Interview with Diabetologist Dr PD Gandhi – Part 1

It’s no secret that diabetes is fast becoming one of India’s most serioous health problems. We caught up with leading diabetologist Dr PD Gandhi to get some expert advice on the disease.

Q. What are the signs (early) and symptoms of diabetes? 

A.  Most of the times early diabetes is asymptomatic, meaning the patient does not shows any signs or symptoms of the disease. We have found that in more than 50% of the cases, diabetes have been diagnosed in routine investigation or during investigations being done before any clinical procedure. The obvious symptoms of diabetes appear at a later stage.

When blood sugar goes very high, a triad of symptoms appear in patients suffering from diabetes. These are:

  1. Polyuria (frequent urination),
  2. Polydipsia (excessive thirst) and
  3. Polyphagia (excessive hunger).

The other signs and symptoms for diabetes include generalised weakness, giddiness and weight loss. In advanced cases, when blood sugars are very high a peculiar feature of diabetes is an increase in appetite, accompanied by a marked loss of weight. Often patients also suffer from infections in the genital areas, like candidiasis.

Diabetes facts to know

Q. In case I have a strong family history (i.e. father or mother suffer from diabetes), how can I avoid becoming diabetic? What is the genetic influence of diabetes?

A. Diabetes does have a genetic influence. It is, in fact, known also as a genetic disorder. You could say that the genes load the gun and environmental factors trigger it.

If either of the parents is diabetic the chances of the person suffering from the disease increase by 20-30%. And if both the parents are diabetic, the chances increase by up to 60%. If diabetes is present in 2 generations, the person falls into a high-risk zone for diabetes.

If you are genetically predisposed to the disease, the best way of prevention is – healthy eating habits, regular exercise and prevention of obesity.

A person showing the following traits would fall into a high-risk group – if you’re above the age of 35, suffer from obesity, have a family history of diabetes or have had diabetes during pregnancy. Such people check their blood sugar levels at regular intervals (at least once a year), as this will help us in early detection and treatment of the disease.

Q. How has the trend of diabetes been in India in the last 2 decades? Is there increase in the number of people suffering from it or increase in the awareness about the disease?

A. The trend of diabetes in India in the last two decades has been on the rise. As per the WHO, the diabetic population in urban India is about 16 – 18 % and the diabetic population in rural India is about 6 – 8%

India is the diabetes capital of the world. It’s worth mentioning that we had approximately 19 million diabetic patients in India in 1997. Today, we have around 41 million diabetics in India. It is predicted that by 2025 we will have around 87 million diabetics in India, i.e. almost every 5th diabetic patient in the world will be Indian.

Q. What are the different types of diabetes, and which one is more commonly found in India? Also comment on gestational and juvenile diabetes.

A. Broadly speaking diabetes has been categorised into 4 types:

  1. Type 1 Diabetes Mellitus – Also referred as juvenile diabetes. In this form of diabetes there is absolutely no insulin production in the body. Hence the mode of treatment in these patients is only in the form of insulin. It is found in about 2-3 % of all Indian diabetics.
  2. Type 2 Diabetes Mellitus – This is the commonest and most prevalent form of diabetes. It affects between 95-98 % of all diabetics in India. It mostly affects adults above the age of 30 or 35 and is more common in obese people. Very recently, type 2 diabetes has been surprisingly found in children, due to increase in child obesity.
  3. Gestational diabetes Mellitus – This type of diabetes is generally detected when a woman is between 4 to 5 months or 20 weeks pregnant. This form of diabetes is reversible in nature and can be controlled by proper diet and if required, insulin.
  4. Secondary Diabetes – This form of diabetes is not very commonly found. As the name suggests, it is secondary to any hormonal disorder, drugs or any pancreatic dysfunction.
Read part 2 of the interview with Dr PD Gandhi here
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