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The incidence of diabetes in India in the year 2000 was 19.40 million, when our country was recognized of having the maximum number of NIDDM in the world.

In the current year of 2007 we have a diabetic population of 38 million. And researchers are predicting that by the year 2030 we should be having 78 million diabetics in India. India is going to have a huge diabetic population it would be a great challenge for the health care providers.

All the authorities on diabetes namely Joslin Diabetes Centre, International Diabetes Federation, WHO etc., say in one voice that only diabetes education to the Indian population would help them in coping up with this dreaded disease.

1. In which country was diabetis first identified and treated? Go to Top

Dr. Susurutha and Dr. Charak first identified it in India more than 2500 years ago. They named the disease as “Madumek “, meaning sweet urine.

2. Other than by symptoms, how did Dr. Susurutha confirm a person as diabetic? Go to Top

Dr. Susurutha did not have any blood sugar monitor and urine sugar strips to confirm and monitor his diabetic patients. What he did was he use to straight away taste the urine of a suspected diabetic, and if it tasted sweetly he use to confirm him as a diabetic patient and would start the necessary treatment with exercise, diet or Aurvedic medicines.

So dedicated were the Doctors during those good old days. But in our current era, patients them selves find it repulsive to test their own urine for sugar. These people should know that our urine is more hygienic than the drinking water provided by the corporation. In fact it is life saving for the fishermen who get lost in the sea.

3. Will a non-diabetic have sugar in urine? Go to Top

No, a non – diabetic will generally not have sugar in urine at any given time. But uncontrolled diabetic will generally pass sugar in his urine. Usually, if a diabetic’s blood sugar goes above 180 mg/dl, he would start showing sugar in urine. That is why in mass diabetes screening camps, testing the urine for sugar is more logical.
Those who are positive can be reconfirmed with a blood sugar test.

4. Will a non-diabetic have sugar in his blood? Go to Top

Of course he will have sugar in his blood. The only difference is: a non-diabetics blood sugar will not go beyond 120 mg/dl, while it would go beyond 180 mg/dl for a diabetic.
Like a car needs fuel to run about, humans need sugar in the same way.

5. What is the normal blood sugar value for a non-diabetic Go to Top

These values differ by 10 to 15% based on the sample and the methodology used.But in general it is between 80 to 120 mg/dl. But in diabetics the blood sugars are capable of going beyond 180 mg/dl.
Before Breakfast - fasting < 110
Before lunch, supper and snack < 110 Bedtime < 120

6. What should be the blood sugar value for diagnosis of diabetes? Go to Top

• Fasting plasma glucose is above 126 mg/dl:
• Diabetes symptoms exist and casual plasma glucose is equal to or above 200 mg/dl: or
• Plasma glucose is equal to or above 200mg/dl during an oral glucose tolerance test.

7. What is the target blood sugar value for a diabetic patient? Go to Top

A diabetic can monitor his blood sugar at six different times in a day, based on his three meals.
He can do a test before a meal. The control values are given below.

Just before a meal

Good Control      80 to 110
Okay                111 to 125
Bad Control       above 125

2 hours after a meal

Good Control      120 to 140
Okay                141 to 200
Bad Control       above 200

The above consensus values have been arrived at after consulting most of the Doctors, managing diabetes in India.

8. Is diabetes a rich man's disease? Go to Top

No! Diabetes does not differentiate between the rich and the poor; it comes to everybody. You get it whether you are young or old, man or woman, city man or a villager, Indian or American, white skinned or black skinned. It is a very democratic disease.

9. What are the symptoms of diabetes? Go to Top

• Having to go to the bathroom very frequently to urinate.
• Being very thirsty.
• Increased hunger.
• Extreme unexplained fatigue.
• Blurry vision.
• Irritability.
• Weight loss without a reason.
• Delayed healing of wounds.
• Frequent skin, bladder or gum infections.
• Burning, pricking or tingling sensation in the feet.
• Leg cramps.
• Women giving birth to over weight babies.

10. Can a person have diabetes without any of the classical symptoms? Go to Top

Yes! A person can have diabetes without having any symptoms of diabetes. In fact many of them get used to the symptoms so much, that they are not able to differentiate between normal and abnormal. Even doctors and paramedics who are well informed about the disease are diagnosed late.

11. Is diabetes a hereditary disease? Go to Top

Yes! Type 2 diabetes, which is otherwise called as Non insuline dependant diabetes mellitus or maturity onset diabetes mellitus, is hereditary. Research has shown that if both the parents are diabetic, the chances of their children getting diabetes are almost 100%. Research has further shown that all the chronic diseases are also hereditary.

12. Even though I have a family history of diabetes, when will I get it? Go to Top

Even though you may have a family history of diabetes, you will get it only when you subject yourself to one of the following. They are called as Triggering factors.

• Excess weight.
• Lazy habits.
• Mental Stress.
• Women having frequent abortions or childbirth.
• Excess intake of Carbohydrates or free sugars.
• Long term use of steroid drugs, like predinisolone and contraceptive pills.
• Advancing age.

13. Can children have diabetes? Go to Top

Yes, children can also have diabetes. It is called as Insuline dependant Diabetes or type 1 diabetes or juvenile diabetes. The youngest diabetes so far seen is a 2 months year old baby, which died of complications in another 2 months, because of wrong diagnosis. This record was beaten a month ago, when I saw an infant of 2 days having diabetes. The symptoms are so severe that this type of diabetes never goes undetected.

14. What is gestational diabetes? Go to Top

As the name gestational suggests, it is diabetes that affect some of the pregnant mothers. It is there as long as they are pregnant and vanishes once the child is born. And during this period these mothers should be on insuline, if they want to have a healthy baby.

15. Now how do we get diabetes? Go to Top

To understand that, first we should know when our body gets energy. We do not get it when we eat a full stomach, nor do we get it when it is digested and becomes sugar, nor do we get it when sugar enters a blood stream. Only when the sugar in our blood enters each and every cell in our body do we get the energy.

Now sugar cannot enter the cell on its own, it needs a guide namely insuline to take it to the respective cells. This insuline is produced in the beta cells in the islets of Langerhans in pancreas.

In a normal person whenever blood sugar rises, automatically the insuline also rise, and whenever blood sugar decreases the insuline secretion also decreases. But in a diabetic either because of reduced insuline secretion or because of the inferior quality of the insuline produced, the tissues use up not all the sugar molecules in the blood. Hence the blood sugar accumulates and goes on rising, and starts getting exceeded in the urine, once it goes above 180 mg/dl.

16. Does insuline have any other function other than bringing down the blood sugar? Go to Top

Yes, insuline also helps in storing the sugar by way of Glycogen in the liver and muscles, and as fat in adipose tissue.

17. How important is this diabetes education? Go to Top

Without diabetes education it is very difficult for a patient to control his blood sugar, as he has to confront it every minute, everyday, every year, throughout his life.

A diabetic should know what all will increase his sugars and what all will decrease it. He should know, that if he keeps his sugars in control what all the complications he could save himself from. He should know the parameters, which he can test, control and monitor in the house itself.

It has been found that those diabetics who had undergone patient education were able to control their blood sugars much better than those who had not.

In fact the Bible for diabetes treatment namely Joslin Diabetes Manual says Diabetes education is not part of the treatment, but it is the treatment. Joslin Diabetes Centre cannot be wrong, as they have been managing diabetes for more than 100 years.

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