On 12 Nov, 2022, Seniors Today hosted their weekly Health Live @ Seniors Today webinar on Diabetes Management for Senior Citizens to mark World Diabetes Day, which is celebrated on 14 Nov every year to spread awareness about the disease. This week we had with us Dr Behram Pardiwalla, Director – Internal Medicine at Wockhardt Hospitals, who spoke on and answer questions about Diabetes Management for Senior Citizens, to mark the day.
About Dr Behram Pardiwalla:
After schooling in La Martiniere Kolkata, Dr Pardiwalla did his undergraduate and postgraduate degrees from the Seth GS Medical College and KEM Hospital, Mumbai. Dr Pardiwalla was awarded the Lord Sandhurst Gold Medal and Vasant Khanolkar Prize and was also the recipient of the Bombay University Merit Scholarship for Postgraduate studies and was voted the Best Resident at the KEM Hospital. Dr Pardiwalla is also a postgraduate teacher in medicine for the Diplomate of National Board (DNB) examination at Breach Candy Hospital and is also Unit Head at the Parsi General Hospitals.
Dr Pardiwala is Regional faculty for the International Diabetic Federation Course in Diabetes. He is Life Member, Association of Physicians in India. He is Founder, Life Member, Indian Society of Critical Care and Committee Member, Indian Burns Research Society.
At the beginning and during Covid, a lot of patients were newly diagnosed with diabetes, because somehow Covid affected the pancreas- the organ that secretes insulin, and this is also why some already known cases of diabetes became worse, not known cases, became diabetic. Steroids were also given as a part of the treatment of Covid-19 which also caused diabetes in some patients.
Around 10-15% of the newly diagnosed patients with diabetes are contributed by the Covid-19 pandemic.
77 million people live with diabetes, 134 million people are estimated to be affected by the year 2045.
We have in India, the second largest population of diabetics, world wide.
The prevalence of diabetes ranges from 2-40%, depending on the region; but unfortunately, every 6th person with diabetes, worldwide, is an Indian.
Type 2 diabetes is not just an adult onset disease.
In Indians over the age of 65, 17 to 20% are diabetic.
1/4th of the young adult population is at a high risk of developing g diabetes and it remains undetected.
The mean HbA1c tells us about the control of diabetes in a diabetic individual, in India, the average is 9%, which is 2% higher than the global standards.
In 50% of the Indian patients, targets for metabolic control are not met.
Rule of 50 in diabetes: 50% of diabetics in India are unaware patients, 50% of the aware/ diagnosed patients are taking treatment. Out of the 50% taking treatment, only 50% are under control.
Why is there so much concern about diabetics? This is because of its complex metabolism, you can have a lot of complications which include neuropathy, retinopathy, and nephropathy. You can also have cerebrovascular disease, where you can get a stroke or a coronary artery disease where you run the risk of suffering from a heart attack. Peripheral arterial disease which can lead to an amputation.
If you have a family history of diabetes, the chances of you getting diabetes is as follows- if one parent has it, you have a 30-40%. If both parents have it, the chances are between 50- 75%.
You can prevent the onset of diabetes by being extremely conscious of your weight, lifestyle and diet.
- keep your weight to the minimum required for you age and height
- Exercise for at least 30-45 min
- Consume a very healthy and controlled diet
If you have been diagnosed with diabetes, ie your fasting blood sugar is over 130 and your blood sugar levels are over 180 in the postprandial state, it is very difficult to bring your blood sugar levels to normal without medication.
It is difficult to reverse diabetes but it can be controlled.
In the pre diabetic stage, where you have an impaired fasting glucose or you have an postprandial glucose, that is a potentially reversible stage where lifestyle modifications, diet and exercise have a great role to play.
