epidemic threat

Almost 3.5 lakh Indians died of diabetes in 2015

Diabetes may soon be a bigger problem than TB, HIV and malaria together, say endocrinologists.

With a genetic predisposition brought to the fore by changing lifestyles, deaths due to diabetes increased 50% in India between 2005 and 2015, and is now the seventh most common cause of death in the country, up from the 11th rank in 2005, according to data published by the Global Burden of Disease.

Ischemic heart disease continues to be the highest cause of death, followed by chronic obstructive pulmonary disease, cerebrovascular disease, lower respiratory infection, diarrhoeal diseases and tuberculosis.

In 2015, 346,000 people died of diabetes, which caused 3.3% of all deaths that year, with an annual increase of 2.7% from 1990, according to the Global Burden of Disease study.

Nearly 26 people die of diabetes per 100,000 population; diabetes is also one of the top causes of disability and accounts for 2.4% of the disability adjusted life years lost (sum of years lost due to disability or premature death due to the disease).

There are 69.1 million people with diabetes in India, the second highest number in the world after China, which has 109 million people with diabetes. Of these, 36 million cases remain undiagnosed, according to this 2015 Diabetes Atlas released by the International Diabetes Federation. Nearly nine percent in the age group of 20-79 have diabetes.

The figures are alarming since diabetes is a chronic disease that not just affects the pancreas’ ability to produce insulin but affects the entire body. Complications caused due to diabetes include heart disease, stroke, kidney failure, vision loss and neuropathy or nerve damage leading to leg amputation.

Unlike other countries, where a majority of people with diabetes are over 60 years old, the prevalence in India is among the 40-59 years age group, affecting productivity of the population.

“Diabetes strikes Indians a decade earlier than the world,” Anoop Misra, chairman, Fortis Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, New Delhi, told IndiaSpend. “This causes reduced productivity, increased absenteeism in working population and gives more time for complications to arise.”

Blame genes and changing lifestyles

Indians are especially predisposed to diabetes due to social and genetic reasons. Peculiar genetic composition of Indians known as "Asian Indian Phenotype" makes them appear thin but with fat depositions around their internal organs.

It makes them prone to greater abdominal fat, insulin resistance, higher levels of bad fat and increased chances of suffering from diabetes and coronary artery disease.

Lifestyle changes with reduced physical activity and carbohydrate-rich diets, along with environmental factors, are increasing India’s diabetes burden, IndiaSpend reported in June 2015.

Cost of diabetes

It is estimated that diabetes patients in urban areas spend Rs 10,000 and patients in rural areas spend Rs 6,260 every year on treatment, according to a 2013 study published by The Association of Physicians of India.

Since most of the healthcare cost is borne out of pocket in India, those in lower economic groups have to bear the greatest burden. Urban poor spend as much as 34% while rural poor spend 27% of their income on diabetes treatment, the study found.

India is predicted to have 123 million diabetes cases aged between 20 and 79 by 2040, according to estimates by the International Diabetes Federation. “We need a national campaign on the level of pulse polio to tackle diabetes, it is soon going to be a problem bigger than TB, HIV and malaria together,” Misra said.

Even though diabetes features in the National Health Mission’s National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke for district-level intervention to prevent non-communicable diseases, it needs to do more to screen, create awareness and monitor and treat the disease to stem the tide.

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Modern home design trends that are radically changing living spaces in India

From structure to finishes, modern homes embody lifestyle.

Homes in India are evolving to become works of art as home owners look to express their taste and lifestyle through design. It’s no surprise that global home design platform Houzz saw over a million visitors every month from India, even before their services were locally available. Architects and homeowners are spending enormous time and effort over structural elements as well as interior features, to create beautiful and comfortable living spaces.

Here’s a look at the top trends that are altering and enhancing home spaces in India.

Cantilevers. A cantilever is a rigid structural element like a beam or slab that protrudes horizontally out of the main structure of a building. The cantilevered structure almost seems to float on air. While small balconies of such type have existed for eons, construction technology has now enabled large cantilevers, that can even become large rooms. A cantilever allows for glass facades on multiple sides, bringing in more sunlight and garden views. It works wonderfully to enhance spectacular views especially in hill or seaside homes. The space below the cantilever can be transformed to a semi-covered garden, porch or a sit-out deck. Cantilevers also help conserve ground space, for lawns or backyards, while enabling more built-up area. Cantilevers need to be designed and constructed carefully else the structure could be unstable and lead to floor vibrations.

Butterfly roofs. Roofs don’t need to be flat - in fact roof design can completely alter the size and feel of the space inside. A butterfly roof is a dramatic roof arrangement shaped, as the name suggests, like a butterfly. It is an inverted version of the typical sloping roof - two roof surfaces slope downwards from opposing edges to join around the middle in the shape of a mild V. This creates more height inside the house and allows for high windows which let in more light. On the inside, the sloping ceiling can be covered in wood, aluminium or metal to make it look stylish. The butterfly roof is less common and is sure to add uniqueness to your home. Leading Indian architecture firms, Sameep Padora’s sP+a and Khosla Associates, have used this style to craft some stunning homes and commercial projects. The Butterfly roof was first used by Le Corbusier, the Swiss-French architect who later designed the city of Chandigarh, in his design of the Maison Errazuriz, a vacation house in Chile in 1930.

Butterfly roof and cantilever (Image credit: Design Milk on Flickr.com)
Butterfly roof and cantilever (Image credit: Design Milk on Flickr.com)

Skylights. Designing a home to allow natural light in is always preferred. However, spaces, surrounding environment and privacy issues don’t always allow for large enough windows. Skylights are essentially windows in the roof, though they can take a variety of forms. A well-positioned skylight can fill a room with natural light and make a huge difference to small rooms as well as large living areas. However, skylights must be intelligently designed to suit the climate and the room. Skylights facing north, if on a sloping roof, will bring in soft light, while a skylight on a flat roof will bring in sharp glare in the afternoons. In the Indian climate, a skylight will definitely reduce the need for artificial lighting but could also increase the need for air-conditioning during the warm months. Apart from this cleaning a skylight requires some effort. Nevertheless, a skylight is a very stylish addition to a home, and one that has huge practical value.

Staircases. Staircases are no longer just functional. In modern houses, staircases are being designed as aesthetic elements in themselves, sometimes even taking the centre-stage. While the form and material depend significantly on practical considerations, there are several trendy options. Floating staircases are hugely popular in modern, minimalist homes and add lightness to a normally heavy structure. Materials like glass, wood, metal and even coloured acrylic are being used in staircases. Additionally, spaces under staircases are being creatively used for storage or home accents.

Floating staircase (Image credit: Design Milk on Flickr.com)
Floating staircase (Image credit: Design Milk on Flickr.com)

Exposed Brick Walls. Brickwork is traditionally covered with plaster and painted. However, ‘exposed’ bricks, that is un-plastered masonry, is becoming popular in homes, restaurants and cafes. It adds a rustic and earthy feel. Exposed brick surfaces can be used in home interiors, on select walls or throughout, as well as exteriors. Exposed bricks need to be treated to be moisture proof. They are also prone to gathering dust and mould, making regular cleaning a must.

Cement work. Don’t underestimate cement and concrete when it comes to design potential. Exposed concrete interiors, like exposed brick, are becoming very popular. The design philosophy is ‘Less is more’ - the structure is simplistic and pops of colour are added through furniture and soft furnishings.

Exposed concrete wall (Image Credit: Getty Images)
Exposed concrete wall (Image Credit: Getty Images)

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