About Us Contact Us Help


Archives

Contribute

 

Diabetes And Kidney Disease In India

Dr. Ajay K. Singh
06/13/2005

The World Health Organization (WHO) has forecast that diabetes rates worldwide are growing in epidemic proportions. It is estimated that by 2025 over 100 million people will have diabetes in South Asia – in India alone 57 million will be affected. While in the developed world, the complications of diabetes are frequently treatable, in India this is far from true.

One of the most common complications of diabetes is kidney disease. Approximately 5 to 10 years after the onset of diabetes, the kidneys frequently become affected. If diabetes in its early phase goes undetected and uncontrolled the likelihood of getting kidney involvement is high. Over 30 to 40% of diabetics may eventually develop kidney disease. Once the kidneys become involved they start leaking protein and kidney function suffers. High blood pressure also develops. As kidney function worsens other complications of kidney disease ensure, including anemia and bone disease. Continuing to tightly control the blood sugars remains a key issue, but control of blood pressure and the use of kidney protective drugs is also paramount. The use of drugs such as angiotensin converting enzyme inhibitors (ACE inhibitors – for example, enalapril or lisinopril) or angiotensin receptor blockers (ARBs – for example, losartan or irbesartan) becomes critical.

The problem for the developing world is that there are few if any programs targeting early detection of diabetes and kidney disease. As well, medications for the treatment of blood pressure and for kidney protection are out of the economic reach of most of the population. Once kidney disease progresses to kidney failure the situation becomes dire. In India, relative to the average income, dialysis and kidney transplantation are expensive and not feasible. As well, most people either have no access to a dialysis facility or are unaware that these are treatment options. In over 90% of people developing kidney failure in India the outcome is death. In 2005, it is estimated that over 100,000 people died because of kidney failure.

The cost of dialysis in India is approximately 1000 rupees per treatment. At a minimum, kidney failure patients need dialysis 2 to 3 times each week – amounting to 2 to 3 thousand rupees in direct expenditure. Adding to this cost is the money that needs to be spent on medications such as epo (to maintain the blood count) and vitamin D (to maintain healthy bones). Most people in India cannot afford to pay this amount of money for treatment even on a short-term basis.

The case for early detection and prevention can be made on economic grounds alone. The human case is obvious and greatly tragic. If diabetes can be detected early then attempts to prevent kidney disease can be vigorously pursued. Once the earliest stages of kidney disease become apparent, preventing progression of kidney disease to kidney failure is important. Unfortunately, the public health care system is starved of resources and doctors can scarcely take care of the patients they already manage. What is urgently needed is a concerted effort involving leaders in India as well as those in the developed world to formulate a strategy to deal with this evolving crisis.

If we have learnt anything from the AIDS crisis in Africa it is that a multi-pronged international effort is needed. It needs to start now and it needs to focus on prevention. Recognizing that both governmental and non-governmental organizations (NGO’s) need to be involved is key. Like the AIDS crisis, both governmental funds and private donations will be required. At least one aspect of the response to this crisis needs to be an embrace of education targeted at increasing awareness among the population. There also needs to be a focus on developing inexpensive screening methods – their value evaluated through the prism of what is pragmatic in a developing country. Changing the medical and health curriculum towards chronic diseases such as diabetes and kidney disease also needs to be a goal because we need skilled doctors and nurses to take care of these patients.  As a start, we need to develop pilot programs that can test out strategies aimed at education and prevention. With the size of the impending diabetes and kidney failure epidemic there is no time to wait.

One such early detection program has begun in Saragur at the HD Kote Taluk near Mysore, Karnataka. The project is part of the “Screening and Early Evaluation of Kidney Disease” (SEEK) project. The SEEK project has 11 sites in India, including several academic centers who are participating. The project is coordinated out of the Brigham and Women’s Hospital in Boston. The Boston team comprises of Dr. Ajay K. Singh, Dr. Bharati Mittal, and Paula Hertello. The SEEK program is supported by the Indian Society of Nephrology and is funded by Janssen-Cilag, a member of the Johnson and Johnson global family.

The HD Kote project is being conduced under the aegis of the Swami Vivekananda Youth Movement (SVYM) -- a leading Indian NGO that has achieved many ground-breaking accomplishments in community health care. The plan is to embark on a kidney disease and diabetes screening program. The first screening was held this week and over 60 subjects were enrolled. Led by Dr. Sreedhara, a nephrologist at Apollo Hospital in Bangalore and Dr. Seetharam a pathologist at SVYM, the pilot program aims to understand the prevalence of diabetes and kidney failure in this rural population.

The progress that’s already been achieved by the SEEK project emphasizes that, for a country as vast and complex as India, more initiatives are needed. More people need to get involved: more private-public, national-international collaborations are essential. If we can recognize diabetes and kidney disease early and consequently prevent kidney failure we would have wisely learnt lessons from the AIDS crisis in the developing world: being pro-active and open to innovative ideas aimed at prevention may be able to prevent a huge human and economic calamity.

(Dr. Ajay K. Singh, is a kidney specialist in Boston, USA, and is on the Harvard Medical School faculty. He is leading a program termed “Screening and Early Evaluation of Kidney Disease (SEEK) based in India at 10 leading centers and targeted at screening and early detection of kidney disease. )

Bookmark and Share | Share your Comments

Comments :
Post a new message
1.new cartoon movies August 12, 2013cartoon porn 
2.Get FREE sample tablets with your order May 19, 2013Amoxil 
3.Sporanox April 25, 2013sporanox 
4.fresh men pics April 18, 2013gay video 
5.cheap buy generic abilify April 10, 2013Gogbroard 
6.Generic Priligy January 28, 2013XRumerTest 
7.SaGHpzdGvZLp November 12, 2012Cinderella 
8.JpmNvAjdlTBQI November 1, 2012Giggles 
9.dxlxmohBOxgWUxyCL October 12, 2012Janess 
10.tRrpDfbiykHTcC September 16, 2012Rangle 
11.fQearhODkIqYLn September 14, 2012Letitia 
12.nNVFtwIUswKldMYsQ September 12, 2012Jaelyn 
13.QqWPLZtlDBvFYuRRv September 6, 2012Ally 
14.PXvfYrfZzMlI September 3, 2012Aira 
15.cheap ED medication August 29, 2012Generic ED medication 
16.SGKHXGFumgzvvIfEEtw August 23, 2012Christina 
17.buy ED medication August 22, 2012ED medication 
18.new video August 20, 2012BeiliaDeeDHaT 
19.yPCSbCESNUWfE August 12, 2012Kamren 
20.EcaPMgIkTsAvVhMsmd July 15, 2012Keesha 
21.sliliaSeisavaSD June 18, 2012Gypeembem 
22.LELLIOCALSD June 8, 2012ShooreSoisa 
23.LELLIOCALSD June 7, 2012ShooreSoisa 
24.rogaine and birth defects buy propecia May 12, 2012Acumaccounk 
25.walgreens propecia price approved May 12, 2012Acumaccounk 
26.cialis generico in parafarmacia May 9, 2012viagra generic 
27.sildenafil citrato viagra May 8, 2012comprar viagra contrareembolso 
28.buy clomid online no prescription ovarian cysts May 7, 2012cheap levitra 
29.buy clomid online no prescription pharmacy May 7, 2012ed pills 
30.buy clomid without prescription male infertility May 6, 2012payday advance 
31.prescription prices buy viagra May 3, 2012viagra pills 
32.order cialis online no prescription May 2, 2012Cialis 
33.where to buy cheap cialis May 1, 2012order Cialis 
34.buy cialis overnight May 1, 2012generic Cialis 
35.buy cialis online australia April 27, 2012Cialis online 
36.buy cialis canada April 27, 2012buy Cialis 
37.buy rolex replica April 25, 2012cheap Priligy 
38.rolex replica swiss April 23, 2012Cialis 
39.replica watches ferrari April 20, 2012Breitling replica 
40.pills buy propecia April 18, 2012buy cialis no prescription 
41.shop cheap propecia April 18, 2012cialis online 
42.propecia cost online uk April 18, 2012cialis online 
43.buy propecia in the university of kentucky April 17, 2012buy cialis without prescription 
44.cvs buy propecia April 17, 2012Buy Cialis 
45.reductil us buy propecia April 17, 2012buy cialis without prescription 
46.buy propecia mrk April 14, 2012buy Propecia online 
47.women's hair loss more for_health_professionals buy propecia April 14, 2012buy Propecia online 
48.buy propecia in california April 13, 2012buy Propecia online 
49.list cheap propecia April 13, 2012Online pharmacy 
50.tadalafil prix April 13, 2012Cialis pharmacie 
51.cialis generique liège April 12, 2012Cialis Generique 
52.tadalafil pas cher April 12, 2012Cialis Generique 
53.acheter du viagra en petite quantité cialis generique April 11, 2012Cialis Generique 
54.scifil cialis generique April 11, 2012Cialis Prix 
55.trouver generique cialis April 11, 2012Cialis en Pharmacie 
56.replica watches worldwide April 9, 2012Replica watches 
57.replica watches high quality April 9, 2012cheap watches 
58.Cialis online pharmacy - make your own cialis online pharmacy April 9, 2012FromCanada 
59.Cialis 20mg - ebay cialis pills April 9, 2012FromCanada 
60.Buy Cialis Tadalafil - buy cialis generic April 8, 2012OrderCialis 
61.Cialis Tablets - cialis 5mg tablets April 8, 2012OrderCialis 
62.Cheap Generic Cialis - tadalafil wiki buy generic cialis April 8, 2012OrderCialis 
63.Buy cheap Cialis - ordering cialis online April 8, 2012CialisCanada 
64.patek replica watches April 8, 2012Replica watches 
65.replica watches london April 8, 2012replica breitling watches 
66.replica watches oakley April 7, 2012cheap watches 
67.replica watches san francisco April 7, 2012Vip replica watches 
68.swiss eta movement replica watches April 7, 2012Vip replica watches 
69.zenith watches replica April 6, 2012fake rolex watches 
70.solid 18k rolex replica April 5, 2012replica Breitling 
71.replica watches mumbai April 5, 2012fake rolex watches 
72.ceramic replica watches April 4, 2012Zithromax 
73.selling replica watches April 4, 2012Azithromycin online 
74.replica watches comparison April 4, 2012Buy Azithromycin 
75.rolex replica real gold April 4, 2012ZPakAntibiotic 
76.uk replica watches April 3, 2012z pack antibiotic 
77.replica watches wiki April 2, 2012Tadalafil 
78.reviews on replica watches April 2, 2012Order Cialis 
79.replica watches quality April 2, 2012Buy Cialis 
80.Buy cheap Cialis - buy cialis soft online April 1, 2012AlprazolamX 
81.replica watches jaeger April 1, 2012Tadalafil 
82.replica watches roger dubuis April 1, 2012Replica Watches 
83.canada replica watches April 1, 2012rolex watches 
84.michele deco replica watches March 31, 2012rolex watches prices 
85.replica watches bangkok March 31, 2012Replica Watches 
86.are replica watches legal March 31, 2012watch replicas 
87.replica watches technomarine March 29, 2012Rolex here 
88.replica watches from dubai March 29, 2012Rolex here 
89.oklahoma board of pharmacy March 25, 2012Viagra 
90.generic cialis cheap March 25, 2012Buy Cialis Online 
91.pills buy tadalafil March 24, 2012Buy Cialis Online 
92.cipla cialis generic March 24, 2012Buy Cialis 
93.buy tadalafil March 23, 2012Cialis SafePharm 
94.cheap tramadol without a over the counter March 22, 2012Buy Carisoprodol 
95.online cheap tramadol hcl March 22, 2012Carisoprodol 
96.hcl acetaminophen side effects buy tramadol March 21, 2012order Tramadol 
97.generic cialis capsules March 21, 2012Xanax 
98.viagra and hemroids cialis generic March 20, 2012Buy Diazepam 
99.buy generic cialis london March 20, 2012Order Diazepam 
100.cuba gooding cialis generic March 17, 2012SaveHair 
101.generic cialis daily use March 17, 2012Buy Propecia 
102.cialis india generic March 15, 2012Buy Levitra 
103.generic cialis work March 14, 2012buy Valium 
104.cialis tadalafil tablets March 13, 2012Generic Valium 
105.cheap generic cialis online March 11, 2012Impotense 
106.mixing viagra cialis generic March 10, 2012carisoprodol 
107.best generic cialis March 9, 2012Soma 
108.generic cialis review March 9, 2012carisoprodol 
109.vinegar metformin cialis generic pills March 8, 2012Buy Valium 
110.generic cialis soft March 7, 2012Buy Valium 
111.online overnight buy ambien March 5, 2012Generic Ambien 
112.sale cheap valium March 4, 2012Valium 
113.generic cialis best price canada February 29, 2012Finasteride 
114.viagra norvasc cialis generic February 29, 2012Buy Clomid 
115.cialis generic purchase February 27, 2012Cialis Farmacia 
116.levaquin cellulitis cialis generic February 26, 2012Cialis Farmacia 
117.wuOHXKKOgTwYEnJn February 25, 2012brettbertles 
118.kamagra chewable tablet cialis generic February 23, 2012Order Cialis 
119.ambien buy comparisons February 21, 2012Buy Ambien 
120.mfXREAlrjfe February 19, 2012zidanetranced 
121.dvd cialis generic February 19, 2012Buy Ambien 
122.lyme azithromycin no prescription February 19, 2012Generic Xanax 
123.before buy propecia online February 19, 2012Buy Viagra 
124.buy propecia without prescription viagra pills February 17, 2012Finasteride 
125.best buy propecia February 16, 2012Propecia 
126.zithromax drug interactions colds flu February 16, 2012Zithromax 
127.buy propecia in canada discount February 16, 2012Propecia 
128.iWWipnSJIgDKgEybnEw February 15, 2012fromdahell 
129.iSValfXYGYhKh February 12, 2012renaebl 
130.PKRLCZVXNxYFrzSFI February 10, 2012mir1press 
131.hovmSRdLWeDQBJo February 9, 2012MrTazuk 
132.RTuMhIaxFQtPiPs February 6, 2012iShuffleee 
133.HjJUKhYIlJiaM February 1, 2012OoJulikoO 
134.UQKdyknZFpkzXQTRC January 27, 2012siamesegoth 
135.FlXUIDzOxYLCwGWkH January 26, 2012jvnmqwege 
136.QdwwVHUrfJuvefRhhyT January 26, 2012Finch 
137.PTNtIiTYsmNbY January 25, 2012Loradae 
138.xNhTTNPAiItNvgQu January 23, 2012Emmy 

In this Issue
Bollywood Baatein


With the loss of original ideas and enough of copying movies from Hollywood, Bollywood is all set to go retro. Old films are getting re-launched and filmmakers are digging into History books for film subjects.
[more]

Bollywood Baatein
Lokvani Talks To Indira Maini


"First time home owners are the most fun to work with," says Indira Maini, Real Estate Agent for Coldwell Bankers.
[more]

Lokvani Talks To Indira Maini
Youth Forum - Ekal Vidyalaya


An eighth-grader from Westborough describes her visit to a unique school in India.
[more]

Youth Forum - Ekal Vidyalaya
Building A 21st Century Pharma Company


Josh Berger of Vertex Pharmaceutical shares the secrets of building 21st century pharma company at TiE-Boston's monthly dinner meeting.
[more]

Building A 21st Century Pharma Company
Samskrita Bharati Organizes Shloka Competition For Children


A Shloka recitation competition for children was successfully organized by Samskrita Bharati in the Greater Boston area with over fifty children participating.
[more]

Samskrita Bharati Organizes Shloka Competition For Children

You may also access this article through our web-site http://www.lokvani.com/


Mr. Bhushan Akshikar, Dr. Ajay Singh and Dr. Bharati Mittal.




Home | About Us | Contact Us | Copyrights Help