The World's Invisible Enemy : Diabetes

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Diabetes is a global epidemic and has undergone a wicked transformation and has now shifted to younger age groups, rural areas and the poor due to lifestyle changes. Inadequately managed, it affects the entire body leading to as many as ten complications. Understanding what causes diabetes, its prevention, early detection, and disease control can stem this epidemic. By emphasizing three simple solutions with 96 illustrations, this book aims to bring diabetes prevention and care within the grasp of every reader.

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Dr. V. Lakshminarayan, MD_ University of Mysore, FICC, Graduate Diplomate in Diabetes Care, University of New castle, Australia. Shreehari Diabetes Foundation Kuvempunagar No. 176, Aniketana road, Ist cross (south), Mysore Karnataka India, is a visionary who identified the rising global tide of diabetes. In order to self-empower the common man to combat diabetes, he has dedicated his life to public education. His Kannada work "Madhumeha Dashavyadhigala Moola’, awarded the "Shreshta Vydhya Sahitya Kruti Award’, is a best seller. His relentless service has been honored with the "Karnataka Rajyotsava Award", "Doctor of Letters" by the Kuvempu University, and the "Dr. BR Ambedkar National Award" to name a few.

Dr. Sooraj Tejaswi, an Associate Professor, served as the Director of the Gastroenterology & Hepatology Fellowship at the University of California Davis. His publications in clinical diabetes as an Indian Academy of Sciences research scholar at the All India Institute of Medical Sciences (AIIMS) has been cited more than 100 times. He is currently focused on health issues affecting the Indian diaspora in the United States.

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It gives me great pleasure to write this ‘Foreword’ for the book "The World’s Invisible Enemy: Diabetes" by Dr. V. Lakshminarayan and his son Dr. Sooraj Tejaswi. I have known Dr. Lakshminarayan for many years and admire him for his deep knowledge of medicine in general, and diabetes, in particular. He is a good speaker, a talented writer, an excellent clinician and above all a great human being. I have always been struck by his humility, his passion for excellence and his deep sense of humility. It is therefore a great pleasure for me to write a Foreword to his book.

Today, diabetes has become a global epidemic and India has the second largest number of people with diabetes in the world, 72.9 million, according to IDF Atlas 2017. Moreover, it has also an even larger number of people with pre-diabetes (77.4 million). Diabetes is no longer a disease of the rich, the old or urban people. The epidemic is rapidly shifting to younger ages, to rural areas and to the poor. This places a huge burden on not only the individual, family and the society but also the nation, as a whole. A century ago, there was an adage, "Know syphilis and know medicine". Today, this could be changed to ‘Know diabetes and know medicine’ because diabetes has its ramifications all over the body and produces numerous complications. Moreover it is known as ‘a good disease with bad companions’ because several comorbidities like hypertension, dyslipidemia, obesity, cardiovascular disease and stroke, non-alcoholic fatty liver diseases and even some forms of cancers are associated with diabetes. Therefore the title of Dr. Lakshminarayan’s book "The World’s Invisible Enemy: Diabetes" is appropriate. A thorough understanding of diabetes, its early detection, prevention and control can help not only individuals with diabetes, but also those with associated diseases and complications. This book covers all aspects of diabetes starting with history of diabetes, the acute and chronic complications of diabetes and various aspects of treatment of the disorder. I congratulate Dr. Lakshminarayan and Dr. Tejaswi on this excellent publication and wish them all the very best with its publication.

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India is a great country with a glorious history. Ancient India was at the forefront of science. Our ancient ayurvedic treatise Charaka Samhitha described the four cardinal principles to prevent lifestyle related diseases such as diabetes as far back as 2300 years ago, namely "achar, ahar, vyayam and yoga". However, today India and the entire world are at the center of a growing diabetes epidemic.

Diabetes is a consequence of our own making. We have deviated from the lifestyle prescribed in our ancient scriptures, which advocate a positive mindset, active lifestyle and moderation in life. Nowadays, our lives are not in harmony with the laws of nature. We are either overeating or eating the wrong food. We are sedentary either by choice or compulsions of a big city life. We are struggling to cope with the stresses of modern life.

Diabetes is a disease that spares no organ in the body. Diabetics are three times more likely to have high blood pressure, 4 times more likely to die from a heart attack, and 4 times more likely to have a stroke. Diabetes is particularly hard on the Indian kidneys causing kidney failure at a 10-40 times higher rate than Caucasians. On a more sensitive note, diabetic men are 3 times more likely to develop erectile dysfunction, and they do so 10 years earlier than non-diabetics.

Today, diabetes is no longer a disease of just the rich and old. Type 2 diabetes, which is usually diagnosed at the age of 40-50 years, is now being reported in kids as young as 9! In fact, Indian kids have an 11-fold higher risk of developing diabetes than Caucasian children. Youth account for 70% of India’s population. Our future is crippled if the status quo prevails.

Diabetes is not a disease limited by a country’s borders, and has followed Indians to every part of the globe. Indians are the fastest growing minority in the USA, and are the second largest ethnic group in Britain after Caucasians. They have double the rate of diabetes compared to Whites.

Thus, whether we like it or not, diabetes is at everyone's doorstep today. Look around you, and you will see a friend, family member, neighbor or co-worker suffering from diabetes.

Unfortunately, this major public crisis is not getting the attention it warrants. In our effort to fight this epidemic, we have meticulously combed through the entire scientific literature to identify research work that specifically addresses diabetes and its related problems affecting the Indian population. We have drawn on the 20 years of professional experience in treating patients with diabetes, the diabetes research experience gained at the All India Institute of Medical Sciences, New Delhi, and research conducted at the Sreehari Diabetes and Research Center, Mysuru, and the diabetes education acquired at the University of Newcastle, Australia, in authoring this book. The contents of this book is spread over 28 chapters, divided into 3 parts: The fundamentals of diabetes, The 10 major complications of diabetes, and The solutions to diabetes.

We have highlighted simple, but very effective measures to counter diabetes. For example, eating a diet that contains complex carbohydrates (whole grains, vegetables, and fruits) instead of simple sugars (Coke, Pepsi, sweets, maida, white rice, etc) causes less stress on the pancreas. Consuming plant-based protein (dals, peas, nuts, seeds, etc) leads to less hunger, and consequently, better blood sugar control. Healthy fats (mono and poly unsaturated fats) in moderation are both essential and beneficial for health. On the contrary, the so-called "fat free" foods are likely to lead to poor diabetes control. The spices we routinely use in our kitchen (Indian spices - jeera, methi, sarson, kali mirch, etc) tend to lower our blood sugar and cholesterol levels. A healthy diet, combined with regular physical activity can reduce the risk of diabetes by 71%. For every kilogram of excess weight that you burn, the risk of diabetes falls by 16%. Yoga reduces blood sugar levels within hours, and leads to sustained benefit. This book is packed with many such facts and figures, which will bring diabetes prevention and control within the grasp of every reader.

It is our sincere hope and prayer that this book serves to uncover this silently burgeoning epidemic of diabetes, and provide the readers useful tips to combat it.

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