The call for a diabetes friendly environment for children warrants the attention of medical professionals, parents, educational authorities and policy makers to take note of these requirements and create an environment for such children with a compromised metabolic homeostasis.
The following article advises:
“Soak methi at night. Drink four glasses of water immediately after getting up in the morning without brushing. Chew soaked methi along with water. Do yoga and pranayama. Make a mixture of gudmar powder, karela powder, bel powder, neem leaves powder, a little haldi, kal megh powder and take one spoonful powder after meals twice daily. Make atta of 8 kg of wheat, 1 kg of chana, 1 kg of barley (jao), half kg of soybean. Roti of this mixer is itself a medicine. It will not only control your sugar level but also give you proper nourishment. This is my sixteen years of experience. I have not taken a single allopathic medicine in 16 years and managing diabetics very well. Do not eat bhajia, pakoda etc much. Avoid direct intake of sugar. Most important keep your stress level under control.”
The article sums up in a nutshell the other aspects of diabetes apart from its therapeutic options. It indirectly provides an easy answer to some of the problems faced by diabetics. It says how one could use Indian dietary constituents to take care of your body water, minerals and dietary requirements. It also brings out the beneficial effects of yoga in general and pranayama in particular in activating your system including the endocrine secretions apart from fulfilling your need to do exercise to keep your weight under control and develop a healthy body. This information and guidelines help to create an Indian method of adopting a life style and nutrition guidelines which will be easy to follow. The diet chart with dos and don’ts does not give a positive approach to healthy living. Instead of suggesting do not take refined carbohydrates, do not eat sweets and fruits with high glycemic index, a dietary approach based on Indian tradition and ancient Indian wisdom will take care of the preventive as well as protective aspects of diabetes care. Here the diabetic team could take the help of Naturopathy to suggest a diet to the diabetic patients including the children. Rather a dietician trained in Indian herbs and nature cure will help strengthen the team of diabetic professionals.
Exercise which has become mandatory to maintain body weight can take the help of yoga for it teaches how to rejuvenate your system with appropriate choice of asanas without the help of say western equipments or a modern gym with power exercises. This will address poor patients’ needs without giving them much economic burden.
With thousands of publications and population studies yet the world of diabetologists look for the elusive medicine that can cure diabetes or control diabetes. Therefore, the most important component of Diabetes control in any population is public awareness and proper dissemination of information available to the patient. The information must be clear, in a simple language without much ambiguity.
“Diabetes cannot be cured completely. It can be controlled.”
There is a moral responsibility on the part of the multimedia, including television channels, to monitor the content on such issues that would provide wrong information and therefore wrong approach to the treatment of diabetes.
Any claim that there are alternative therapies available to cure diabetes completely will shift the focus of the patent towards such a treatment as the patient is looking for a relief from a constant monitoring of blood glucose, adjustment of dietary intake and a constant visit to a diabetic clinic. It carries an economic burden, psychological stress and a faster relief from the disorder.
We have reputed diabetic control centres with research facilities and publications. At a grass root level how does it benefit the patient from a disease that is chronic, debilitating and demoralising?
The Indian poor patient does not have the luxury of carrying glucometer or the acumen to accurately measure or handle such a handy instrument. Even if the patient develops expertise in monitoring his or her own blood glucose what motivation does one needs to continue such monitoring and adjusting say the diet or dose of the drug prescribed.
If the patient is a school going kid how does a family or diabetologist deal with such a kid in a hectic day-to-day life of the parents as well as the physicians? Do we have a family physician who could guide the kid and the parents to deal with such a patient?
Do we emphatically advise the patient — keep the blood glucose in control without allowing it to fluctuate for such fluctuations will result in diabetic complications.
As we insist for monitoring of blood glucose or glycated haemoglobin do we advise the patient to self-monitor urinary albumin level, say with a simple heat coagulation test or with Albustix? Such a test will help prevent a patient developing renal disorder which may ultimately end up in kidney failure or kidney transplantation? Albustix use may help a patient to know one’s kidney function.
How do we educate a diabetic patient to take care of one’s feet with protected footwear or say podiatric care? Do we have podiatrics as a separate branch of study?
Therefore government has the responsibility to have primary health centre to screen for diabetics and direct them to a government hospital that has a specialized diabetic unit or a hospital devoted to diabetes.
District level government hospitals need to have a unit devoted to say obesity, diabetes and cardiac disease with different layers of accessibility to the needy patients.
The first layer should be to screen for say obesity / impaired glucose tolerance (IGT)/diabetes — like say a technician to measure obesity, a clinical chemistry laboratory to measure blood glucose, followed by glycated haemoglobin, urine albumin and lipid profile in a suspect patient.
The second layer is to have a dietician with a naturopath to suggest how judiciously one could use easily available Indian condiments as well as vegetables to provide a balanced diet with special reference to diabetic patients.
The unit should also include a yoga teacher to teach the patient useful but specific asanas to stimulate insulin secretion, maintain flexibility of the body and personal hygiene.
The third layer may have a general physician and diabetologist.
The fourth layer could have a superspecialist to handle renal, retinal, neural and cardiac care.
A social worker employed to measure and monitor obesity in the patient.
Diabetes is not just a metabolic disorder but a non-communicable disease that needs the attention of the Indian health professionals and government. Though we could pride as a nation having young adult human resources we need to make them healthy and protect them from diabosity that afflicts a sizeable population of India including the children. One such aspect is to provide the necessary facilities including the suitable environment for children to fight diabetes and remain healthy.
by Dr D S Sheriff