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December 2005 - January 2006
Is the Indian Way of Life or Genetics leading to Diabetes and Amputation?
India has the largest number of diabetic patients in the world with around 40 million people affected, the highest number in any one country. Indians are 6 times more likely to develop diabetes than their white counterparts and this can lead to unnecessary amputation and lifelong misery.
Is it all in the genes? Or is the Indian lifestyle to blame?
on your genes
Chennai-based diabetes specialist, V Mohan, announced this theory at the Nobel Forum in Sweden and at the Diabetic Conference in Athens. He described research that is underway to see whether gene therapy can be developed to make the PPAR-Gamma gene better protect Indians from diabetes. But a solution could be decades away.
on your lifestyle
The main reason stems from diet, which has become elaborate and rich, cooked in fats and oils and has high sugar content.
Insulin resistance is related to the distribution of body fat. Diabetes is not due to the amount of fat, but the high concentration of fat around the centre where the insulin is produced. The body is unable to use it effectively leading to the incidence of Type 2 Diabetes.
Finally the reason for high rates of diabetes is the changes in environmental conditions and the increase in urbanisation of young Indians who have adopted a sedentary lifestyle where they lack physical activity. Exercise decreases insulin resistance and reduces the chances of developing diabetes in later life.
Type 2 diabetes is often viewed as a “mild” or a less serious form, but the consequences of ignoring this can be critical. This affects over 10% of the Indian adult population as compared with only 2% of the indigenous white Caucasian.
Patients with Type 2 diabetes are at a greater risk of developing heart disease, renal failure, blindness and diabetic foot ulcers. All too often the impetus behind an amputation is the doctor’s frustration and impatience with treating a recalcitrant wound.
Sujata Jolly, a scientist of Indian origin, has carried out extensive studies on diabetic foot problems. At a conference in Helsinki in October she said, “in diabetics blood circulation to the foot is compromised. A small scratch, cut or even everyday bumps have the potential of becoming fully-fledged chronic ulcers.”
Sujata further added, “In the UK, diabetes is the second most common cause of lower limb amputation and is 15 times higher than in the non-diabetics; as many as 15% of the foot ulcers result in amputation”
Conservative MEP and health spokesman in the European Parliament John Bowis echoed the same concern when he addressed a press conference earlier this month in Brussels “Every 30 seconds, a lower limb is lost to diabetes somewhere in the world”. He stressed, “It is clear that management strategies need to be improved in order to ameliorate diabetic foot care and prevent amputations.”
Sujata believes that her research has lead to a solution to preventing amputation and is now attempting to rewrite the theory of wound management.
this year Sujata addressed a Medical Convention in Florida, emphasising
a move away from conventional approaches to wound management. These
procedures involve the applications of various dressings and ointments
creating an environment for moist wound healing.
Her new development, Youki The Wound Healer, is a spray-on dressing based on natural proteins and amino acids. It forms a breathable film over the wound providing an ideal environment for healing without causing the trauma often associated with traditional dressings. Since its launch thousands of patients have successfully used Youki to help heal their ulcers and many have avoided amputations.
Youki The Wound Healer is specially formulated to assist the skin’s natural repair mechanism by providing optimum conditions for healing. The skin is encouraged to heal itself safely, effectively and with minimum scarring.
John Bowis MEP also stressed “there is an urgent need for action to bring about improvements in diabetic care for the millions of people with diabetes living in the world, and particularly in Europe today.”
It appears that wound care based on bandages and dressing needs a radical revision, and the future lies with Youki and moving away from the moist wound environment.