hemorrhages. If any of the leaking fluid accumulates in the central part of the retina (called the macula), the vision is affected. This condition is called Macular Edema.

In Prolierative Diabetic Retinopathy, new abnormal blood vessels grow, which extend over the surface of the retina. These vessels occasionally invade the gelationus contents of the eye, the vitreous.The proliferating blood vessels frequently break, causing vitreous bleeding that may significantly decrease vision. Fibrous tissue may grow over the new blood vessels and distort vision. Occassionally, the tissue may contract and pull the retina off the inner surface of the eye, causing atractional retinal detachment.

Symptoms

There are no symptoms in the early stages of diabetic retinopathy. Vision may not change untile the disease is advanced or the Macula is affected. The earliest sign may be an abrupt change in eyglass prescription. The blood sugar affected. The earliest sign may be an abrupt change in eyeglass prescription. The blood sugar effects the water content of the lens of the eye and, therefore, spectacle prescription changes. Sudden increase in blood sugar will cause an increase in myopia. This often occurs before the detection of the disease. Diabetic Retinopathy may begin in eyes without one noticing any change in vison. Unfortunately, there may be extensive and sever changes before vision is affected. Thus it is very important to have the eyes examined regularly at six-month or yearly intervals depending on duration and/or severity of the diabetes.

Detection of Diabetic Retionapthy:

Diabetic retinopathy is detected during an examination of the back of the eye Fundoscopy through dilated (enlarged) pupils and by testing your vison. Dilatation is the method through which, after putting some eyedrops, we can see what is inside, to properly evaluate the Retina. We look for evidence of Diabetic Retinopathy. Based on the findings a Fluorescein Angiogram may be advised.

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