Diabetes Mellitus: Busting Myths through Mythology

Of the two deities, Ganesha and Shiva, who do you think has diabetes? Hazard a guess!

shive and ganeshMythology suggests that Ganesha developed diabetes but was cured by a drug or treatment administered by Shiva appropriately named Shiv Gutika. If you search for Shiv Gutika on the interweb today you’ll run into generic and rather unfantastic suggestions of antioxidants, leaving you with little information to what this miracle drug may have been. To reverse engineer what Shiv Gutika may have been let’s perform a differential diagnosis with available info and some assumptions (only encouraged here to indulge our scientific/ mythological curiosity: (please avoid practising assumptions when controlling or managing diabetes).

Assumption 1- Ganesha is overweight and therefore has type 2 diabetes.
Ganesha was put on a diet and encouraged to exercise. This led to weight loss but, for the sake of argument, did not resolve diabetes.
Conclusion: Diabetes was not entirely diet and lifestyle induced.

ganesha_and_kuberaAssumption 2- Ganesha has an insatiable appetite (as evidenced through the story of Ganesha polishing off food of an entire settlement when invited by Kuber for a meal).
BBeyond polyphagia (an increased appetite) seen in diabetes there are individuals who suffer a complete deficiency of a hormone Leptin. Leptin is a hormone produced by the fat cells of the body that signals our brains that we’re full. Ergo a deficiency of leptin means that the body and brain no longer know when to stop. The appropriate remedy in this case may have been hormone replacement therapy. Let’s assume however that this did not correct the condition.
Conclusion: Ganesha is not Leptin deficient.

Assumption 3- Ganesha has immune dysfunction
He underwent a major transplant surgery (needing steroids in post-op care) at a young age, possibly leading to immune dysfunction and therefore diabetes. Hence, his diabetes may be steroid induced.
Immunomodulators may have been administered to restore and improve immune function while lowering inflammation.
Conclusion: Immune dysfunction may have led to diabetes (i.e. steroid induced diabetes).

shive gutikaAssumption 4- Ganesha has autoimmune type 1 diabetes
Ganesha may have been diagnosed with the autoimmune type 1 diabetes. This assumption may be supported by a subsequent gluten free diet since approximately 10% of individuals with type 1 diabetes also have celiacs disease. It may be possible that without well calculated carbohydrate counting he struggles with insulin dosage and therefore has heavy storage of fats around abdomen and major energy imbalance leading to an erratic appetite.
Conclusion: Shiv Gutika is Insulin.

This analogy should highlight that the nature of treatment and management of diabetes depends on the underlying pathology. Moreover prevention strategies can also be personalised and optimised based on better identification of individual risk factors.

Moving from Mythology to Myths about Diabetes

Diabetes-By-TypeAlthough historically Diabetes has been categorised as the aggressive but less frequent type 1 diabetes and the more frequent and lifestyle associated type 2 diabetes mellitus, it appears that the categories are expanding by the year. Beyond type 1 and 2, diabetes is now better recognised as that associated with pregnancy (gestational diabetes), single gene mutation based (maturity onset diabetes of the young or MODY), type 3 diabetes (Alzheimer’s disease), drug/ steroid induced diabetes and other forms where high blood glucose is secondary to another pathology. This leads us to the first myth:

#1 Diabetes is a metabolic disease

blood gloucose chart
As a matter of fact diabetes is a syndrome. Diabetes mellitus is the group of conditions that comes together to result in prolonged high blood glucose.

Insulin resistance, high blood pressure, obesity, high cholesterol, even autoimmunity are all underlying stimuli that lead to diabetes but should not be deemed to be the defining features of diabetes. Although we tend to emphasize more on these in India as there is a general lack of awareness about these basic problems as well.

#2 Type 1 diabetes is deadly but simple while Type 2 is milder but complex

Type 1 diabetes is traditionally understood as an autoimmune, aggressive condition that manifests in children and type 2 diabetes is associated with aging, lifestyle, genetics and body weight. Now the surprising thing here might be that as a matter of fact, the youngest individual diagnosed with type 2 diabetes is 3 years old and there is a growing population of adults with autoimmune diabetes referred to as the Latent Autoimmune Diabetes in Adults (LADA).
Interestingly recent research strongly supports that childhood obesity is contributing to expanding incidence of type 1 diabetes globally making both type 1 and type 2 diabetes complex conditions involving multiple genes and environmental contributors. Basically ‘khichdi’!

Bottom-line remains that in the absence of stringent control and management, all types of diabetes are deadly and massively affect the quality of life of individuals.

#3 Men are more prone to diabetes than women

men vs women with diabetes in india2
Recent epidemiological studies indicate that while the odds slightly better in favour of females, this is true for diabetes of the young. In adults the incidence of diabetes is approximately comparable between men and women. However female sex hormones (estradiols) act as protection against heart conditions until menopause i.e. men with diabetes have a higher risk of heart disease.

#4 Diabetes is a disease of the rich

The incidence of diabetes is comparable between First World countries and Third World countries. Infact within India the incidence of diabetes is comparable between the urban and rural populations. Investigations have also suggested that low cost and easily accessible processed foods in developing countries contribute to the growing population of obesity induced diabetes in less affluent populations. In a country where 270 million people live below the poverty line, obesity seems to be a distant issue, but India is under siege.

#5 Diabetes is just a way of life now, nothing a pill or insulin can’t solve

Yes and no! Ofcourse there are multiple pharmacological methods of controlling and managing diabetes however given the complexity of diabetes a clear diagnosis and understanding of the primary cause is critical. In a number of cases of lifestyle induced diabetes the condition can be practically reversed through changes in diet, stress management and exercise. Moreover, prevention is better than cure! Why manage a condition with medicine when you can take steps to lower your risk and improve your overall health. This also holds true for the multiple complications associated with diabetes.

Recent research is dedicated to population wide observations to better screen, detect and forecast diabetes potentially leading to a more personalised and targeted approach to treatment. Personalised medicine is the future of diabetes prevention and management, and with your involvement as an individual, this tool for healthcare can become a practical and immediately applicable. To learn more about personalised medicine and diabetes prediction write to me at kirti@medbiomarkers.com

About the Author:

kirti kaulDr. Kirti Kaul (Co-Founder at Dr. Mango & German Diabetes Centre post doctorate)
On mission to positively impact over a million lives in India through Diabetes research, awareness & prevention programmes.
Professional experience: LinkedIN
Publications: Research Gate

Your personalised preliminary Diabetes Risk Assessment: http://bit.ly/2bhkGT4

4 Comments on this article

  • Aparna September 17, 2016
    Nice analogy Kirti. And some of the myths busted. Looking forward for more such infortaining articles.

    Reply

    • Dr. Kirti Kaul September 17, 2016
      Thanks Aparna. Education and self-monitoring are the crucial tools and the future of healthcare. SKB is doing an incredible job of empowering individuals, but we still face a massive challenge with 1 in 5 Indians living with diabetes where unfortunately over 60% don't know of their diagnosis until a major complication has occurred. "Prevention is better than cure" should really be the mantra we all need to adopt to handle this epidemic. This relies on personalised medicine and early prediction. If interested we are currently offering a personalised preliminary diabetes risk assessment report. Please follow the linkhttp://bit.ly/2bhkGT4.

      Reply

  • Namita Joshi September 17, 2016
    Very useful piece! Please keep writing :)

    Reply

    • Dr. Kirti Kaul September 17, 2016
      Thank you Namita. Glad you found the post useful. Did you know diabetes claims a life every 7 seconds...that's more than HIV-AIDS...and diabetes is not contagious. "Prevention is better than cure" should really be the mantra we all need to adopt to handle this epidemic. This relies on personalised medicine and early prediction. If interested we are currently offering a personalised preliminary diabetes risk assessment report. Please follow the linkhttp://bit.ly/2bhkGT4.

      Reply

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