Everything You Need to Know about Diabetes
By Lubna Mirza, MD
“Let’s check your blood sugar!” I asked my mother one day during my fellowship in Endocrinology, Diabetes and Metabolism at the University of Oklahoma. She was in her 50s with increased body weight. Her finger stick blood sugar was 325mg/dl. I looked at her pill box. She was on a blood pressure medicine, a water pill and an aspirin.
“Do you know that you have diabetes?” I asked her. No! She said her doctor had told her that she had some high sugars and she needed to watch her diet. That was all the information and education she was given. I started her on appropriate medications right away that she is now taking on a regular basis. Her overall disease is better controlled as compared to before. While talking to her about diabetes I realized there is a gap between current western information/treatment of the disease and understanding of this disease in ethnic minority groups in America.
Have you heard the saying that at some point in your life you find yourself in a position where there is an important job to be done and the person who can do it is you. That was the moment I decided to write a book about diabetes in Urdu. This book “Everything you need to know about diabetes”( in Urdu) is now available from Tate publishing in Mustang, Oklahoma.
If you are reading this article thinking it is going to say we are wonderful and awesome and there is nothing wrong with us and our schools, hospitals, police department, streets and people are greatest in the world then I would gently request that you stop reading here.
This paper is about diabetes and lack of education and interest to learn about this serious illness in the South Asian population. Our culture is all about don’t ask and don’t tell. The attitude is that if I ignore a problem it must not exist. At this time, Pakistan is the fastest growing country in the whole world and the population is expected to double in the next 40 years. Diabetes is a huge disease burden on the community. We will not talk about the exploding HIV-infected individuals or the uncontrolled population issues today although they do need serious consideration.
Diabetes is increasing all over the world. As per World Health Organization estimates, there are 7.5million diabetics in Pakistan. This number is expected to go up to 11 million in 2025. These numbers need to be taken with a salt of grain since there are many walking around with diabetes without the knowledge of it. South Asians are at a disproportionately increased risk for developing diabetes as compared to Europeans and other Asians. Diabetes is a complex disease which leads to multiple complications such as eye disease, kidney disease, and nerve damage with loss of feeling in feet, heart attacks and strokes.
All of my relatives older than 40 years in America are diabetics today. We are a family with multiple doctors and teachers. It’s not an uneducated family. One of my cousins told me he gets phone calls from the pharmacy to come and pick up his Metformin. “I don’t take this stuff” he said, “If I continue to take medicine for diabetes, it will get worse”. There is very little physical activity and weight gain in women is considered a norm.
One of my cousins who had recently moved to America from Karachi once said to me, “You look weak!” “My body mass index is in normal range!” I told him. Body mass index is a measure of how much you weigh for your height. A normal healthy BMI is between 18 and 23. Over 25 is overweight and over 27 is obese for South Asians. Regular exercise or maintaining a healthy body weight is not on most people’s to do list. There is little knowledge among people about the food groups in a healthy diet, calorie counting, essential minerals and vitamins and portion control.
There is a huge need for doctors from South Asia to help educate these patients in America and I hope that the blog www.diabetesinurdu.com and the book “Everything you need to know about diabetes” in the Urdu language will help bridge some of these gaps in knowledge and understanding of this serious illness.
If you have any questions, you may ask them by visiting the blog site.