STUDIES SHOW 70MN PREDIABETICS, DOCS SAY CONDITION MUST NOT BE IGNORED

Little did Bhaskar (40) know that his itchy scalp was linked to a deeper medical condition. Doctors had put him on anti–bacterial drugs, medicated shampoo and soaps. When none of these helped, an HbA1C test found him to be prediabetic.

Prediabetes is a condition where the blood glucose levels are above normal, but short of the levels at which diabetes is diagnosed. It predisposes people to a high risk of developing diabetes. People with prediabetes will develop type 2 diabetes within five years unless they change their lifestyle, say doctors.

The American Diabetes Association has recently suggested that the blood test called glycated haemoglobin (A1C) or HbA1C blood test – a single test to diagnose three–monthly glucose levels – could be a simpler test to diagnose prediabetes – as it does not require fasting, and also because it reflects long–term glucose levels.

A study by Indian Council for Medical Research (ICMR) shows that there are 60 million diabetes and 70 million prediabetes patientsin India.Prevalence of prediabetes is 10–15 % in urban population and 7–9 % in rural population.

An analysis by a city–based accredited pathology lab shows that the prevalence of prediabetes among people who have undergone HbA1C tests in Pune has touched 30% in the last two years.

"In 2012, a total of 19,064 people underwentHb1ACtest atour lab and among them 5,914 were prediabetic. This year, 20,334 people opted for the test and 6,385 were found prediabetic. If these people initiatelifestyle modificationsincluding diet, exercise and stress control well in time, they can curb the rapid progression to full–blown diabetes," said pathologist Awanti Golwilkar–Mehandale of Golwilkar Metropolis laboratory.

City–based endocrinologist A G Unnikrishnan said, "If this data reflects HbA1C testing in healthy individuals, then it shows that the proportion of people with prediabetes is increasing."

An increasing occurrence of prediabetes suggests the need for aggressive community measures to improve diet control, exercise and avoiding stress which hasten conversion of prediabetes to diabetes, he added.

Endocrinologist Vaishali Deshmukh said, "If the HbA1C test shows the count between 5.7% and 6.5% then the person is at high risk for diabetes and is called prediabetic. Similarly, if fasting blood sugar is between 100–125 mg/dl (also called impaired fasting glucose IFG) and oral glucose tolerance test with post glucose two hours blood sugar between 140–199 mg/dl (also called impaired glucose tolerance IGT), then a person is called prediabetic."

She said every individual who has high risk of prediabetes should be tested. Among prediabetes patients, 25% of them progresstodiabetes,25% revertto normal and 50% stay in prediabetes rangeover next 3–5 years.The riskof conversion to diabetes is higher in patients as their blood glucose is in the higher range , said endocrinologist Sandeep Kharb of Aditya Birla Memorial Hospital.

Unnikrishnan said people with prediabetes should be treated with dietcontrol exercise and medications like metformin be started only if blood glucose levels remain high for more than 6 months. "It has been recognized that many people with prediabetes already have high cholesterol, obesity and high blood pressures which predispose them to heart disease," he added.

Prediabetics must take appropriate medical advice. The American Association of Clinical Endocrinologists has included diet and exercise for obesity management as one of the treatments for prediabetes. It is well–known that weight loss of 5–10% can result in improvement of blood glucose in obese subjects, he added.

Prediabetes is an important indicator that persons must take medical measures (focusing on diet control and exercise) to prevent diabetes, said Unnikrishnan who heads the endocrinology department at the Chellaram Diabetes Institute.

Diabetologist Sonali Bhojane said theobese andtheoverweight are athigh risk of diabetes or fall in the category of pre–diabetes due to increased fat in the body that causes insulin resistance resulting in elevated sugar levels and type–2 diabetes.

"The second reason is poor lifestyle and lack of exercise. Working population in high stress environment is likely to get diabetes because of long working hours, poor sleeping habits, lack of physical activity leading to borderline sugar levels, fatty liver, deranged lipid levels along with low levels of vitamin B–12 and metabolic syndrome," said Bhojane who practises at Columbia Asia Hospital.

Indus Health Plus has released an abnormality report which shows a substantial section of the country's population suffering from diabetes, a silent killer. The study found that the consumption of oil, ghee and butter is high and cholesterol rich diet increases obesity and hypertension.

In Maharashtra, sugar levels were foundtobehigh among youthespecially between the age group of 25–35 years of age. “Younger women between 30–35 years are prone to diabetes because of sedentary lifestyle. The population in the western region tends to eat fried food and no fruits and therefore many men andwomen wereseen tobe athigher risk of diabetes and obesity. Diabetes risk levels were high among men and women between 45–50 years of age," said preventive healthcare expert Amol Naikwadi, joint managing director of Indus Health Plus.

November 14 is Frederick Banting's birthday. Banting, along with Charles Best, discovered insulin. The day is observed as World Diabetic Day