why diabetes is a rising drawback in Pakistan

“It’s rapid urbanization and the associated lifestyle changes and the fast food avalanche. Food is available on a phone call. And the consumption of sugary drinks. “

An explosion in fast food, including local specialties like biryani, dangerously increases the waistline.

“I’m thinking of Biryani and I’m thinking of the McDonald’s double decker in America. And they keep getting fatter and have no choice because that’s the cheapest food for them, “said Prof. Ahsan.

Dr. Ali Jawa, a Lahore-based endocrinologist, said people still believed they needed big, hearty meals like working in the fields when many now lived sedentary lives.

Additionally, the drawstring pants in traditional Pakistani clothing meant people were often less aware of their growing waists, he said.

“There really aren’t many countries in the world where obesity and overweight are not a problem,” said Nicola Guess, a nutritionist at Kings College London.

“Everyone is exercising less and India and Pakistan are no exception and everyone is eating more and again these two are no exception.”

In South Asia, however, another factor appears to be at work. The risk of diabetes increases not only from being overweight, it also depends on where that weight is going.

South Asians, including those living in the west, develop type 2 diabetes with much less weight gain. “No one has yet figured out exactly why someone of Indian descent develops type 2 diabetes at a lower body weight, but they seem unable to store the fat in safe places,” says Dr. Guess.

Wrong spots include getting fat around the abdomen, liver, muscles, blood vessels, and insulin-producing pancreas.

“South Asians do this at much lower body mass indices. You’re starting to move excess fat into areas of less weight gain, ”explains Prof. Naveed Sattar of the University of Glasgow.

He said there is evidence that when excess fat reaches these areas, it interferes with sugar regulation, for example that the liver, which can act as a sugar store, is releasing too much or too little memory. The pancreas can produce less insulin.

He said, “South Asians are much more prone to putting fat in the wrong places with less weight gain and that insulin production can also be decreased. So for less weight gain, they will develop diabetes faster.

“They were all fine 20 years ago, when this urbanization didn’t exist, when there wasn’t this sedentary lifestyle, when they were all a little leaner, had a little more muscle, and were way below the threshold.”

The changes mean that people are developing it younger and younger, giving them more years of life with a chronic condition. Addressing the problem will likely require a combination of public information campaigns and behavior changes to make healthier choices, avoid the development of the condition, and increase the availability of simple drugs that can help treat the condition.

Governments are doing too little to address the severity of the problem, perhaps because solutions have to be long term, said Prof. Vivek Jha, director of the George Institute in India. Diabetes was now the leading cause of kidney failure and a major contributor to heart disease.

The widespread use of statins and drugs to lower sugar and blood pressure can have a big impact on those who already have the disease. But preventing people from developing it was more difficult.

“There is no shortcut for it. There is no such thing as a magic bullet. It’s not that you can tell them there is something you can do here, ”he said.

Dr. Shoukat tells his Karachi patients that medicine should be the last resort. “You should watch your diet, add good healthy things to your diet, and be careful,” he said.

“Exercise 10 to 15 minutes a day. Get in the habit of walking. “

But his requests often meet a skeptical audience. “When patients are told to abstain, they will complain that you prohibit anything,” he said.

“One of our patients and his wife have diabetes. His eldest son was diagnosed with diabetes seven years ago. After that, I strongly instructed his other siblings to take precautions and watch out for their diet. Sure, but they didn’t, which resulted in three more siblings suffering from the disease. “

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