Type 2 diabetes can be more severe in younger people

Health Care, Heart Care Foundation of India, Medicine Comments Off

This condition increases the risk of comorbid conditions by two to three times

New Delhi, 07 December 2017: A new study has indicated that Type-2 diabetes is more aggressive in younger people than in adults. The research has also indicated that the risk of complications in younger people with type-2 diabetes is two to three times higher than type-1 diabetes. It is alarming to note that one in every four (25.3%) people under 25 with diabetes in India has adult-onset type-2 diabetes. This condition should ideally strike only older adults with a family history of diabetes, obesity, unhealthy diets and inactivity.

Younger people with Type 2 diabetes do not need to be on insulin. However, they are at a greater risk of developing life-threatening complications such as kidney damage and heart problems than those who are dependent on insulin. The data indicates that about 56.1% of the registered young diabetics have been hospitalized at least once for acute diabetes-related complications. Additionally, 1 in 7 of them had at least one complication or “co-morbid” condition.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, “A high-calorie diet rich in processed and junk food, obesity, and inactivity are some of the reasons for the increased number of younger people with diabetes in the country. Not getting checked in a timely manner and not following the doctor’s protocol further complicates matters for them, putting them at a risk of acquiring comorbid conditions at a relatively younger age. There is also a belief that because young people with Type 2 diabetes do not need insulin, it is not as sinister as it seems. However, this is a false notion. This condition requires immediate treatment and management.”

A young person with Type 2 diabetes may have no symptoms. If there are some, these may be usually mild and in most cases, develop gradually and include thirst and frequent urination.

Adding further, Dr Aggarwal, said, “Small and gradual changes can be made in the family so that no one is left out. This will also be encouraging for youngsters with adults setting examples for a healthy lifestyle. Such changes can help a youngster lose weight (if that is the issue) or help them make better eating choices, thereby lowering the chances of developing Type 2 diabetes. This is truer for those with a genetic susceptibility to the condition. Operating as a team, a family, is much more likely to be successful.”

Here are some tips to manage Type 2 diabetes in young adults.

  • Maintain a healthy weight by exercising every day and consuming a healthy diet.
  • Get your blood glucose levels monitored at regular intervals.
  • Do not consume refined sugar in any form as this can get absorbed into the blood stream more easily and cause further complications.
  • Reduce stress through activities such as meditation and yoga.

Straight from the Heart: Government Policies Influenced by IMA so far

Health Care Comments Off

• NABH has recognized IMA as facilitator for its pre-entry level NABH accreditation certification.
• IMA has been able to halt the PM’s announcement to write drugs without brand names.
• IMA has been able to halt the government move to allow pharmacist to substitute drugs.
• IMA has opposed online pharmacies.
• IMA has been able to halt the MTP Bill allowing AYUSH doctors to perform MTPs.
• IMA has been able to halt, so far, the government’s alleged efforts in allowing technicians to run diagnostic labs and sign the reports.
• IMA drug policy of ‘one drug- one company-one price’ has been accepted by government in principle.
• IMA persuaded the government to raise the age of retirement to 65 years for EHS doctors and later extend it to other categories of doctors.
• Kerala state has included ‘Noise & Health’ as a chapter in the 8th standard syllabus on the initiative of IMA NISS.
• Delhi can now avail free MRI, CT scan, PET scan tests at 21 private laboratories. The residents are required to show referral letter from the selected 30 government hospitals or 23 state run polyclinics to avail the free service.
• IMA, has time and again demanded to disperse fund for treatment of trauma victims during the golden hour rather than giving compensation after 5 or 6 years. IMA also suggested ways and means of mobilization of the fund for this purpose, besides asking the insurance companies to make the payment. One suggestion for fund mobilization was as follows: CSR funds should be made to pool to a central corpus fund and not be allowed to get fragmented by giving responsibility to the companies itself. For example, Govt. may plan a corpus for trauma care and companies may be asked to contribute half of their CSR contributions to the same. The Road Transport and Safety Bill 2015 and Road Traffic Accident Act 2016 were passed in the Parliament, 2017. The following clause in the Road Transport and Safety Bill 2015 is a great victory to IMA’s demand on trauma care.

THE ROAD TRANSPORT AND SAFETY BILL, 2015: Scheme for Golden Hour ‘141. (1) Notwithstanding anything contained in the General Insurance Companies (Nationalisation) Act, 1972 or any other law for the time being in force or any instrument having the force of law, the insurance companies for the time being carrying on general insurance business in India shall provide in accordance with the provisions of this Act and the scheme made under sub-section (2), for treatment of road crash victims during the Golden Hour”. “(2) The Central Government shall make a scheme for the cashless treatment of victims of the road crash during the Golden Hour and such scheme may contain provisions for creation of a fund for such treatment. Refund in certain cases of compensation paid under section140”.

• May 06, 2017: Allahabad: Concerned over the acute shortage of doctors, the state government has decided to rope in private doctors, including specialists, to treat patients at government-run district hospitals as well as community and primary health centres across Uttar Pradesh. Select states like Karnataka have in the past managed to introduce such a system effectively. “Indian Medical Association will act as our facilitators for the initiative and it would be in coordination with its office-bearers that we plan to work out a duty roster for these doctors who volunteer for the task,”

• Jaipur: Facing acute shortage of specialists, the state health department has selected 273 MBBS doctors for second batch of one-year certificate course of specialization in 10 different specialties: orthopedics, emergency medicine, ENT, obstetrics & gynecology, pediatrics, pathology, radio diagnosis, anesthesia, ophthalmology and general surgery. The first batch of 233 MBBS doctors have already completed their certificate course of specialization and got postings in trauma centers, maternal and child care units, community health centers and district hospitals as specialist doctors. Existing government medical colleges offered the courses. MBBS doctors with certificate courses have signed a bond of Rs. 25 lakh. (MBBS doctors can practice as specialists)
• E-mail received from Principal Secretary for Health & F.W. Dept: Govt. of Karnataka has strongly suggested that if IMA Karnataka can give the list of Doctors, who are willing to work in PHC’s then AYUSH doctors shall not be appointed in these PHCs
• Medical Wellness Board meeting: Focus on domestic medical tourism and IMA recognized centres where patients can undergo treatment at fixed charges including complications, would be set up.
• Both President India and Prime Minister of India condemned violence against doctors
• Government of Gujarat announced new health policy 2016 inviting involvement of private sector in health care
• Bombay High Court 77 of 2015: Adequate security at hospitals, not more than two attendants of a patient will be allowed to enter the hospital through the main gate.
• IMA has been able to implement introduction of stents and ortho devices in NLEM
• IMA has been able to get a white paper made on Indian Medical Services with MCI
• IMA has been able to get IMA- WHO workshop on AMR and making of an IMA AMR policy
• IMA has been able to pursue the Dept. of Pharmacovigilance Programme of India (PvPi) to make IMA as nodal centre of IMA pharmacovigilance department.
• IMA was able to pursue Delhi Government in closing the schools during pollution epidemic
• IMA was able to get Delhi High Court to take up the matter regarding Delhi pollution and organization of Delhi Marathon.
• IMA challenged the WHO and Lancet report on pollution causing premature deaths.
• Delhi High Court suo moto involved IMA on the issue of violence against doctors.
• IMA made NCERT change its chapter on health service where they had made derogatory writings on private health care.
• IMA was able to influence timely release of payments for oxygen after the Gorakhpur tragedy.
• IMA was able to have CGHS release part payments due to various CGHS empanelled hospitals.
• IMA was able to get a clarification from IRDA that post breast cancer mastectomy is not a plastic surgery and that Crohn’s disease is not an autoimmune disorder.
• IMA was being able to halt the start of NEXT so far.
• IMA was able to halt the conversion of MCI to non-democratic NMC.
• IMA was able to get the MCI revert to its earlier decision of age bar for NEET exam.
• IMA was able to pursue MCI for making a centralizing number of IMR.
• IMA was able to reinitiate Dr BC Roy National Awards.
• Under the new health policy, the health budget will increase from 1% to 2.5% of GDP
• IMA was able to get health care services out of GST.
• NACO started test and treat HIV policy.
• IMA GTN Policy: GeneXpert in every TB case, trace all contacts and notify all TBG patients
• IMA was able to introduce Depen and Pentids after their shortage in the market.
• IMA was able to roll back the suspension of AIIMS residents after a strike following the death of a nursing student at AIIMS.
• ICMR has set up a registry of rare diseases. A disease is defined as rare when it affects less than one in 2,500 individuals. Over 70mn Indians suffer from such disorders and live with them throughout their lives. There are only 500 FDA-approved drugs for over 7,000 rare diseases globally. The health ministry is currently discussing a draft policy for treatment of rare diseases. This is what I spoke in my Presidential address.
• In my presidential address at central council meet, I had said, “We also want the Ministry of Health to declare an Epidemic or Disaster Fund aimed at providing free services to all affected. The government announces ex-gratia grant to the families in case of any flood, fire, or train mishap; the same should be announced for any death during the epidemic or for any calamity in the family.” Now NCDRC has held that a malaria death caused by mosquito bite is an accident, and directed the insurer to honor its policy to a widow. (The same will be applicable to dengue deaths also). The commission also cited Blacks Law dictionary that describes an accident as “an unanticipated and untoward event that causes harm”.

Pradhan Mantri Suraksha Bima Yojana covers accidental death and disability cover of Rs 2 lakh at a premium of Rs 12 per year. The benefit of accidental insurance cover of Rs 1 lakh is also extended to all with accounts under the Pradhan Mantri Jan Dhan Yojana (PMJDY) launched on August 28, 2014 by Prime Minister Narendra Modi. The premium for the insurance cover is borne by the National Payments Corp of India.

• Death due to negligence is an accident: NCDRC, LIC vs Shri Narender Singh on 2 July, 2012: Revision Petition No. 2056 of 2012: Justice J. M. Malik: The word accident is derived from the Latin verb “accidere” signifying fall upon, befall, happen, chance, in its most commonly accepted meaning. According to Webster’s dictionary, accident means (1) an unfortunate incident that happens in unexpectedly and unintentionally, typically resulting in damage or injury (2) A crash involving road or other vehicles, typically one that causes serious damage or injury. According to free online dictionary, accident means an unexpected and undesirable event, especially one resulting in damage or harm car accidents on icy roads. According to business dictionary, accident means in general, an unplanned, unexpected, and undesigned (not purposely caused) event which occurs suddenly and causes (1) injury or…

According to Oxford dictionary, accident means a thing that happens, an event, an event that is without apparent cause or unexpected; an unfortunate event, esp. one causing injury or damage, Chance, fortune, an unfavourable symptom, a casual appearance or effect, an irregularity in the landscape.

Admittedly, the life assured died during an operation by the treating doctors for the treatment of her tubes. Thus, the injury to the life assured was an accident caused by outward, violent and visible means and therefore, the Life Insurance Corporation of India cannot be absolved from its liability to pay the accidental benefits to the complainant.

Last but not the least, some distinction has to be drawn between the accidental death and natural or normal death. Learned counsel for the petitioner did not pick up the conflict with para 7 of the complaint noted above. The absence of anaesthetist before the operation puts the case of the complainant in an impregnable position. Without calling the anaesthetist the above said two doctors should not have treated the patient at all. This itself speaks deficiency in service on the part of the doctors as well as negligence and rashness. The revision petition is lame of strength and therefore, the same is dismissed.

• IMA was able to get the Inter-Ministerial meeting recommendations finalized.
• IMA was able to change the perception that mobile towers are linked to cancer.
• Dr RK Gupta IMA Member form Bilaspur CG State got relief by High Court. He was accused of 13 deaths in the female Sterilization camp organised by Chhattisgarh health department in year 2014. He was arrested during initial phase as accused. IMA CG State helped him in legal battle. The high court pointed out substandard drugs (spurious drugs) used during the operative course as cause of deaths and not the operative procedure.
• IMA met the West Bengal Chief Minister and was able to have her order to get all medical negligence cases to WB State Medical council first and to have a redressal mechanism within the hospital first.
• IMA Karnataka was able to pursue the government in modifying the Karnataka CEA.
• IMA was able to get all the PCR van police personal get trained in CPR in Delhi.
• Now under-five child deaths in India will be examined through minimally invasive autopsies to ascertain the exact cause of death, which will benefit in districts like Gorakhpur where child deaths are high. The under-five mortality rate in India stands at 50 per 1000 live births. The pilot project that will begin in January, 2018, at New Delhi’s Safdarjung hospital, is a part of the global CHAMPS— Child Health and Mortality Prevention Surveillance, project, wherein tissue biopsies of the brain, liver, spleen and other tissues are taken in a minimally invasive way.

Dr KK Aggarwal
National President