Open up your mind and your potential reaches infinity…

Archive for the ‘Science’ Category

In a gentle way, you can shake the world ~ Gandhi


Once upon a time, there was a wise man who used to go to the ocean to do his writing. He had a habit of walking on the beach before he began his work.

One day, as he was walking along the shore, he looked down the beach and saw a human figure moving like a dancer. He smiled to himself at the thought of someone who would dance to the day, and so, he walked faster to catch up.

As he got closer, he noticed that the figure was that of a young man, and that what he was doing was not dancing at all. The young man was reaching down to the shore, picking up small objects, and throwing them into the ocean.

He came closer still and called out “Good morning! May I ask what it is that you are doing?”

The young man paused, looked up, and replied “Throwing starfish into the ocean.”

“I must ask, then, why are you throwing starfish into the ocean?” asked the somewhat startled wise man.

To this, the young man replied, “The sun is up and the tide is going out. If I don’t throw them in, they’ll die.”

Upon hearing this, the wise man commented, “But, young man, do you not realize that there are miles and miles of beach and there are starfish all along every mile? You can’t possibly make a difference!”

At this, the young man bent down, picked up yet another starfish, and threw it into the ocean. As it met the water, he said,
“It made a difference for that one.”

The story is authored by Loren Corey Eiseley a highly respected anthropologist, science writer, ecologist, and poet.

Moral of the story in Gandhi’s words: In a gentle way, you can shake the world.

Saying it poetically:

If you deny
the power of
one tiny effort,
Light a candle
in the dark,
And watch
the small flame
defy & define
the darkness.

(Inspired from a quote by Anne Franke).
flame

The secret wish of every status quo is, it impatiently awaits to be broken. Don’t believe ! Give it a try.

Female foeticide: A curse of modern times


First published as cover story in The Rationale June 2012: http://therationale.org/June_1_ver/Female.html

The first time I personally heard of female foeticide( abortion of female foetus) being practiced in India, was during my clinical posting in the Radiology department as a Medical student in Delhi, in the late 80s. The patient with third pregnancy, and two previous girls, two girls, wanted to know the gender of the baby in the Ultrasound at 6 weeks.

The annoyed registrar had shooed her away, but then shared with us in the doctors room, that : “She will in any case go to a private clinic, get the gender detected and will definitely abort it of found a girl”.

We as students expressed our dismay, a male registrar retorted in humor: “Evil should be nipped in bud.”

Female foeticide, killing the female fetus in the womb, is a modern phenomenon, as compared to the age old existence of Female Infanticide, the killing of the female new born or infant. It began in Asian societies like India and China sometime in the late seventies, coinciding with the campaigns of family planning, easing of medical termination of pregnancy (also called legal abortions) and with availability of the ultrasound machine to monitor pregnancy. Although, there were other tools available for checking the sex of the fetus  through amniocentesis, but was an invasive procedure, and could lead to complications like abortion. Moreover, unlike the Ultrasound, Amniocentesis was not a tool available to the layman, or semi-trained medical professionals to abuse it to their advantage.

As a medical professional and as a female member this very society, one kept hearing of the news of women asking for gender detection, simply to select the baby of their choice

However, it was the 2001 census which shocked the world. It brought forth the hard figures that the practice of female foeticide was not just existent, but flourishing. The overall Indian ratio of 927 girls to 1000 boys in the 0-6 year’s age group, when in the world the ratio was 1045 vs 1000. The statistics were more skewed in the Northern Indian states of Punjab, Haryana, Uttar Pradesh etc than in the Southern states.

And it went on, quietly, unabated, under the cover of legal abortions, and with Ultrasound getting cheaper and more easily available to all levels of health workers. The trend caught up, rose in numbers and spread to other states.
The census reports for the 2011 nailed the speculation that the trend was catching pace, with the stats now being 914 vs 100 for girls vs boys. In some of the states it has gone to as low as in 800s e.g. Uttar Pradesh (899 girls for 1,000 boys), Haryana (830), Punjab (846) and national capital Delhi (866).
The conditional sex ratio for second-order births when the firstborn was a girl, fell from 906 per 1000 boys (99% CI 798—1013) in 1990 to 836 (733—939) in 2005; an annual decline of 0•52% (p for trend=0•002), reported medical journal Lancet in May 2011.

What also came forth in the 2001 census was that it was more of an urban phenomenon and more so practiced by the upper middle class of educated families.

The Urban and Rural ratios being 946 and 900 respectively, to 1000 boys.

“Declines were much greater in mothers with 10 or more years of education than in mothers with no education, and in wealthier households compared with poorer households.” reported a Study published in Lancet, in May 2011.

Better economic conditions and higher education, instead of improving their thinking, enabled their misogynistic mindset to dispense away the extra income, and abuse the modern technology to their advantage. Thus defeating our age old myths of education, and economic circumstances will increase the plight of women. Perhaps our technological knowhow and economic affluence has developed faster than our brains.

The irony is that it is the same communities affluent, well educated, and even God fearing religious strata of society, who celebrates ‘Kanjak’, the day when young girls are worshipped as Goddesses, has now started to kill their own Goddesses in the womb.

Innovations in bypassing the laws:
In the mid 80s some Indian states began passing legislation like the Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, which banned sex determination tests. In the 90s the same act was legislated in the centre too. The Act carries a three-year imprisonment and Rs10, 000 fines for offenders, prohibiting the gender disclosure of the foetus during Ultra sound. However, tens of thousands of Private clinics with cheaper version of Ultrasound machines had mushroomed till then, all over the North Indian cities, performing the gender detection and the abortion of the female foetus as a ‘package’.

There have been reports that certain clinics in small cities display openly billboards with incentives: “Do you want to spend 500 or 50 lakhs” referring to the cost of abortion against the cost of raising a girl child and marrying her off with a dowry.
The gender disclosure law which was an offence, is creatively bypassed, by using code words like: For girl vs boy as:
Jai Mata Di vs Jai Sri Krishna
Pink city Jaipur vs Blue City Jodhpur
Jalebi vs Laddoo.

It is not just the men of the family, but the senior women like the mothers in law who coerce the women to resort to sex selection. Many expectant mothers have to undergo multiple abortions, jeopardising their health before the desired boy is conceived.
Needless to repeat it the mindset of boys being ‘assets ’, kul deepaks (the lamps of heritage) , are looked up as bread winners, carers for the old age, continuation of family name, as a necessity to perform the last rites of the parents.
On the other hand the impression of girls as liabilities, ‘paraya dhan’ (someone else’s wealth), ‘bojh’ (burden) because of the expense involved in marrying them off with a fat dowry, need to protect them physically and morally, and likely to bring disrepute to the family if their morality is lost.

UNPFA report “India Towards Population and Development Goals”(1997), estimates that 48 million women were ‘missing’ from India’s population since the turn of the century. The report further states “If the sex ratio of 1036 females per 1000 males observed in some states of Kerala in 1991 had prevailed in the whole country, the number of would be 455 million instead of the 407 million (in the 1991 census). Thus, there is a case of between 32 to 48 million missing females in the Indian society as of 1991 that needs to be explained.”

According to UNICEF, India tops the list as far as illegal abortions and female foeticides are concerned. Of the 15 million illegal abortions carried out in the world in 1997, India accounted for 4 million, 90% of which were intended to eliminate the girl child.

Another study reported in the Lancet journal indicates that 8-10 million females were aborted during the past 10 years,( from 2001 to 2011) mainly to couples whose firstborn was a girl and among the more well-off families. This number is much bigger than all the men and women killed in genocides put together.
Much to the dismay, a recent report published by Toronto Star, talked of preliminary reports of such skewed ratios, in favour of a boy, in the second and third order births among the Indians settled in Canada.

However, this phenomenon is not just restricted to India; another major country facing the menace of female foeticide is China.

The preference for boys, in China too is tied to their religious belief that male heirs are necessary to carry on the family name and take care of the family spirits. A Chinese family worries that if there is no son no one will look after them and keep them company in the afterlife. Confucius said, “There are three ways of being disloyal to your ancestors. Not carrying on the family name is the worse.”

Chinese parents openly celebrate when they have boys, and some even show disappointment when they have girls. Newborn girls are given names like Pandi (“expecting a boy”), Yanan (“second to a boy”) in hopes the next child will be a boy. Six million women bear the names Lai-di (“call for a brother”) and Ziao-di (“bring a brother”).
“Daughters are like water that splashes out of the family and cannot be gotten back after marriage.”, a Chinese saying resonates with the belief we as South Asians have of girls being a ‘guest’ in their parents homes.

The statistics suggest that China did not have a skewed male: female ratio till the one child norm was enforced. After the enforcement, the rate of abortion of female fetuses increased in China, thereby accelerating a demographic decline after 1979. As most Chinese families are given incentives to have only one child, they would want it to be a son. However later the Law was eased especially for those who had a first girl child, hence giving a legal government sanction to the preference of a boy.
In 2005 figures, 118 boys were born for every 100 girls, up from 110 boys per 100 girls in 2000 and 112 in 1990.

Recently in the past few years, Vietnam has experienced an unusual rapid change in the sex ratio at birth.. The ratio was about 106 male births per 100 female births, in 2000 and has it increased to 112 in 2008.

“Currently, China reports higher sex ratio at birth than Vietnam. However, what is striking in Vietnam is the unusually rapid rise of the SRB [sex ratio at birth] recorded over the last few years.” says a UNFPA representative.

There are no studies existent from Pakistan, but as mentioned in by an investigating journalist in the TV program Lekin by Sana Bucha, there are 3,000 single room clinics existent just in Karachi, with one or two employees, performing illegal abortions, 90% of them being for the female child. This is despite of abortions being illegal in Pakistan, unlike in India or China. This could be just the tip of the iceberg.

A 2005 study estimated that over 90 million females were “missing” from the expected population in Asian countries including China, India, Pakistan, Afghanistan, Burma, South Korea and Taiwan alone, and suggested that sex-selective abortion plays a huge role in this deficit.

Research suggests that instead of economic conditions, like poverty or education, it is the cultural beliefs that play a much larger role in gender preference and sex-selective abortion. To prove this, in places like sub-Saharan Africa, Latin America, and the Caribbean such deviations in sex ratios do not exist in.

As scientific progress furthers and the technology becomes more affordable and available to the common man, the curse of Female feticide, is likely to follow the course it is following currently. There are already available on internet, home monitoring kits, to detect the sex of the new foetus from blood or even urine samples. With abortion techniques getting more medical than surgical, the situation may simply go out of hands of the health personnel even..

The affluent and the educated who perform this would realise its curse only as it will be going to bite them back when their sons will find it extremely daunting task to find brides, and will be forced to stay bachelors.
It is estimated that by 2020 there could be more than 35 million young ‘surplus’ males in China and 25 million in India.

This has actually begun to be seen in smaller scale in various states in India and China. It is already happening that single men are more involved in violence and crimes, resorting to drug addiction and alcoholism, after being frustrated to find a suitable spouse. Women once again are being punished with a rise in rapes, in prostitution demands and through other crimes against them. In some places there have been reports of women being forced to share husbands (polyandry).

In India, the legislation prohibiting gender-selective abortions has so far been evaded easily, and there have hardly been any prosecutions. One wonder what is it that will change the mindsets if education and affluence could not. Would any activism, any mass media campaigns, any icons be able to change this?

My heart shudders to imagine, where and when shall this stop, if at all.
Are we just going to learn it the real hard way?

Dr. Ilmana Fasih
19 May 2012

“Rationality ka janaza hai, zara dhoom se nikley”


The heading was the best tweet, I found on #waterkit. ( Courtesy: Urooj Zia).

There have been few moments in my ‘virtual’  life, when Tweets have been so hilarious.

#waterkit hashtag was  tragically comical.

Based upon the dialogues exchanged in an epic  TV program on this invention, I could not help summarise it this way:

Ye qissa hai Physics key balatkar ka
Aur Waterkit se chalne waali ek car ka
Jab mil baithe syaane chaar
Do minister, ek scientist, ek Engr Waqar

Dikhaya aisa duniya ko chamatkar
Petrol , Bijli sub huwe bekaar
Karwayein kyun Auto-specialists se inspection
Kya kee hai kisi ne pehle aisee invention

Mamoo ban gaye anchors Talat-o-HamidMir
Aur Dr AtaUrRehman huwe lakeer ke faqeer
PhDiyaan sabki ho gayein fuzool
Koora huwe Thermodynamics ke usool

Theory nahin hum practical ko maante hain
“Water is H20”, kya aap ye raz jaante hain
Wikipedia se hum ne kiya hai confirm
H2O se Hydrogen nikalne ka irada hai firm.

Faqat jahalat ki rail-pail hai
Sub moh-maya ka khel hai.
Duniya hansegi to hansti rahey,
Gumrahi ki gari buss chalti rahey.

Stress~the silent killer


You are not alone. Stress is a phenomenon affecting all people from all walks of life, in all countries.

Stress is man’s psycho-emotional response to everyday challenging issues and its overload of demands, in excess to his capacity to cope.

What causes stress? 

Stress can  be caused by multiple reasons that occur in everyday life,  like  unexpected turns and twists in career, relationship problems in family or outside, financial losses, fear of disease or death, even a small tiff with near and dear ones may cause stress.

As goes the saying, “There is no stress either before birth or after death”

How does stress affect us?

The manifestation of stress depending upon its intensity or duration. It begins in the head, but descends down to affect the whole body. There can be a healthy body only when there is a healthy mind. It may manifest outwardly as:

  • Insomnia
  • Involuntary weight loss or gain
  • Irritability
  • Anxiety
  • Anger/ Rage

Stress being silent operator, most people do not realize that they are dangerously living with it, till they suffer from its grave after affects.
And when prolonged without intervention can lead to serious issues like:

  • Bodyache/Backaches ( all pains seem exaggerated in stress)
  • Asthma ( not all but some asthmatic attacks are result of psychogenic stress)
  • Hypertension
  • Stomach ulcers
  • Diabetes
  • Heart (cardiovascular) diseases.
  • Depression
  • Suicides.
Studies show: Stress is a major contributing factors either directly or indirectly, to coronary artery disease, cancer, respiratory disorders, injuries due to accidents, cirrhosis of the liver and suicides.

DO YOU KNOW?  

One American is reported to be dying every minute due to stress related cardiac arrest. The medical costs due to direct or indirect consequences of stress alone have been estimated in the United States at well over 1 billion US dollars per year.

A person tries to commit suicide in China every two minutes, giving the country one of the highest suicide rates in the world. These have positive correlation with high intensity stress, owing to an ultra modern life style in a highly competitive environment.

What should you NOT do during stress:

 Smoking
 Drinking too much
 Overeating or under eating
 Long hours in front of the TV or computer
 Withdrawing from friends, family, and activities
 Using pills or drugs to relax
 Sleeping too much
 Procrastinating
 Keeping toobusy to avoid facing problems
 Taking out your stress on others (lashing out, angry outbursts, physical violence)
 Carry your office work or stress at home.

KNOW THAT: “Anger is an acid that can do more harm to the vessel in which it is stored than to anything on which it is poured.” ~Mark Twain

How to control Stress:

The key principle to follow in case of stress would be to ignore what cannot be controlled and to control what cannot be ignored.

Face the music: For managing stress there can be two approaches ‘fight’ or ‘flight’. Either face the music or escape it. You cannot wish away stress. It is and will be an integral part of modern and increasingly competitive society.

Stay in control: Do not let the stress to control you. Keep stress under check through will power, proper cultivation of mind, cultivation of positive psyche and meditation.

Be an optimist: Optimistic outlook, cheerful temperament, positive attitude, cultivating sympathy, self discipline, all help to keep mind in good shape. Session with God can be a kind of divine-de-stressor.

Eat Healthy: By having a healthy diet, doing regular exercise, and getting enough sleep your body will be able to cope with the stress.

Move forward: Do not needlessly get tied to the past, get over hangover of the last night and start the morning with a hope for a bright day and brighter tomorrow.
Think of pleasant past, enjoy your present and plan for a future with cheers.

Be a home pigeon: Make home your love nest, where office does not exist. Parents, wife, children are your love companions. Reserve Sundays and holiday for spending time with your loved ones, for relaxation and recreation. Your family is the last line of defense against stress.

Tickle your funny bone: Include humor in your life. Laugh away the oddities of life.

Love yourself: Have a me time. Listen to music, see movies, read favorite authors, cultivate hobbies.

Be a social animal: Invite friends over at home, eat together, laugh together, spend week ends or vacations out with friends.

BOTTOM LINE: You can yourself pose to CALM down stress, what ‘CALMPOSE’ cannot do. 🙂

This text of this blog is generously contributed by Dr Raminderjit Singh. Thank you, Doc 🙂

OsteoArthritis ~the wear and tear joint disease


Osteoarthritis (OA) is the commonest form of arthritis that occurs as a result of wear and tear of the joint.
As the protective cushion over the bones within the joints, called cartilage, gets worn out gradually, the symptoms get worse. The joints begin to crackle, get stiff, then pain and ultimately cause limited mobility.

Note: This is different from Rheumatoid Arthritis, which occurs in young age, and is less common, but more severe.

Which Joints?

It can occur in any joint, but the most commonly affected are those joints that are used the most- of hands, lower back, knees and hip.

What happens to the joints?

In knee joint:

In the spine:

What can a damaged joint do?
From stiffness, the joints progress to pain off and on, then more lasting pain, ultimately leading to limitation of joint movement, and restricted mobility. The damaged joint can cause blockage of blood supply to the joints, bleeding in the joint or permanent bone impairment.

Although there are pain killers, acupuncture, physiotherapy which can reduce pain, or even surgical procedures like joint replacements, which can improve joint function, but it is the wisest to slow the wear and tear ahead of time.

Risks that are associated with increased wear and tear osteoarthritis are:

Older age.
Gender: Women are more likely to develop osteoarthritis, though it isn’t clear why.
Bone deformities: Some people are born with malformed joints or defective cartilage, which can increase the risk of osteoarthritis.
Joint injuries:Injuries from sports or from an accident, hasten the wear and tear, and hence OA.
Obesity: It is common sense that heavier the weight, faster and worse is the wear and tear.
Sedentary lifestyle as the more the activity, the more nourished is the cartilage.
Occupational: Jobs that cause repetitive stress of a particular joint also increase the wear and tear-like the joints of hands in typists, computer users, knees n those who stand for long like the policemen, etc.
Other diseases.: Diabetes, underactive Thyroid, Gout or Paget’s disease of bone can increase the wear and tear OA.

How can we slow down the wear and tear of joints?

OA is not inevitable with old age one follows a healthy life style. However,  cannot avoid age related wear and tear, but one can certainly minimize the damage caused by misuse of our joints.

You can be a best friend of your joints if you:

1 – Maintain Your Ideal Body Weight : A force of 3-6 times a person’s body weight is exerted across the knee while walking e.g.being 10 pounds overweight increases the force on the knee by 30-60 lbs with each step taken while walking. The force across the hip is, at most, 3 times the body weight. Losing weight reduces stress on the joints substantially.

2 – Exercise Regularly and Participate in Regular Physical Activity For optimal joint health, it’s recommended that people perform 30 minutes of moderately strenuous exercise at least 5 days a week. It’s an established fact that regular exercise has health benefits

3 – Protect Your Joints: There are several joint protection principles, which if followed, will help to conserve energy and preserve joint function. The advice is quite simple, but you must be mindful of proper movements and recognize body signals (e.g., pain). Good posture and proper body mechanics is important.
Check the various Joint protection techniqueshttp://www.spectrumrehab.net/Articles/joint-protection-techniques.html

4 – Avoid Repetitive Stress on the Joints: Signs of repetitive stress include too many uninterrupted repetitions of an activity or motion, unnatural or awkward motions, overexertion, incorrect posture, and muscle fatigue. Unfortunately most of them are occupational and hard to avoid. Hence one has to create innovative ways to avoid them.
{Clue: Search on internet prevention of joint stress specific to your occupation}.

5 – Listen to Your Pain: This recommendation seems so obvious, yet people don’t always do it. Learning to view pain as a signal that you are overdoing it and that it’s time to rest requires conscious effort. Balancing rest and activity is optimal for healthy joints. It’s part of self-management to learn not to overuse your joints and to learn not to push past your limits. Consider that the pain is like a stop sign.

6 – Avoid Injury to Joints: Previous joint injury is recognized as a common cause of osteoarthritis. In joints burdened by improper alignment due to injury, articular cartilage wears away and osteoarthritis can begin to develop. Avoid injury if at all possible — and if you do injure a joint, seek treatment immediately.

Myths about OsteoArthritis:

slide-1

Do not call them mad, please!


Published in The News Blog on February 22, 2012 :http://blogs.thenews.com.pk/blogs/2012/02/22/do-not-call-them-mad-please/

When I feel feverish, lethargic, sneeze and have a runny nose, all know I suffer from common cold, and that I am infected with a virus. If I tell them that I went to see my GP and am taking meds, they all know medications will take care of me. No one will judge me. All will empathise, give an extra advice to take rest. Some will even hug me for support, without realising that I might be transferring the virus to them. Even if they get one next day, it will be just a passing mention, “Oh I too got your flu”.

If I feel low, lethargic, don’t feel happy, lose my appetite and cry for no reason, they all ‘know’ I am an ungrateful person, who has got everything from a good family to a good home to a good carrier and is still being thankless. Not many will hug me to say, Yes we know you are depressed and there has to be no reason for it. It is because of imbalance of chemicals in your brain.”

And if I tell them I am trying to help myself by going to a psychiatrist, and am on medications or psychotherapy, they would give a stunned look and say nothing. Not many will hug me or tell me “You did the right thing”.

I also know behind my back tongues will wag and eyes will roll. Some may even diagnose “I have gone mad.”

Yes they would give me advice to read scriptures to be thankful. Or to go to some Aalim or Pir and get my “nazar jhaaroed”.

According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ,  almost 78 per cent of people are suffering from some kind of psychological disorder.

Indeed, 78% of us are affected with one form of psychiatric disorder or the other. It could be a mild anxiety with minor worries, on one end, to a full blown schizophrenia, on the other, where one is cut off from the reality of this world, which in medical terminology is called “loss of insight.”

However, none of them is madness. In fact there is no such thing as madness.
Going through the 954 page document, above mentioned, I did not find any mention of an ailment called ‘madness’. I even looked up into the index at the end, the  M section  began with Major Depressive Disorder, then after Mathematics disorder, the next mention was Medication induced disorder.

Thanks to the advances of medical sciences, we now know there is always a chemical basis of psychiatric diseases. This is the reason they are quite capable of being corrected by medications. Some may be completely corrected, while some partially.

Thanks also to the sophisticated PET brain scanning techniques, we can now see with our own two eyes that Depressive Disorder or Anxiety Disorders or any other psychiatric disorders are real ailments and not mere myths.

Perhaps, our scientific knowledge of psychiatric ailments needs to cross a lot more frontiers, to be able to understand and treat all these disorders more efficiently.

Exactly  as in a common cold there are triggers like exposure to cold, or exhaustion which cause them to come again, there are environmental triggers in the psychiatric disorders too—usual ones like stress, troubled relationships, or as trivial as some taunts or sometimes as subtle as winter season.

Do we ridicule those who have fever, or cancer, or diabetes or heart attack? But we do ridicule, poke fun or bad mouth about those suffering from Depressive disorders, Anxiety Disorders, Eating Disorders, ADHD , Personality Disorders or Learning Disorders etc.

We empathise with those who do have their sight, hearing or physical ability missing and often remark that nature compensates them with some other strength or skill.

Same is true of the various Psychiatric Disorders. The people affected by them are endowed with some other skills. World’s best writers are known to be Bipolar, and many of the inventors were known to have either Obsessive Compulsive Disorder or Learning Disorder.

We all love ourselves. No one wants to fall sick, whether with common cold or with depression or of any ailment, no matter how trivial.

With the statistics of 78% affected with some psychiatric disorder, we may be definitely seeing four- fifths of our near and dear ones affected by some psychiatric disorder, ranging  from a very mild to a very serious one. Some of them may be in need of a professional help too.

So next time you see anyone you would wish to label ‘mad’,  just understand them and don’t be a trigger for them to get worse.

Know that they didn’t want to be unwell either.
And please, I beg you, do not call them mad.  

Chemical basis of some mental disorders. 

P.S. This blogpost was written in response to the @ExpressTribune ‘s article:

Celebs with mental disorders: Lock up the crazy

Know the bitter truth of Diabetes


PART-I

The tsunami wave of diabetes mellitus and its health and economic consequences is threatening much of the world. The need to prevent and control this debilitating chronic disease is urgent, before desperation sets in.” Journal of Royal Society of medicine.


How does this  matter to us South Asians?
Indian Subcontinent (which includes India, Pakistan, Nepal, Bangladesh and Sri Lanka) is the epicentre of this Diabetic pandemic. By 2025, over 2/3rds of the diabetics would be living in our subcontinent.
Link:  http://171.66.127.115/content/100/3/115.full

How are we more vulnerable as compared to other ethnicities?
We South Asians get Diabetes:
• 10 years earlier
• At lower levels of obesity
• Suffer longer with more complications
• Have 3-8 times higher risk of dying from Diabetes than Europeans..

Why are we more vulnerable than other ethnicities?
Again the same answer as for the Heart Disease—Our genetic makeup coupled with our unhealthy lifestyle i.e. faulty diet, obesity, sedentary habits and lack of health awareness.

Can we really do anything?
Yes, research proves that we can avert or at least postpone Diabetes and improve our quality of life through various lifestyle modifications.


What should we know?
First, know that Diabetes is no more the disease of the affluent; even the poor have it.

Second, it is no more a disease of the middle aged. Diabetes Type 2 which was earlier called the Maturity onset diabetes has now been seen to occur amongst the South Asians in early 20s and many get in their 30s.

Thirdly, in order to live a life without Diabetes we need to start early and change our life style. However, it is better late than never.

PART-II

What should we do?

If you are not a Diabetic

Step 1 : Know whether you are at high risk of Diabetes Mellitus or not.

Check your risk from the risk-factors chart:

Or better see YOUR RISK OF DIABETES  from  the  Diabetic Risk Calculator at the link below.
Link:  http://www.diabetes.org/diabetes-basics/prevention/diabetes-risk-test/

(ADV*** : Dont skip this ^^ step!!)

Important: In case you are a high risk group, please consult your doctor and ask him to screen for Diabetes. He will do some blood test on you while fasting and after meals to check your blood sugar levels.

Step 2: Get more physically active :

Benefits of exercise:
• You will lose weight
• It will lower your blood sugar
• Boost your sensitivity to insulin –which will keep your blood sugar in the normal range.

More, refer to Blog 1 : https://thinkloud65.wordpress.com/2011/12/31/living-a-healthy-lifestyle/)

Step 3: Lose the extra weight.

Obesity is one of the main culprits in causing Insulin resistance and hence Diabetes- Abdominal fat is the real culprit.


Tip: If you are obese or over weight, loss of every kilo will reduce the risk by 16%. And if you lose 10% of your body weight, you will cut the risk of developing diabetes by 60%.

Step 4: Make long term dietary changes.

Add fibre to your diet. This simply means eat more of fruits, vegetables, beans, whole grains, nuts and seeds as they are rich source of fibre. 

Benefits: Fibre reduces the risk of Diabetes, of Heart disease and risk of colon cancers. They also promote weight loss.

Check Glycemic Index of the foods you eat. Choose foods with low Glycemic Index as this maintains more constant blood sugar levels.

Tip: Print out a chart of foods by Glycaemic Index and put it over the fridge, so that it is easy to refer to them while selecting food.

For more on Glycaemic Index : http://www.diabetes.ca/for-professionals/resources/nutrition/glycemic-index/

Step 5 ; Try to manage your stress:  Stress increases hormones in the body which predispose to Diabetes.

IMPORTANT NEWS: The research has shown that if one follows the above measure, at least 50 % postponement of DM is possible.

PART-III

For those who are already Diabetic

Remember:

Diabetes is a lifelong responsibility.

You may not feel unwell in the initial years but persistently raise blood sugar levels can gradually harm each and every organ of the body, more seriously the organs essential for life-heart and kidneys.

To the Diabetic, I would just give a few outline tips here, as  it is important for you to be under a regular care of a QUALIFIED DIABETOLOGIST   to manage your health:

Step 1: Make a promise to yourself that you will take care of your diabetes by being FULLY INFORMED  of the disease. (Just google ‘Diabetes Mellitus’ and there you are).

Step 2: Try to keep the blood sugar in normal range through diet,  exercise, weight control, medications and regular smedical consultations.  A normal sugar levels maintained are as good as being non diabetic.

Step 3: DIET: Diabetics should be very watchful of their calorie intake, and must take meals LOW  in SUGAR, FAT and SALT content. You must consult a DIETICIAN to make meal plan, ideally.

See  links for dietary guidance: http://www.diabetes.ca/files/JTB17x_11_CPGO3_1103.pdf

Try  this SOUTH ASIAN DIABETIC MEAL PLAN BOOK :http://www.diabetes.ca/documents/about-diabetes/Recipe_Booklet_high_res.pdf

Other SA recipes: http://www.pamf.org/southasian/healthy/recipes/

Step 4: Get blood sugars checked at regular intervals…at home and by the doctor.
Through your doctor: Make sure you have HbA1c tested every 3-6 months. The test that shows the average amount of sugar in your blood over 3 months. It tells how well you are controlling your diabetes.

An HbA1c of 6% or less is normal. See the other levels:

Home Glucose Monitoring : Home sugar testing is also important. You must have a glucometer for this.  Ask your doctor how frequently and when should you check your  blood sugar yourself at home.

Step 5: Keep your Blood Pressure and Cholesterol under control.


Step 6: Regular health checkups to assess complications of diabetes—Have your KIDNEYS, HEART, NERVES and EYE check ups EVERY YEAR .

Ask your doctor by name —> to check for COMPLICATIONS of Diabetes.

Warning*: Long periods of uncontrolled Diabetes can cause painless Heart Attack,  Kidneys to fail,  Nerves to get numb and Eyes with loss of Vision. (This is intended not to scare you, but inform you of the seriousness of the problem).

Step 7: Take care of your FEET: Diabetes causes nerve damage which can cause injuries to feet without being noticed due to loss of pain sensation.


IMPORTANT: 

  • Check your feet everyday for cuts, blisters, redness or swelling. Consult the doctor is any such thing is seen.
  • Keep the feet clean, dry and moisturized everyday to prevent any infections.

Step8: Brush your teeth and floss them everyday. Have dental checkups every year and mention to the doctor that you are a diabetic.

Step 9: Ask your doctor if you need to take a Aspirin tablet everyday to prevent heart attack and stroke.

See the benefit of aspirin in Diabetes in this link: http://www.diabeticlive.com/diabetes-101/diabetes-news/new-study-on-aspirin-and-diabetes/#.TzwKiE4gf1k

Step 10: DO NOT SMOKE as it accelerates all the diabetic complications. If you drink, do it in moderation.

Step 11: Manage  STRESS: Stress increases Blood Sugar levels , increases food indiscretions and one tends to neglect the health. Hence manage your stress smartly.

Last but not the least, maintain a sense of humor. You may not ‘delete’ Diabetes from your life but you can ‘minimize’  it by knowing and following the right steps.

🙂