I left New York on a chilly New Year’s Day to embark on a research and care mission in southern India. The experience would expose me to a fascinating culture and allow me to pursue my clinical research passion: reversing the tide of diabetes, a disease that is projected to reach epidemic proportions in India and across the globe over the next decade.
As a research fellow in endocrinology at Einstein, I am part of Dr. Meredith Hawkins’ clinical research team seeking a better understanding of global diabetes. My work focuses on the basic mechanisms concerning obesity and insulin resistance and how these mechanisms relate to diabetes development. One of our objectives is to devise and implement ways to improve diabetes care here in the Bronx.
In India I was looking to apply those lessons on a global scale by partnering with the Christian Medical College in Vellore.
Just a few days after my arrival, as I was traveling back to my temporary housing, I exited my bus earlier than I should have and realized I was lost. The initial moments were unsettling. I was in an unfamiliar setting, thousands of miles from home. A nearby auto driver saw what was happening and insisted on showing me the way, later refusing a small cash tip as a “thank you.” This random act of kindness made me feel immediately welcome. I felt even more committed to helping the Indian people in their fight against diabetes.
From the onset of my stay, I found unexpected parallels between the work I do in the Bronx and that done at Vellore. Research studies in both places are done in a similar manner, which reduced the learning curve for me. My interactions with patients made a strong impression on me. I was filled with concern for their well-being—and also with questions: “Will they forget their medication?” I wondered. “Will they wear the proper footwear? Why aren’t diet and exercise appealing?” These questions are similar to the ones I ask in the Bronx.
In Vellore, I was particularly interested in learning more about malnutrition-modulated diabetes, often referred to as “lean diabetes,” a condition in which individuals may get quite ill, but don’t have type 1 diabetes.
Lean diabetes is where India and the Bronx diverge. In the United States, the onset of diabetes later in life is often associated with increased body mass index (BMI)—the ratio of a person’s weight to his or her height. Patients in India tend to have much lower BMIs.
Studying this group of Indians with lean diabetes might provide answers that could help stem the looming Indian diabetes epidemic. Our questions include: Why is the incidence of diabetes increasing so rapidly in India? Why are so many with lean body mass starting to show clinical signs of diabetes? And what other factors might be involved?
Reflecting on my experiences in India, I realize that feeling “close to home” made studying diabetes from a global perspective even more important to me. I left Vellore with a renewed sense of purpose concerning my research and a richer understanding of how the experience of diabetes can cross time zones, continents and cultures.
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Perhaps this divergence in diabetes onset relative to BMI might be attributed to higher body fat composition among people of South East Asian descent. I was informed of this discrepancy by SATHI director Dr. Sunanda Gaur at Robert Wood Johnson Medical School in NJ. https://rwjms.rutgers.edu/global_health/sathi/research.html
The work you are engaging is exciting and profound. I look forward to hearing about your journey and your discoveries. Sincerely, Melissa
It’s good that you think about the condition of India but in india there is a lack of awareness.When the people will become aware.the half of work will complete automatically.