Obesity and High Genetic Vulnerability cause Diabetes in India

IMARC Group, one of the world’s leading research and advisory firms, finds that the total number of diabetes patients in India grew at CAGR of nearly 3% during 2004 - 2012. Estimates from their latest report entitled “Indian Diabetes Market Report: Epidemiology, Patients, Prevalence, Oral Anti-diabetics, Insulin and Diagnostics”, suggests that the total number of diabetes patients in India is expected to reach 107 million by 2032.

Findings from the report suggest that a major driver of the diabetes epidemic in India is the increasing levels of obesity. The Indian population that had faced under nutrition for a long time is now exposed to high fat diets and sedentary lifestyles. As a result of increasing disposable incomes and flourishing fast food chains, there were around 157 million overweight and 24 million obese people living in India in 2010. The report expects these levels to increase significantly by 2015.

Apart from the increasing obesity levels, the report also found that Indians are genetically more vulnerable to diabetes compared to other population groups. According to an analyst at IMARC Group “As a result of a higher percentage of body fat to muscle, Indians are more vulnerable to type-2 diabetes compared to other population groups. This fat increases the sugar levels as it gets deposited around the abdomen and interferes with insulin. As a result, Indians get diabetes at a much younger age compared to other population groups”.

IMARC’s new report “Indian Diabetes Market Report: Epidemiology, Patients, Prevalence, Oral Anti-diabetics, Insulin and Diagnostics” provides an analytical and statistical insight into the Indian diabetes market. The report provides both current and future trends in the prevalence, demographical breakup, diagnosis and treatment of diabetes in India. The report has segmented the Indian diabetes market into three segments - Oral Anti-diabetics, Insulin and Diabetes Diagnostics. For each of the aforementioned categories, the report provides historical and future market sales, performance of key classes and the performance of top players.

The research study serves as an exceptional tool to understand the epidemiology, market trends, therapeutic structure, competitive structure and the outlook of the Indian diabetes market. This report can serve as an excellent guide for investors, researchers, consultants, marketing strategists and all those who are planning to foray into the Indian diabetes market in some form or the other.

Economic Survey 2013: Plan Outlay for Health up by 13.9 Per Cent

New Delhi: The economic survey tabled today in Parliament  by the Finance Ministry has increased the plan outlay for health up by 13.9 per cent for the year 2013-14. 


The Survey noted that the government had increased its plan outlay for health by 13.9% to Rs.30,4777 crores in 2012-13. Under the NHRM, over 1.4 lakhs Health Human Resources have been added (upto September, 2012) and under infrastructure strengthening 10,473 sub centres, 714 primary Health Centres and 245 community Health centres have been newly constructed. A sum of Rs.520 crore have been released to open 132 ANM schools and 137 general nursing and mid wifery schools in districts where there are no such schools. Opening of six Nursing colleges at the sites of AIIMS like institution at a total cost of Rs 120 crore is also under consideration. 

The survey also noted that due to Janini Suraksha Yojana, the number of institutional delivery have increased from 1.08 crores during 2005-06 to 1.75 crores during 2011-12. 

In 2012-13 under Indira Gandhi Matritva Sahyog Yogna (IGMSY), a budgetary outlay of Rs.520 crores was allocated to target over12.5 lakhs pregnant and lactating women, the survay said, adding, that the allocation of gender budgeting as a percentage of total budget have gone up from 2.8 % in 2005-06 to 5.96 in 2012-13. 

A proposal for strengthening and restructuring of the ICDS scheme within an overall budget allocation of Rs.1,23,580 crores during the XIIth Plan has been approved. Under Sabla Programme against an allocation of Rs.750 crores for 2012-13, Rs.496 crores has been released. In 2012-13 under Indira Gandhi Matritva Sahyog Yogna (IGMSY), a budgetary outlay of Rs.520 crores is outlayed to cover 12.5 lakhs pregnant and lactating women . 

The Survey points out that Janini Suraksha Yojana (JSY), Janini Shishu Suraksha Yojana (JSSK) and Indira Gandhi Matritva Sahyog Yojana (IGMSY) have many overlapping features and the same beneficiaries. This calls for a careful exercise in identifying overlapping schemes and weeding out or converging them, the survey further said. 

Highlights of Economic survey 2013:

• Economic growth pegged at 6.1-6.7% in 2013-14
• March 2013 inflation estimated at 6.2-6.6%
• Priority will be to rein in high inflation
• FDI in retail to pave the way for investment in new technology and marketing of agriculture produce
• Survey calls for widening of tax base and prioritising expenditure to bridge fiscal deficit
• Calls for curbing gold imports to contain current account deficit
• Aadhaar-based direct cash transfer scheme can help plug leakages in subsidies
• With subsidies bill increasing, danger of missing fiscal targets is real in FY13
• Survey pitches for hike in prices of diesel and LPG to cut subsidy burden.
• Foreign Exchange reserves remains steady at $295.6 billion at December, 2012-end
• At present, overall energy deficit is about 8.6 pc and peak shortage of power is about 9 pc. 
• Infrastructure bottlenecks affecting industrial sector performance
• Prospects for world trade as well as of India are still uncertain.
• Pitches for further opening of sectors for FDI

Omega-6 cooking oil increases heart ailment

 

In a recent study conducted by Dr. Christopher Ramsden, a clinical investigator with the U.S. National Institutes of Health in Washington, researchers offered a fresh analysis of data from the Sydney Diet Heart Study, which studied 458 Australian men aged 30 to 59 with a history of cardiovascular disease for more than three years."The group that was fed Omega-6 from Safflower oil, they had increased risk of death from all causes as well as death due to coronary heart disease and death due to cardiovascular disease" said study author Dr. Christopher Ramsden.

New Delhi: Since long the health monitoring bodies have allowed companies to put health messages on their labels saying that replacing saturated fats with poly-unsaturated fat Omega-6 rich vegetable oils help lower cholesterol. But in a story carried widely on CBC-TV's The National, this theory has been trashed.


Dr. Ramsden speculated that having more omega-6 in the diet could promote oxidation and inflammation in the arteries.

Nutrition professor Richard Bazinet, who studies fatty acids at the University of Toronto said this week's study in the British Medical Journal suggesting that omega-6s may borderline increase heart attack risk, needs to be publicized for public safety.

Dr. Artemis Simopoulos, President of the Centre for Genetics, Nutrition and Health in Washington advised "The goal should be to consume a balanced amount of omega-6 and omega-3 fatty acids". She added "We should lower the intake of omega-6 rich oils such as corn oil, sunflower, safflower, cottonseed oil, including soybean," Dr. Simopoulos said. "Increase the amount of omega-3 fatty acids in our diet, which can be obtained from oils that are rich in omega-3s such as flaxseed oil, Canola oil."

For consumers, the subtle and shifting messages can be confusing. Dr. Bazinet advises reading labels carefully". Like Simopoulos, he said "flax and canola are the safer options and people might want to stay away from the straight safflower, corn and sunflower oils that typically make up five per cent of purchases".
In India, the most widely sold cooking oils like Safflower (Saffola), Soyabean, Sunflower, Cottonseed contain very high Omega-6 fats. It would be in the interest of the consumers to look at better options like Canola Oil that has high Omega-3 and the right ratio of Omega-3:6 ratio (1:2).

When we spoke to Dr. Anoop Mishra, HoD of Diabetes and Metabolic Diseases, Fortis Hospital, he added "I would rate Canola Oil as no. 1 amongst all available cooking oils in India". In a teleconversation with Jivo Wellness who are the largest sellers of Canola Oil in India we learnt that lakhs of consumers have been shifting to Canola Oil primarily due to the health benefits offered like lowest bad saturated fats, high Omega-3, best ratio of Omega-3:6. With rising medical costs, it is felt that Good health comes at a low cost if we use our choices carefully.

Promote alternative medicines to spread healthcare services: Experts

Healthcare experts today called for promoting complimentary and alternative medicines which they said can open new vistas in science and cater to a large segment of population by focusing on good nutrition and preventive practices.

However, jurisdictions where alternative practices are sufficiently widespread should be licensed and regulated, they said at a conference organised by The Associated Chambers of Commerce and Industry of India (ASSOCHAM).

Alternative medicines are frequently grouped with complimentary or integrative medicines which refer to the same interventions when used in conjunction with mainstream techniques. More focus is required on validation of their process technologies and scientific evaluation, said Dr H.K. Chopra, co-chairman of ASSOCHAM Hospitals and Healthcare Committee.

“Research and development programmes in newly-emerging and challenging areas of science in Ayurveda need to be encouraged so that they can be marketed worldwide,” he said. A recent systematic review of studies in 13 countries concludes that about 31 per cent of cancer patients use some form of complimentary and alternative medicines.

Dr J.D. Sarangi, special secretary at the Delhi government’s department of health and family welfare, said the growing interest in alternative medicines is a positive symbol for the medical community which has started moving from a narrow approach to more holistic remedies.
However, the scientific community has to debate that in the era of evidence-based medicine, should official endorsement be given to remedies that cannot be scientifically proven.

Among those present during the inaugural session were Dr C.K. Katiyar, vice-president and head of ayurveda department at Dabur, Dr R.K. Khandal, director at Shriram Institute for Industrial Research, Dr Shikha Sharma, managing director of Nutri-Health Systems, Dr Lalit Verma, secretary at the Central Council of Homeopathy, and Arun Kumar, deputy secretary general of ASSOCHAM.

India invests only one per cent of GDP in primary healthcare centres. The country has an average of 0.6 doctors per 1,000 people against the global average of 1.23. The country’s healthcare sector currently estimated at Rs 3.75 lakh crore is likely to double in volume over the next five years.

Now, girls attain puberty at 10 years!

Now, girls are reaching puberty, two years earlier. The age of attaining sexual maturity among a girl, when she changes physically, hormonally and sexually has dipped, especially in urban India, to 10 years from 12-13 earlier, not just in India but globally, according to a Times of India report. 

A study published in the Lancet on Wednesday says the age of 18 years clearly no longer signifies adulthood.

According to it, the earlier onset of puberty has increased the window of risk associated with adolescence. It said previous generations of parents viewed the physical changes of puberty as being of greatest significance with raging hormones being blamed for much of adolescent bad behaviour.

Professor Susan Sawyer and George Patton (Murdoch Children's Research Institute, Melbourne and University of Melbourne) say, "Puberty is increasingly recognized as a significant physiological event that catapults adolescents into higher risk for a range of health-related behaviours like mental disorders and substance use," said the study.

Dr Rajiv Chhabra, chief of pediatrics at the Artemis Health Institute, agrees with the findings. He said the phenomenon is leaving girls with well-developed bodies, which they're not emotionally equipped to handle. "Premature puberty is becoming common among girls in India. Lifestyle and dietary changes could be fuelling this trend. Vegetables and eggs containing hormones like oxytocin can hasten puberty. Earlier, we would tell parents to teach a girl the concept of menstrual cycle when she turns 13. Now, we ask parents to talk about it to their 10-year-old daughters," said Dr Chhabra.

Promote alternative medicines to spread healthcare services: experts

Healthcare experts today called for promoting complimentary and alternative medicines which they said can open new vistas in science and cater to a large segment of population by focusing on good nutrition and preventive practices.

However, jurisdictions where alternative practices are sufficiently widespread should be licensed and regulated, they said at a conference organised by The Associated Chambers of Commerce and Industry of India (ASSOCHAM).

Alternative medicines are frequently grouped with complimentary or integrative medicines which refer to the same interventions when used in conjunction with mainstream techniques. More focus is required on validation of their process technologies and scientific evaluation, said Dr H.K. Chopra, co-chairman of ASSOCHAM Hospitals and Healthcare Committee.

“Research and development programmes in newly-emerging and challenging areas of science in Ayurveda need to be encouraged so that they can be marketed worldwide,” he said. A recent systematic review of studies in 13 countries concludes that about 31 per cent of cancer patients use some form of complimentary and alternative medicines.

Dr J.D. Sarangi, special secretary at the Delhi government’s department of health and family welfare, said the growing interest in alternative medicines is a positive symbol for the medical community which has started moving from a narrow approach to more holistic remedies.
However, the scientific community has to debate that in the era of evidence-based medicine, should official endorsement be given to remedies that cannot be scientifically proven.

Among those present during the inaugural session were Dr C.K. Katiyar, vice-president and head of ayurveda department at Dabur, Dr R.K. Khandal, director at Shriram Institute for Industrial Research, Dr Shikha Sharma, managing director of Nutri-Health Systems, Dr Lalit Verma, secretary at the Central Council of Homeopathy, and Arun Kumar, deputy secretary general of ASSOCHAM.

India invests only one per cent of GDP in primary healthcare centres. The country has an average of 0.6 doctors per 1,000 people against the global average of 1.23. The country’s healthcare sector currently estimated at Rs 3.75 lakh crore is likely to double in volume over the next five years.
 

US-based Indian creates first artificial kidney

New Delhi: US-based Indian origin researcher Shuvo Roy has created the world’s first implantable artificial kidney. What’s sensational about Roy’s creation is that the organ, no larger than a coffee cup, will be able to mimic the kidney’s most vital functions like filtering toxins out of the bloodstream, regulate blood pressure and produce the all important vitamin D. The artificial kidney has been tested successfully on a small number of animals. Large-scale trials on animals and humans are expected over the next five years.

Once available, and if affordable, this creation by the Roy-led team at University of California will do away with the need for kidney dialysis. This will be a boon for all patients with chronic kidney disease (CKD). At present in India, of the 1.5 lakh new patients who suffer from endstage renal failure annually, only 3,500 get kidney transplants and 6,000-10,000 undergo dialysis. The rest perish due to an acute shortage of dialysis centres and nephrologists to man them. CKD is rising at a rapid pace in India and the majority of those who perish are either unable to find a suitable organ for transplantation or are unable to pay for the high dialysis costs.

According to Roy, the device has a filtration section to remove toxins from the blood, alongside a compartment with renal cells to conduct other functions of a kidney. He believes the artificial kidney could last for decades and require no pumps or batteries. Patients wouldn’t require anti-rejection drugs (as is required after transplants) either because there would be no exposed natural tissues for the immune system to attack. The University of California team is awaiting approval to conduct larger scale animal and human trials. Already, it has successfully tested the implant in a few rats and pigs. “The payoff to the patient community is tremendous,” said Roy.

“It could have a transformative impact on their lives...With the right financial support, I think we could reach clinical trials in five years. But it’s hard to say how long after that it becomes commercially available due to the uncertainties of the FDA and commercialization prospects.’’

THE ULTIMATE RELIEVER?
The artificial, implantable kidney developed by Dr Shuvo Roy is the size of a coffee cup and is ready for test on humans. If successful, it could replace the need for dialysis and transplants for lakhs of people suffering from chronic kidney diseases

The patient’s blood passes through two stages after entering the device
1- Filter Side: Silicon membranes filter the blood and remove toxins
2 - Cellular Side: A bed of kidney cells (grown with help of tissue engineering) regulates chemical balance of the blood

SHUVO ROY
Roy’s father is from India while his mother is a Bangladeshi. Born in Bangladesh, young Roy spent some time in India as well. Studied in Uganda, where his father was a doctor. Went to US for higher studies

KIDNEY DISEASE IN INDIA
Every year, 1.5 lakh new patients end up suffering from end-stage renal failure. Only 3,500 get transplants and 6,000 undergo dialysis. The rest die due to shortage of dialysis centres and nephrologists Patient undergoing dialysis  spends 10,000 a month, with the  process taking up to 72 hours ‘

Artificial kidney will be boon for India’
So what would this artificial kidney mean for India? ‘‘It will be a real boon,’’ said Dr S C Tiwari, director of nephrology and renal transplantion medicine at Fortis health care. He added: ‘‘The biggest problem with CKD patients in India is that majority of them are diagnosed in the final stages where they would either require constant dialysis or a transplant. They would require dialysis three times week. However, of the two lakh CKD patients requiring dialysis, only 10,000 get it, mainly because they can’t afford it. Maybe only 1,000 such patients get it for free or at a subsidized rate in government hospitals. The artificial kidney, when available and if affordable, will be a miracle.’’ Dr Madan Bahadur, nephrologist with Mumbai’s Jaslok Hospital added, ‘‘Work on creating tubular cells (that perform the biochemical work of the kidney) began a decade back. But bio-chemical engineering has so far not managed to replicate the kidney.’’ According to Dr Jitendra Kumar, head of nephrology at Asian Institute of Medical Sciences, the main reason why this artificial kidney will be a real breakthrough is because it will be able to mimic the vital functions of a kidney like regulate BP and produce vitamin D — things a dialysis can’t do.