Exploring Diabetes Prevention and Management in Chennai, India

– written by Pranati Panuganti, SURF Recipient

The Health Sciences Library

The Health Sciences Library

Many Indians like my grandmother are suffering from diabetes and other chronic diseases, which motivated me to pursue a summer internship at the Madras Diabetes Research Foundation (MDRF) in Chennai, India. My two-month stay in this urban city served a two-fold purpose: (1) To learn how food, culture, and other lifestyle practices influence the rapidly escalating prevalence of diabetes in Chennai, and (2) To analyze the effectiveness of a school-based intervention in teaching Chennai’s youth about diabetes.

At MDRF, I was a research assistant for the ORANGE study: Obesity Reduction, Awareness, and Screening for Non-communicable diseases through Group Education. Phase I of this study is a screener for diabetes risk factors in 2,000 randomly selected children from residential colonies in Chennai. During our 7:00AM field visits on Saturday mornings, my team performed anthropometric measurements, an oral glucose tolerance test, and administered a questionnaire about the child’s lifestyle practices. A trend I noticed among many participants is they do not willingly engage in sports or exercise. Rather, their physical activity seems to come from activities of daily living, such as getting to and from work.

After screening for diabetes in these colonies, select individuals with pre-diabetes or diabetes were invited to Dr. Mohan’s Diabetes Hospital for consultation. I met an 11-year old research participant who attends a boarding school where he only learns Sanskrit, and no math, science, or English. When the diabetologist asked about playtime, the boy’s eyes widened and he shook his hands to exclaim, “No! We are beaten if not studying!” I have learned this boy is one of many children in India who face barriers to healthy living stemming from illiteracy. Without being able to read and write, it is difficult for people like him to learn from intervention strategies and health promotion programs, such as pamphlets, posters, and presentations.

Phase II of the ORANGE study involved a school-based co-curriculum intervention for diabetes awareness and self-management training in children and adolescents across Chennai. I analyzed intervention results and identified several emerging themes. First, I found that students of lower socioeconomic status (SES) had trouble distinguishing non-communicable and infectious diseases. For example, many students from low SES suggested sanitation as a healthy habit to prevent diabetes. Among students of high SES, many mistakenly associate an expensive lifestyle with a healthy lifestyle. Finally, among both low and high SES students, there seems to be a lack of awareness of physical activity and an increased emphasis on diet as healthy behaviors to prevent or manage diabetes.

These issues and emerging themes call for two restructured intervention programs, one tailored towards students from low SES and one for those from high SES. This experience has taught me that improving the health of low-income populations depends on meeting the basic, grass-root needs of the people (such as clean water, clothing, and literacy), before intervening to improve diabetes prevention and management.

For more details & pictures, stop by my blog at: www.pranatiloveschennai.wordpress.com