Annals of Pharma Research
ISSN: 2347- 1956
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A SURVEY ON BEHAVIOR OF DIABETES PATIENTS IN KANPUR SOUTH-UTTAR PRADESH, INDIA
Anupam Kr Sachan*, Neelkanth M Pujari, Raj Kumar and Saurabh Singh
Dayanand Di nanath College, Institute of Pharmacy, NH#86, Hamirpur Road, Ramai pur, Kanpur-209214, Uttar Pradesh
ABSTRACT
A survey was carried out among an adul t urban/rural
population of Indi a to assess the patients medication
choi ce for diabetes mellitus in Kanpur south region (U.P.
state). Exactly a hundred people with diabetes were
randomly selected for listing and questioned about their
currently used anti-diabetic therapy/medicine. The
diabetic status of the subjects was self-reported. The
patients with diabetes were independent of age, being
affected from diabetes, for their activities of daily living
were included in the survey. Among the total patients,
80% are mal e and 20% are females. The 47% of the
studied population are servicemen, 20% are
businessmen, 13% are farmer, 10% hous ewife and 10%
are students amongst the total patients. The patients are
using marketed anti-diabetic products and natural
products. The patients are using 48% allopathic products,
28% herbal product and 19% natural products. Mostly
peoples came to know that 39% are diabetic at the age of
35-50 years, 20-35years (33%), above 50 years (21%) and
less people know below 20 years (7%). The peoples are
spending money on the buyi ng of anti-diabetic products
above Rs 500(40%), Rs 200-500(26%), Rs 100-200 (12%),
below Rs 100 (12%). In the market there are vari ous anti-
diabetic products are available like allopathic and herbal
drugs. The doctors and vari ous print/electroni c media
influence people to buy the anti-diabetic products.
Doctors influenced 69% of the population, 15% went for
their own choi ce, T.V. media influenced 10% people, and
the rest 6% of the studied population are influenced by
family advi ce. People are more keen to get faster relief
medications, as they are bus y in rush running life. People
preferably taking the Allopathic medications mostly
recommended by the RMPs. Yet they are well familiar to
the Herbal and Natural cure products. Herbal products in
the market are more costly, although have less side
effects. On other hand the home remedies, i.e. the
natural products are easily available and more effective
in long term curative treatment.
Key Words: population survey, Anti-diabetic products,
Herbal & Natural products
INTRODUCTION
Diabetes is one of the most serious medical condi tions
affecting our nation today. The number of people, who
have it, has been ri sing alarmingly. Diabetes used to be
referred to as adult onset diabetes, but no longer. In
recent years, the incidence among children and
adol escents has exploded. Much of that surge is due to
the dramatic increase in the last 20 years in the number
Corresponding Author: Mr. Anupam Kr. Sachan, Associate Professor, Dayanand Dinanath College, Institute of Pharmacy,
NH#86, Hamirpur Road, Ramaipur, Kanpur-209214, Uttar Pradesh, India.
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Research Article
OPEN ACCESS
of young people who are phys ically inactive and
overweight or obese.1
Diabetes represents a spectrum of metabolic disorders,
which has become a major health challenge worl dwide.2
The unprecedented economic development and rapid
urbanization in Asian countries, particularl y in Indi a has
led to a shift in heal th probl ems from communi cable to
non-communi cable diseases. Of all the non-
communi cable diseases, diabetes and cardiovascular
diseases lead the list.3
Diabetes is a disease characteri zed by elevation of blood
glucose (a sugar) caused by decreased production of the
hormone insulin and/or increased resistance to the
action of insulin by certai n cells. Glucose is the bodys
mai n fuel. When we eat carbohydrates (pasta, bread,
ri ce, grains, fruits, and vegetables), the digestive system
breaks them down into glucose, which is released into
the bloods tream so the body can use it for energy.
Glucose also gets stored in the liver as glycogen, which
can later be broken down back into glucose when the
body needs fuel.9
Insulin, which is produced in the pancreas, regulates both
the movement of glucose into the bodys cells and the
breakdown in the liver of glycogen into glucose. Both
actions are cri tical to keeping blood sugar levels within
normal ranges.1
Type 1 diabetes is the condi tion usually diagnosed in
childhood or the early teen years the pancreas, over a
relatively brief period of time, stops producing insulin
altogether. The onset of the disease is usually abrupt,
with severe symptoms that requi re immediate attention.
Type 1 diabetes is an autoimmune disease, which
means the body attacks itself. Specifically, aberrant
immune cells damage and destroy the part of the
pancreas that produces insulin. People with type 1
diabetes must inject insulin every day.
In Type 2 diabetes, the pancreas produces enough
insulin, at least in the early years of the disease. But for
reasons that are still not well understood, the bodys
cells become resistant or insensitive to it. To
compensate, the pancreas pumps out increasing
amounts of insulin to normal ize blood glucose levels.
Over time as long as a decade this ever-increasing
production becomes unsustai nable, and the pancreas
ability to produce insulin decl ines.
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Anupam Kr Sachan et al.,
As a result, the telltal e marker and probl em of diabetes
emerges: glucose levels ri se in the blood because it is
unable to enter the bodys cells. The excess glucose is
damaging to the bodys tissue and l eads to the symptoms
and complications of diabetes. When the blood glucose
level gets high enough, the sugar begins to appear in the
urine and causes increased uri nation.6,7
Elevated blood sugar puts a strain on almost every organ
and other parts of the body. Over years , it is particularl y
toxic to the bodys blood vessels; it causes them to
thicken. This leads to probl ems in the eyes and ki dneys,
the heart, the liver, and the blood circulation system.
High blood sugar also damages the nerves. Proper
treatment that keeps blood sugar in the normal range
sharply reduces the risk of these complications.8
Symptoms and Complications
The symptoms of type 2 diabetes tend to develop
gradually over time and i nclude:
Fatigue
Blurred vi sion
Frequent urination
Numbness or tingling in hands or feet
Increased thirs t and hunger
Infections and s low heal ing of wounds
Diabetes also significantly raises the ri sk of a host of
other probl ems. These include: stroke, nerve damage,
kidney damage; damage to the eye as well as total
blindness ; impotence, poor wound heal ing, and
susceptibility to infections that can worsen and requi re
amputations of toes, feet, or part of a leg. In addi tion,
people with diabetes are very likely to have other
dangerous heal th condi tions. One study found that 47
percent of people with diabetes had two other heart
disease ri sk factors (such as smoking, high blood
press ure, and high chol esterol), and 18 percent had three
or more.1
India Scenario
Diabetes has emerged as a major healthcare probl em in
Indi a. According to Diabetes Atlas published by the
International Diabetes Federation (IDF), there were an
estimated 40 million persons with diabetes in Indi a in
2007 and this number is predicted to ri se to almost 70
million people by 2025. The countries with the largest
number of diabetic people will be Indi a, China and USA
by 2030. It is estimated that every fifth person with
diabetes will be an Indi an. Due to these sheer numbers,
the economic burden due to diabetes in Indi a is amongst
the highest in the worl d. The real burden of the disease is
however due to its associated complications which lead
to increased morbi dity and mortality. WHO estimates
that mortality from diabetes, heart disease and stroke
costs about $210 billion i n Indi a in the year 2005. Much
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Annals of Pharma Research, 2014, 2 (02), 66-69
of the heart disease and stroke in these estimates was
linked to diabetes. WHO estimates that diabetes, heart
disease and stroke together will cost about $333.6 billion
over the next 10 years in Indi a alone.10,11
Rapid urbanization and industrialization have produced
advancement on the social and economic front in
developi ng countries such as Indi a which have resulted in
dramatic lifestyle changes leadi ng to lifestyle related
diseases. The transition from a traditional to modern
lifestyle, consumption of diets ri ch in fat and calories
combined with a high level of mental stress has
compounded the probl em further.13 There are several
studies from vari ous parts of Indi a which reveal a rising
trend in the preval ence of type II diabetes in the urban
areas. A National Urban Survey in 2000 observed that the
preval ence of diabetes in urban Indi a in adul ts was 12.1
per cent per cent. Recent data has illustrated the impact
of socio-economic transition occurring in rural Indi a. The
transition has occurred in the last 15 years and the
preval ence has risen from 2.4 percent to 6.4 percent.4,12
MATERIALS AND METHODS
We carri ed out the study amongst pers ons with diabetes
from urban/rural Indi a with the objective of
understanding their perceptions, attitudes and practices
in relation to their disease and its management. The
study design was an initial listing followed by a
qualitative survey using a structured questionnaire.5
Exactly, a hundred people with diabetes were randomly
selected for listing and questioned about their currently
used anti-diabetic therapy/medicine.
The diabetic status of the subjects was self-reported. The
patients with diabetes were independent of age, being
affected from diabetes, for their activities of daily living
were included in the survey. The survey was conducted
by researchers in the language understood by the
patients, in their own homes, at a time convenient to the
patients. The questionnaire consisted of both, option
lists, as well as open ended questions dependi ng on the
information being elicited. The information collected was
recorded on structured forms codi fied for computer
analysis. The validity of collected data was reconfi rmed
by random counter checks and repeat interviews.
Fig. 1: Gender of popul ation
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Anupam Kr Sachan et al.,
Fig. 2: Occupation of Popul ation
Fig. 3: Type of Diabetic medication
Fig. 4: Age of being Diabetic
Fig. 5: Monthly expenditure on
Fig. 6: Source of Knowledge
RESULTS
Among the total patients, 80% are mal e and 20% are
females [Fig.1]. The 47% of the studied population are
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Annals of Pharma Research, 2014, 2 (02), 66-69
servicemen, 20% are businessmen, 13% are farmer, 10%
hous ewife and 10% are students amongst the total
patients [Fig.2]. The patients are using marketed anti-
diabetic products and natural products. The patients are
using 48% allopathic products, 28% herbal product and
19% natural products [Fig.3]. Mostly (39%) peoples came
to know that they are diabetic at the age of 35-50 years,
20-35years (33%), above 50 years (21%) and l ess people
know below 20 years (7%) [Fig.4]. The peoples are
spending money on the buyi ng on diabetes products
above Rs. 500(40%), Rs. 200-500(26%), Rs. 100-200
(12%), below Rs. 100 (12%) [Fig.5]. In the market there
are vari ous anti-diabetic products are available like
allopathic and herbal drugs. The doctors and vari ous
print/electroni c media influence people to buy the anti-
diabetic products. Doctors influenced 69% of the
population, 15% went for their own choi ce, T.V. media
influenced 10% people, and the rest 6% of the studied
population are influenced by family advi ce [Fig.6].
CONCLUSIONS
The aims of this survey were to identify a population-
based cohort of diabetic patients. Multiple independent
data sources were used and the capture-recapture
method was appl ied to estimate the completeness of
ascertai nment of the survey. This study was undertaken
to provide a basis for the planni ng of medication
interventions to improve diabetes care and a baseline for
future eval uations of trends in di abetes care. This report
documents the survey methodol ogy and provides
validating data on the techni cal survey execution. Over
the last decade, a broad expansion has occurred in the
tools and techni ques for the clinical management of
diabetes. This has been accompanied by significant
changes in recommended approaches to the care of
patients with this disease. Most of the people are using
the allopathic and herbal products of vari ous
pharmaceutical companies of Indi a. The Doctors and
print/electroni c media are more frequently influenci ng
the people to purchase the pharmaceutical anti-diabetic
products.
People are more keen to get faster relief medications, as
they are busy in rush runni ng life. People preferably
taking the Allopathic medications mostly recommended
by the RMPs. Yet they are well familiar to the Herbal and
Natural cure products. Herbal products in the market are
more costly, although have less side effects. On other
hand the home remedies, i.e. the natural products are
easily available and more effective in long term curative
treatment.
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