Srinagar: When 30-year-old Shazia (name changed) found that she had developed diabetes, her already strained marriage hit new lows. Crippled by anxiety and doubt over her health, she slid into depression, which led to a divorce, and that only worsened her depression. Result – a toxic cycle which she is struggling hard to break.
“The fear of abandonment was so strong that she used to inject insulin in the washroom. Her worst fears came true when her husband found out about her disease and immediately sought a divorce,” the endocrinologist treating her said.
Diabetic patients in Kashmir complain of facing social stigma even today while consulting doctors and undergoing treatment, with young people complaining of especially tough social complications.
Sample this: A couple in their 40’s with a history of diabetes started bickering with each other at the doctor’s clinic.
“The female was already undergoing treatment for diabetes. Her husband’s test reports also confirmed his diabetic status. Rather than acknowledging the disease, he blamed his wife for contracting it from her. Despite being educated, he failed to understand that diabetes is non-contagious,” the doctor said.
Even as more Kashmiris get diagnosed with diabetes each year, there is still a lot of confusion and misinformation about the disease. Diabetes occurs when the body doesn’t produce enough insulin or can’t use it effectively. There are two types of diabetes – type 1 diabetes and type 2 diabetes. In type 1 diabetes, the body doesn’t produce insulin at all, making it one of the most common chronic diseases in children. In type 2 diabetes, the body doesn’t respond to insulin or is not able to make enough of it.
Official data reveals that eight percent of the population in the valley suffers from Type 2 diabetes. Further, 40-60 percent of the population are those with undiagnosed diabetes.
Many times, misunderstanding around the disease can cause people with diabetes to feel awkward or ashamed in their everyday lives.
On world diabetes day, The Kashmir Monitor listed a few considerations to help spread understanding of what people with diabetes experience.
“Stigma and discrimination can lead to worse health outcomes. People with diabetes report feelings of fear, embarrassment, blame, guilt, anxiety, and low self-esteem as a result of being stigmatized. These negative emotions can result in depression and higher levels of stress, which increases the risk of developing health complications such as retinopathy, macrovascular problems, and sexual dysfunction,” Dr. Mohammad Hayat Bhat, Consultant Endocrinologist at Govt Superspeciality Hospital, Government Medical College, Srinagar said.
He said in addition, stigma and prejudice may result in worse self-care and diabetes management.
“For example, I have encountered so many patients who avoid social activities, inject insulin only at home (and thus delaying or omitting injections), make unhealthy food choices to avoid declining what is offered, and, when possible, manipulate glucose diaries and data to avoid judgment from significant others or healthcare professionals,” he said.
Dr. Sheikh Mohammad Saleem, Community Medicine Specialist said breaking myths around the disease is also the need of the hour and can help one fight the deadly effects of the disease better.
“There is a popular myth that if a person is put on insulin it means his disease is severe. In reality, insulin is suggested to some for particular reasons like high HBA1C (3months’sugar average), increased urination, losing weight, etc. In some these can be reversed especially with controlling weight, bringing BMI to less than 23, etc,” Saleem said.
Similarly, he said the second common misconception is that diabetes is caused by eating sweet food or sugar “The truth is there are multiple contributing factors in the occurrence of disease including genetic and lifestyle,” he said.
Saleem added some patients also believe that lifestyle changes like morning walk and a healthy diet are not effective as their blood sugar level remains high despite following them.
“Moderate intensity work-out (brisk walk/strength and weight training) that makes one sweat for at least 45 minutes for almost 6 days a week and strict diabetic diet is known to minimize the need for higher doses and more classes of diabetic meds for good sugar control,” he said.