Times of India
02 March 2011
By Rupali Mukherjee
Mumbai, India

Indians should develop their own medical guidelines to tackle ailments like diabetes and heart disease, as the protocols currently used in India to treat them are more suited to westerners, says a latest International Journal of Obesity study. Experts say Indians face a higher risk of diabetes and heart disease due to dietary habits and lifestyle than Americans and Europeans, yet much of treatment protocols for these diseases are borrowed from the West.

The study says prevention and management strategies for such disorders should be more aggressive and tailored for Indians because of the differences between two ethnic groups — Indians and Caucasians. Dr A Misra and L Khurana’s review on "Obesityrelated non–communicable diseases: South Asians v/s White Caucasians" provides a comprehensive view of how differences (physiological, biochemical and attitudinal factors) between the two ethnic groups may lead to diseases like diabetes, hyper–tension and cholesterol–related ailments among South Asians.

"Imbalanced nutrition, physical inactivity, perinatal adverse events and genetic differences are also important contributory factors," says the review.

Other differences between South Asians and white Caucasians include lower disease awareness and healthseeking behaviour, delayed diagnosis and religious and socio–cultural factors. All these factors result in poorer prevention, less aggressive therapy, poorer response to medical and surgical interventions, and higher morbidity and mortality in the former."

It says recent guidelines advocating lower cut–offs of obesity and abdominal obesity for South Asians as compared with international guidelines are expected to help physicians in better and more effective preventive management. "In view of the data, prevention and management strategies should be more aggressive for South Asians for more positive health outcomes."

Dr Misra, chairman of Fortis Hospital’s diabetes and metabolic disease centre, says, "This is the first study of its kind that gives a complete picture of the risks, development of disease and associated complications." He said Indians are several times at risk of developing these problems compared to Americans or Europeans. "There are hardly any national guidelines on prevention and management of obesityrelated diseases. We should become aggressive on these fronts."

Experts say this becomes even more serious considering that over half of diabetics in the world live in India and China. The two countries have outpaced the developed economies, experts say.

Mumbai’s Lilavati Hospital endocrinologist Dr Shashank Joshi said the study is relevant as Indians have not been medically recognized. "We need treatment, prevention and screening methods and medicines suited to our body types," said Dr Joshi, also the president of All–India Association of Advancement for Research in Obesity. "It is time we have national policy guidelines on treatment, etc, suited to Indians."