Most diabetics unaware of their condition: HCFI

Health Care, Heart Care Foundation of India, Medicine, Social Health Community No Comments

People with risk factors such as a family history of diabetes must take precautions at an early age

New Delhi, 21st May 2019: A large-scale population-based study has found that only half the Indian adults in the most productive age group (15-49 years) are aware that they suffer from diabetes. Only one-fourth of those diagnosed and treated have their blood sugar under control. In light of the poor level of awareness, treatment and control, the need of the hour is to focus on primary prevention and screening efforts. This will help reduce the burden and impact of diabetes in India.

According to the WHO, there are about 62 million people living with diabetes in India, a number that is projected to increase to 70 million by 2025. The ‘lifestyle disease’ is a massive public health obstacle for the second most populated country in the world. Diabetes can increase the risk of life-threatening complications including kidney damage and heart disease.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, 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.”

The symptoms of Type 2 diabetes develop slowly, over time. Some of them include increased thirst and hunger, frequent urination, weight loss, fatigue, blurred vision, slow healing of infections and wounds, and skin darkening in certain areas.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, 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.”

Our ancient rituals and traditions have given us a way out of this conundrum. They advocate the principles of ‘variety’ and ‘moderation’, that is, ieat a variety of foods, and in moderation.

They recommend including all seven colors (red, orange, yellow, green, blue/purple, white) and six tastes (sweet, sour, salty, bitter, pungent, and astringent) for a balanced diet.

HCFI’s Formula of 80 to live up to the age of 80 without lifestyle disorders.

  • Keep lower BP, LDL ‘bad’ cholesterol levels, resting heart rate, fasting sugar and abdominal girth levels all less than 80.
  • Walk 80 minutes a day, brisk walk for 80 min a week with a speed of 80 steps (at least) per minute
  • Eat less and not more than 80 gm or ml of caloric food each meal.
  • Observe cereal fast 80 days in a year.
  • Do not smoke or be ready to shell out Rs. 80,000/- for treatment.
  • Do not drink alcohol; if you do, do not consume more than 80 ml per day for men (50% for women) or 80 grams per week. Ten grams of alcohol is present in 30 ml or 1 oz of 80 proof liquor.
  • If you are a heart patient, consider 80 mg aspirin and 80 mg atorvastatin a day.
  • Keep kidney and lung functions more than 80%.
  • Avoid exposure to PM 2.5 and PM 10 levels < 90 mcg/m3.
  • Avoid exposure to >80 dB of noise.
  • Take vitamin D through sunlight 80 days in a year.
  • Do 80 cycles of pranayama (parasympathetic breathing) in a day with a speed of 4 per minute.
  • Spend 80 minutes with yourself every day (relaxation, meditation, helping others etc.).

Be careful of the amount of exposure to the sun during peak summer: HCFI

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Sun safety measures can help prevent skin cancer

New Delhi, 20th May 2019: Statistics indicate that the incidence of skin cancer is about 70% more in Indian men than women. It is one of the most common types of cancers around the world and can even occur without regular sun exposure. May is observed as the skin cancer awareness month and the need of the hour is to raise awareness on how to protective oneself from the condition.

Skin cancer occurs when there is unchecked growth of unnatural skin cells or tissues. The causes range from genetic factors to exposure to ultraviolet radiation. Although melanoma is the least common form of skin cancer, it accounts for majority of deaths due to the condition. Most skin cancers can be easily prevented by practicing sun safety measures.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “Melanoma is one of the deadliest forms of skin cancer and develops in melanocytes or the pigment cells present in the skin. It can spread to other parts of the body (metastasize) and cause serious illness and death. One can use the ABCDE rule to spot signs of melanoma: A symmetry – one part of a mole or birthmark doesn’t match the other; B order – edges are irregular, ragged, notched, or blurred; Color – this is not the same all over and may include shades of brown or black, sometimes with patches of pink, red, white, or blue; Diameter – spot is larger than ¼ inch across – about the size of a pencil eraser; Evolving – mole is changing in size, shape, or color.”

Some common symptoms of skin cancer include changes to skin; a skin sore that fails to heal; a spot or sore that becomes painful, itchy, or tender, or which bleeds; a spot or lump that looks shiny, waxy, smooth, or pale; a firm red lump that bleeds or appears ulcerated or crusty; and a flat, red spot that is rough, dry, or scaly.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “Cancer, if detected early, can be treated at a much lower cost compared to that incurred when diagnosed at an advanced stage. The mortality rate is also lowered substantially if people report for screening when the earliest symptoms manifest. Unfortunately, nearly two-thirds of cancer cases are diagnosed at an advanced stage, reducing patients’ chances of cure and survival.”

Cancers of unknown primary or CUP accounts for up to 4 to 5 percent of all cancer diagnoses and can be classified into four categories: Adenocarcinoma, Squamous cell carcinoma, Neuroendocrine carcinoma (differentiated or poorly differentiated) and poorly differentiated cancer. Accurate prediction of the tissue of origin using immunohistochemical staining and/or gene expression profiling is now possible in most CUP patients, and site-specific therapy based on these predictions is replacing empiric chemotherapy as the new treatment standard.

Some tips from HCFI

  • Avoid the sun during the middle of the day. Schedule outdoor activities for other times of the day, even in winter or when the sky is cloudy. Clouds offer little protection from damaging rays. Avoiding the sun at its strongest helps you avoid the sunburns and suntans that cause skin damage and increase your risk of developing skin cancer.
  • Wear sunscreen year-round. Sunscreens don’t filter out all harmful UV radiation, especially the radiation that can lead to melanoma, but they do give overall sun protection. Use a broad-spectrum sunscreen with an SPF of at least 15.
  • Wear protective clothing. Cover your skin with dark, tightly woven clothing that covers your arms and legs and a broad-brimmed hat, which provides more protection than a baseball cap or visor does.
  • Opt for sunglasses that block both types of UV radiation — UVA and UVB rays.
  • Avoid tanning beds. Tanning beds emit UV rays and can increase your risk of skin cancer.
  • Become familiar with your skin so you’ll notice changes. Examine your skin regularly for new skin growths or changes in existing moles, freckles, bumps and birthmarks.

Ignore TSH up to 10

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An international panel of experts has concluded that patients with subclinical hypothyroidism should not be routinely offered thyroid hormone replacement therapy.

In the recommendations published online this week in the BMJ, the expert panel writes “for adults with subclinical hypothyroidism, thyroid hormones consistently demonstrate no clinically relevant benefits for quality of life or thyroid-related symptoms, including depressive symptoms, fatigue, and body mass index (BMI).”

The guidance, based on findings from a systematic review and meta-analysis of 21 trials with 2192 participants published in November (JAMA. 2018;320:1349-1359) represents a “strong recommendation” against prescribing thyroid hormones (primarily levothyroxine LT4) in adults with subclinical hypothyroidism.

Subclinical hypothyroidism is defined as elevated thyroid stimulating hormone (TSH) levels when free T4 (thyroxine) levels are normal.

  • Subclinical hypothyroidism is known to affect around 5% of the adult population and 10-15% of the elderly.
  • About 90% of patients with subclinical hypothyroidism have TSH levels of 4-10 mlU/L, but a slight increase may be normal in older people.
  • Symptoms when present include fatigue, muscle cramps, sensitivity to cold, sluggish thinking and depression; as per the expert panel, 20-25% of people with normal thyroid levels report one or two of these symptoms.
  • In the majority of cases, the issue resolves itself. About 62% of people with TSH levels of 4-10 mlU/L have normalization of thyroid levels within 5 years without any treatment, states the report. The risk of overt hypothyroidism emerging from the subclinical forms of the condition ranges between 2% and 5% per year.
  • Observational data suggest an association between subclinical hypothyroidism and an increased risk of coronary heart disease, the associations have not been seen with TSH levels of 5-10 mIU/L.

(Source: Medscape)

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA

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