A Physician & Diabetologist at Diabetic Institute of Pakistan Lahore, in an interview with Haleema Azmat
SN: What actually diabetes is?
Diabetes is basically a metabolic disease which occurs when the pancreas is unable to produce insulin (a hormone) or the body starts resisting the produced insulin. Normally, when food reaches the intestine, it signals the cells in the pancreas to start making insulin. Insulin's function is to help transport the produced glucose from the food to muscles, liver and other body parts. When there is deficiency of insulin, it starts to circulate in the blood instead and piles up affecting other organs.
SN: What causes this hormonal disturbance?
Well, there are two major types of diabetes. In type 1 that usually affects people under 30, pancreas cells become useless and cannot work properly to produce insulin. So, it is given externally. This is called replacement therapy. However, 95 percent of the patients suffer from type 2 diabetes. Obesity, sedentary lifestyle and genetic makeup are to be blamed for it. Lack of physical activity creates insulin resistance or insulin stops working properly. Initially, drugs that decrease insulin resistance and improve insulin production are prescribed to patients. But they may also need insulin at some point in their life. Gestational diabetes is a third type that occurs in pregnant women only. It is controlled through insulin.
SN: People usually think diabetes is caused by excess sugar intake. Is it true?
Yes, people usually think that only excess sugar intake will lead to diabetes. As a matter of fact, sweet products mostly have fats in them too. And they make you fat. Basically, south-east Asians are prone to getting diabetes. So, getting a favorable environment makes ground for the disease. Favorable environment means overeating, putting on weight and lack of exercise. Currently, Pakistan ranks seventh in the world for diabetes. Looking at the trends, it is estimated we will reach the fourth position by 2025.
"People after the age of 45 are recommended to get screened for the disease. The test results can even reveal if the individual is at the borderline and is at the risk of developing the disease in future"
Actually, most patients, probably 90 percent, are not used to physical activity. And those who are into it are actually following their doctor's advice. Rest do not bother. We culturally have a tilt towards eating more and living a laid back life. We have developed food streets more than parks, jogging tracks and sports clubs.
SN: Lack of awareness among people can also be a reason. What is the role of doctors in spreading the word?
Well, not only doctors, the government and media all need to play their part in spreading awareness. In Pakistan, we generally focus on the treatment aspect rather than on the preventive side. Diabetes is a preventable disease. And we as doctors try our best at our end. For instance, when a patient comes to us with their family member, we inform them that even they are at risk of developing the disease. Everyone should take preventive measures seriously by changing their lifestyle. And there is nothing difficult in it. Make it a point to reduce just seven percent of your weight. Similarly, indulge in any sort of physical activity for at least 150 minutes a week. So, a doctor's role is not just limited to his patients. Moreover, media can also help spread the word through campaigns. Ironically, media shows more programs on eating than on exercise. Last but not the least, the government should develop more parks and not allow fast food restaurants to be built within the premises. Even fast food restaurants can play their role to an extent by mentioning calorie count on drinks, fries and burgers. This would help people be aware of what they are eating.