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Times of India
12 November 2010
Bangalore, India

Should patients be given a choice on treatment? No, say doctors. A yet–to–be–released study says that an alarming trend of patients in the state suffering from both diabetes and hypertension.

‘Patients, Comply With Treatment’
As part of the study, 25 to 30 doctors in each state screened their first 10 patients for both diseases and made a baseline data. Then they followed up with the same patients for one and a half years.

"We found that almost 40% to 60% of the patients had both conditions. And 50% had at least two risk factors like high cholesterol or overweight. About 20% to 30% were smokers. Compliance became a major issue. We realized doctors were giving patients space to decide. But that shouldn’t be the case," HOD, diabetes and endocrinology, Manipal Hospital, Dr Mohan Badgandi, said.

Recently, the team of doctors was approached by the Indian Council for Medical Research and the Drug Controls Authority for the findings that can help them decide on mass treatment modalities.

Explaining that lack of compliance and integrated diabetes support, Badgandi said, "Earlier, patients used to come with a predisposed idea that if they are asked to take insulin, they would refuse and try to avoid it for at least a year. Now doctors cannot give them choice. If epidemic have to be dealt with, then compliance has to be there.

I am also planning to start an integrated support system where patients will receive counselling from all sectors like dietician, psychologists, physiotherapists and others," he said. Hypertension did not receive as much attention as diabetes mainly because diabetes is a silent killer and the onset is very early.

Though a large percentage of both diabetics and hypertensives were under treatment, a majority of diabetics (69%) were poorly controlled with their HbA1C percentage levels and 84% of hypertensives were poorly controlled as per the JNC 7 criteria – the 7th report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure.

The study is funded by Sanofi–aventis and is a national, multi–centric, non–randomized, observational study to collect information on prevalence of diagnosed and undiagnosed diabetes and hypertension cases in outpatient clinics in major Indian cities and to understand the extent of risk factors among these patients.

The study screened 20,000 patients, covering people aged 18 years and above in 1,000 centres in metros of Maharashtra, New Delhi, West Bengal, Tamil Nadu, Andhra Pradesh, Karnataka, Gujarat, Uttar Pradesh, Rajasthan and Madhya Pradesh. It has taken into account various parameters – medical history, family history, diet, demographic data, height, weight, waist and hip circumference, blood pressure, pulse, treatment history and fasting blood test for lipids, glucose, (including HbA1c) as well as urine for proteins.

Free Diabetes Camp
Manipal Hospital will conduct a free one–day diabetes camp between 7.30am and 1pm on November 14 for children with Type 1 diabetes on the occasion of World Diabetes day. Free blood tests will be conducted followed by a talk by Dr Shaila Bhattacharyya. Free insulin will be arranged for poor children after income–proof verification.

Watch Kids’ Diet, Advise Nutrition Books
Bangalore: Worried about what your child is eating? It’s a matter of concern as diet and nutrition determine how healthy they are going to be as adults. While incidence of Type 1 diabetes is increasing, Type 2 is also being found in younger age groups.

Ahead of World Diabetes Day (November 14), Manipal Hospital on Thursday released three guide books on dealing with children’s nutrition, infant diet and nutrition, and a carbohydrate counting guide that can be used for Type 1 diabetic children as well.Diet and nutrition expert Sheela Krishnaswamy said that urban children were unhealthier than their rural counterparts.

"The problems are lifestyle–related. In fact, nutrition and proper diet should start at the foetal stage, because most development happens then. Even adults can follow these guides, though the quantity would be different for them," she said. The books compiled by the diet and nutrition department of Manipal Hospital provides information for infants between the age group of six months to 1.5 years, and nutrition for older children.

Consultant paediatric endocrinologist, Manipal Hospital, Dr Shaila Bhattacharya, who launched the Sweet Child Fund specially for underprivileged Type 1 diabetic children, gave a presentation on the grim situation of Type 1 diabetes patients. "When I called for a follow–up on the 400 Type 1 diabetes patients of Manipal Hospital, 10 had died.

They couldn’t follow up treatment because they could not afford it.’’ That prompted her to initiate the fund that will support free consultation and free bed, insulin, glucometer, diabetic alert cards, trimonthly HbA1C tests and annual screening for complications. "All contributions by donors will be supported by Manipal Foundation," she said. She also symbolically made the first cheque contribution to the fund box at the event.

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