Diabetes is no longer the disease of the rich..........will place a very heavy social and economics burden on countries.

Diabetes is no longer the disease of the rich. According to medical experts, majority of cases are among the middle income group and poor. Diabetes is also increasingly an Asian problem. And while still closely associated with bulging waistlines, the disease is now appearing in Asians who are hardly obese, so-called "lean diabetics".

Type 2 diabetes, once called adult-onset diabetes is even appearing in children. In Malaysia, China, Vietnam and Singapore, even pre-teen children are developing type 2 diabetes. In the pas, only type 1 diabetes, which is related to the genes than the environment, was seen in children.

According to experts, they may be the first generation of children that die before their parents. With diabetes appearing across a wider range of age, weight and area than ever before, alongside the obesity epidemic, it is set to be one of the 21st century's biggest health challenges.

Already in the United States, an epidemic of type 2 diabetes has assumed gargantuan proportions. The epidemic has burgeoned alongside an expanding obesity problem, rising faster than heart disease and certain cancers. One in three Americans born in the last five years will develop diabetes. Globally the number of diabetics is expected to double in the next 20 years to 333 million. Yet, it is in Asia Pacific region where the pace and scale of the global epidemic is most alarming.

India alone has some 33 million diabetics and that number is set to double in 20 years. In Malaysia, 1996 data shows that some two million Malaysians have diabetes.

Why has the disease become so prevalent across Asia ? Rapid development has brought on dietary changes as well as reduced physical activity. Smoking, alcohol and the environment are factors. Urbanization in particular motorization has led to reduced physical activities. In Hanoi, Vietnam for example, diabetes has doubled because people have switched from bicycle to motorbikes.

In addition, today's diets are higher in calories. Preparation and processing determine the health value of foods. Red or unpolished rice for example is healthy compared to briyani as well as other refined foods. Polished white rice is likened to eating sugar !

The "coco-colonization" of society -- the spread of Western junk food -- is also a problem. But even traditional meals eaten out often have more calories than when prepared at home. Thus, less exercise and higher calorie intake is contributing to higher risks of diabetes.

It is this situation that is leading to a growing obesity problem. Today, one is six children in New Delhi is fat. There are similar statistics in major Chinese cities. Malaysia has the highest number of overweight people, with one in four tipping the scales.

Most Asian nations are ill-prepared to cope with this crisis. Put frankly, a diabetes epidemic is too costly and burdensome for many countries -- and families -- to bear.

The reason why diabetes is so costly and debilitating is because it affects every single organ of the body. Thus, there is urgent need for preventive action. The right message about diet and exercise has to filter through or else millions of people would be needing bypasses, kidney dialysis and laser treatment in 10 to 15 years. There is also a need for better testing and awareness as people with diabetes are not even diagnosed. Many countries also do not have diabetes plan.

The healthy lifestyle program must be intensified. Diabetes management at clinics also must improve considerably for monitoring, regular eye checks and foot care. All effort must be made to tackle this "disease of development" which, if uncontrolled, will place a very heavy social and economics burden on countries.

Summary: Majority of diabetes cases now are among the less rich afflicting an increasing number Asians. Type 2 diabetes is affecting children and even thin people due to environmental and lifestyle factors. it is a health challenge in Asia as the rate of diabetes is expanding rapidly and alarmingly alongside obesity. Dietary changes due to rapid modernization, lack of exercise, smoking, alcohol, diet rich in calories and refined carbohydrates as well as spread of Western junk food are contributory factors. Diabetes adversely affects body organs requiring urgent preventive action. Dissemination of information related to proper diet and exercise is vital as well as better testing and awareness to prevent a major health crisis. Program on healthy lifestyle and diabetes management and monitoring at clinics must be bolstered and improved.