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[A-List] Asia warned on diabetes threat
by Mangai Balasegaram
BBC Online (February 22 2006)
Le Thu Quy could hardly be described as obese, even by standards in her native
Vietnam.
At just 44 kilograms and 1.47 meters tall, she looks an unlikely candidate for
Type 2 diabetes, a disease associated with obesity and old age in developed
countries.
Yet this petite, 48-year-old nurse is part of a growing and alarming trend in
Asia, where diabetes is stretching across a wider range of age, weight and class
than ever before.
The disease is even striking children. The youngest victim found in Vietnam is
just eleven years old. Japan has a nine-year-old diabetic. And in Singapore, an
epidemic of Type 2 diabetes in children sparked a government campaign, "Trim and
Fit".
"Children are getting a disease that once only affected their grandparents or
parents", said Dr Anil Kapur, Vice-Chairman of the World Diabetes Foundation,
at an international diabetes summit in Hanoi, Vietnam.
The diabetes epidemic is exploding faster in Asia than in any other region in
the world - and beyond previous predictions by experts.
The World Health Organization (WHO) says diabetes cases in Asia will rise by
ninety percent in the next twenty years. The disease - and its related disorders
- is set to become the 21st century's biggest health crisis.
"You're talking about 330 million people affected in the next twenty years.
There is nothing like that with Aids or bird flu", said Paul Zimmet, Director
of the International Diabetes Institute, in Victoria, Australia.
"Yes, you could have a bird flu pandemic. But with diabetes, you walk down the
streets in Harlem [New York City] or Nauru now and you see people with motorized
wheelchairs because of amputations, or people who have gone blind or going for
dialysis."
Asia already has the bulk of cases. It is home to four of the world's five
largest diabetic populations - India, with 33 million cases, and China,
Pakistan and Japan with 23, 9 and 7 million cases respectively
The Pacific island of Nauru has the world's highest diabetes prevalence.
Even in some poorer Asian nations, diabetes rates are twice that of many
European countries. For example, the prevalence in urban Cambodia, at seven
percent, is roughly equal to that in far-wealthier Australia.
Lifestyle changes
Genes are partly to blame. But changing eating patterns and physical activity
are clearly driving the epidemic in Asia.
"In the past decade in Hanoi, where people have switched from bicycles to
motorbikes, diabetes has doubled", said Dr Gauden Galea, Regional Advisor
for Non-Communicable Diseases for WHO's Western Pacific Region.
"That rate of increase in HIV/Aids would cause panic in health circles".
Diet is also changing rapidly, with more people eating out and eating junk food.
Some traditional foods prepared outside the home are also becoming less healthy.
Dr Galea cited studies from Ho Chi Minh City showing how chicken noodle soup
(pho ga), a Vietnamese favourite, had 23% more calories when prepared in
restaurants.
In New Delhi, where one in six children are overweight, adolescents eat out
at an average of at least three times a week, Dr Kapur said.
In big Chinese cities, studies show about twenty percent of children aged seven
and over are overweight.
A genetic cause seems to play a part in some Asians and Pacific Islanders.
Studies show Indians carry certain genes that increase susceptibility to
diabetes and lack genes that provide protection, said Dr V Mohan, director
of the Madras Diabetes Research Foundation.
Other studies show poor nutrition in pregnant women can lead to diabetes
in both the child and mother many years later.
As a chronic disease, diabetes debilitates the body slowly and in a variety
of ways.
"It affects every single organ system", said Dr Kapur.
The World Diabetes Foundation, which supports local diabetes prevention projects
in the region, is working to prevent two disastrous consequences of the disease
for the poor - losing a limb or going blind.
There is still poor awareness, even among health workers, about a disease that
was relatively rare ten years ago, Dr Galea said.
Most of Asia is still hopelessly unprepared for this health crisis,
which will inundate hospitals and strain healthcare budgets, doctors said.
"Hospitals in India are already feeling the pinch", said Dr Mohan.
Asian governments need to take action now, he said.
"Otherwise, in ten to fifteen years time, we will see millions of people
needing bypasses, kidney dialysis and laser treatment", he said.
http://news.bbc.co.uk/2/hi/asia-pacific/4738936.stm
Bill Totten http://billtotten.blogspot.com/
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