For decades now, diabetes has been brewing a silent pandemic which has translated into either a life-threatening or life-long battle for many. But it doesn’t have to be.

Did you know that 1 out of 11 people in India are formally diagnosed with diabetes, while 1 out of 5 are estimated to have diabetes? 

In fact, according to research, India ranks second after China in the global diabetes epidemic with 77 million people living with diabetes. And out of these, 12.1 million are below the age of 65 years, and by 2045, this number is expected to increase to a staggering 27.5 million!

But what’s worse is that, almost 57% of adults with diabetes in India are undiagnosed. This means approximately 43.9 million adult Indians are unaware of the serious condition which is a major cause of blindness, heart attacks, stroke, kidney failure and lower limb amputation. 

As a country housing a massive population of diabetic individuals, it is important for us to look deeper into the nuances of the condition and find innovative solutions to overcome this. For decades now, diabetes has been brewing a silent pandemic which has translated into either a life-threatening or life-long battle for many. 

But it doesn’t have to be that way according to experts today. As an alternative and progressive solution they recommend following the Diabetes Remission (DR) programs which has helped many diagnosed with type 2 diabetes put their condition in remission before embarking on their journey with medications. 

Hence, this time on Practo Connect celebrating World Diabetes Day, we had the pleasure to have Dr Hema Venkataraman, one of the top experts on this subject, share her valuable insights on the science behind DR and the paradigm shift in the approach required by doctors treating patients living with diabetes. 

A consultant Endocrinologist at the University Hospitals Birmingham, NHS, UK, she comes with over 17 years of clinical and academic expertise in chronic health care management. She is the clinical lead and MDT member for the Antenatal and diabetes technology service at University Hospitals Birmingham and a member of various international societies like Diabetes UK, SFE, EASD and ADA. Currently she is also working as a medical lead for Practo Diabetes Remission under Chronic Care.

“The burden of diabetes in India has doubled in the last 20 years, overwhelming the existing health care infrastructure that has not grown proportionately. With as high as 1 in 5 adults estimated to have diabetes, it is time to rethink sustainable diabetes care delivery.  The breakthrough discovery of diabetes remission, is shifting the paradigm of diabetes care, from a glucocentric drug treatment based approach, to a more holistic, large scale prevention strategy targeting the root cause of diabetes. The rollout of a nationwide Diabetes remission program is the need of the hour along with a strong public health campaign and policy change on advertising and healthy eating”, says Dr Venkataraman.

Highlights: 

• Why Diabetes in India is not just a Number’s Game?

“Diabetes is nothing less than a pandemic. Nothing less than what COVID-19 was for us” says Dr Venkataraman. However she also highlights that in India, diabetes is not just a number’s game. It is not just that diabetes is more prevalent in India but instead, it is about morbidity. For instance, Indians get diabetes about 10 years earlier than those in the west.

• Who are Thin-Fat Indians? Diabetes in South-Asians

She adds that while the typical white man with diabetes is an inactive person with a BMI of 35 or 40 and a big pounch, in India it is a different ballgame. She says that in India even a lean hard-working active man with a flat tummy and a BMI of 22 or 23 can be at high risk of diabetes, highlighting the concept of thin-fat Indians.

• The time for Diabetes Remission is Now

“If somebody with breast cancer or any of the cancers were offered remission, there is a 100% chance that the patients would go for it but with diabetes this outlook is yet to be formed. It is time to think about remission and change our outlook towards it. So as doctors our first goal with anybody with diabetes especially a newly diagnosed patient with diabetes should be remission and not treatment or drugs. I think it’s our duty, our responsibility to educate our patients that remission should be their first goal too. It is important to remember that diabetes is no less serious compared to cancer and is among the top four killers in the world,” says Dr Venkataraman.

• Remission vs Reversal/Cure

“In India we have half a dozen startups talking about diabetes reversal, diabetes cure and freedom from diabetes. But as diabetologists and physicians we have a responsibility to set the record straight and to educate our patients the right way. Yes remission means freedom from any signs of obvious disease, but it needs to be emphasised that it is a consistent process of building a healthy lifestyle, and going back to the harmful habits will prevent that. So remission is the right word to use and not reversal or cure” she says.