Times of India
08 July 2010
By Malathy Iyer
Mumbai, India

Uncontrolled Insulin Resistance Higher In Mumbai, Lipid Levels Are A Bigger Worry In Delhi
India is infamous as the diabetes capital of the world, with more than 50.8 million people suffering from it. But the real problem before India, is the masked population that is unaware about the condition. This ignorance leads to the onset of co–morbidities, such as heart and kidney ailments, shows a new survey.

Dr Muruga Vadivale of Sanofi Aventis, the pharma major that is conducting the SITE study, feels that the Delhi and Maharashtra legs of the survey show that the twin epidemic of hypertension and diabetes is not being treated.

“Across the world, there is better and newer medication, and hence better control of both these conditions,” says Vadivale.

In India, though, almost 60% of the patients who visit their doctors fail to show proper control. “This is only because of poor awareness about the disease and the failure to realise that exercise is the key to good health,” he says.

According to Dr Ambrish Mital, head of endocrinology at Medanta– The Medicity in Delhi, and the state coordinator, the results show that 30–40% of those visiting

general practictions are diabetic and don’t know about it. “Worse, about two–thirds of those surveyed are unable to control their diabetes as well as hypertension. This is reflected in the fact that kidney disaese is on the rise as is obvious from the fact that many patients had high protien content in their urine,” adds Dr Mital.

It is, however, the Mumbai versus Delhi angle that is intriguing doctors. While Mumbai has more of uncontrolled diabetes, Delhi has higher lipids and broader waistlines, shows the SITE survey.

Climatic and genetic factors do play a role, but doctors say that diet is a major key here. “Groundnut oil is the favoured oil in west Indian and the population here correspondingly shows a better lipid profile,” says endocrinologist Dr Shashank Joshi from Lilavati Hospital.

Similarly, Delhi with its preference for butter and ghee shows worse lipid levels. “There also is the tendency among Delhiites to eat out more often than those living in Maharashtra. The higher obesity levels could well be a function of this habit,” adds Dr Joshi.

He, however, sees these result as an indicator of a larger ill. “We notice that there are three corners of illhealth now. Apart from blood pressure and glucose, there also is lipids. All contribute to brain stroke or heart attack in the patients.”

Salient Points Of The Survey

• In Maharashtra, 4.6% of those with diabetes were unaware of their status
• In Delhi, the figure is 3%
• In Maharashtra, 25.5% were unaware that they had hypertension
• In Delhi, the figure is 24.24% In Maharashtra, 67.3% of the surveyed patients had diabetes, hypertension or both
• In Delhi, 59.64% of those surveyed had the twin conditions
• Uncontrolled diabetes was a bigger problem in Maharashtra (72%) than Delhi (65%)
• Hypertension was a bigger problem in Maharashtra (72%) than Delhi (65%)
• ncidence of kidney disease is higher in Maharashtra (315) than Delhi (27.1%)
• But, Delhiites (55.4%) had worse lipids than the people of Maharashtra (20%)
• In Maharashtra, 82.8% of the patients had truncal obesity while in Delhi, the figure stood at 88.5%

What is Diabetes?
Diabetes is the inability of the human body to produce insulin. It is believed that 7% of the general population suffers from diabetes, but a Chennai study pegs it at 19%

What is Hypertension?
In this condition, blood pressure remains abnormally high (a reading of 140/90 mm Hg or greater). Around 25% of Indians suffer from this ailment