18 November, 2009 - Sixty-three-year old Chedup Gyeltshen never complained about food, nor does his wife remember him falling sick because of what he ate.

But it wasn’t until he started drinking lots of water that the couple sought medical care. The father of seven and a retired soldier was then diagnosed with diabetes. “He used to drink almost five litres of water everyday,” recalled his wife Passang. That was seven years ago.

Chedup’s pork paa diet had to be replaced with kharang (ground maize) and chapatti (unleavened bread). But his diet couldn’t be monitored regularly nor did he listen to his family’s insistence on exercising. “Whenever I was in the fields, he’d steal and eat sugar or milk powder,” said Passang. “And he fell sick every time he gave into his cravings.” Even on short walks, he would stop by the shops along the roads to buy sweets.

Chedup suffered burning sensations in his legs and small wounds on his body took a long time to heal. “He faints often, his body goes stiff and the soil, where he urinates turns almost black, like it’s burnt,” said Passang. He recently fainted in the toilet and was admitted to Thimphu referral hospital. At the hospital, he is given insulin shots thrice a day and his diet monitored.

Chedup is among the 1,487 registered diabetic patients in Thimphu. Most are above 45 years old and not literate. “There are some, who’ve been living with diabetes for 15 to 30 years,” said one of the dieticians, Pemba Yangchen.

Most cases seen in Bhutan are Type 2 diabetes, the result of a sedentary lifestyle and unhealthy diet, say health officials. “Bhutan has been seeing diabetes cases for the past decade,” said medical specialist Dr Tashi Wangdi. “It’s only in the past five years the government took serious notice, because by then the change in the disease pattern could be seen.” The program for lifestyle diseases with the health ministry, however, is only a year old.

According to the 2009 annual health bulletin, there were 2,541 diabetes patients nationwide, with 15 deaths last year. From 634 in 2004, it increased to 944 in 2005. In 2006, there were 1,470 cases of diabetes, which increased to 1,732 in 2007.

The “rich man’s disease” once more called for attention on November 14, when Bhutan marked the global diabetes day with a walk to create awareness on the disease. “Our message is that everyone, who is 40 years old, should get their sugar level checked, so that diabetic cases can be detected early,” said Dr Tashi Wangdi. “And those younger than 40 should check their sugar level annually.”

Diabetes, he said, is not a very expensive disease in terms of treatment, but it’s a chronic and progressive disease. “Early detection is the problem because people don’t realise that they are suffering from diabetes. But, in the long run, it damages the eyes, kidneys and heart and, when that happens, there is enormous burden on the health system,” he said. The symptoms include blurred vision, fatigue, slow-healing infections, increased appetite, thirst and urination.

Diabetes occurs when the level of sugar (glucose) in the body increases. The sugar then becomes a toxin and injures blood vessels. “When blood vessels are damaged, there is no flow of food and oxygen. The tissues die and then the other organs start failing,” he said. “It’s a slow poison but which will surely damage.”