Silent Killer

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Earlier this year, Chan Tak "Anson" Shin developed a rash on his leg that wouldn't heal. Not overly concerned, he visited a doctor near his home in Hong Kong's New Territories and underwent a string of blood tests. The diagnosis? Type 2 diabetes, long known as "adult-onset diabetes." Genetically speaking, Anson was an ideal candidate for the disease. Both his grandfathers had suffered from it in their later years, as did his father and two uncles. And, by his own admission, Anson led a less than healthy lifestyle, spending most of his spare time playing a computer game called Heroes of the Three Kingdoms. He loved to eat too. He'd scarf down bags of potato chips at a sitting, and he dined at McDonald's and Pizza Hut several times a week. But in another sense, Anson was a shockingly unlikely victim of adult-onset diabetes. He was, after all, just a kid—a regular, somewhat plump 13-year-old boy.

Diabetes isn't behaving the way it did in the past. Forget your former notions of the disease: that it strikes old aunties and the rich, or that it seldom kills. Diabetes no longer cares about class distinctions or age—it's becoming as prevalent in Asian slums as in mansions, and it's ravaging the young like never before. The numbers are staggering. The World Health Organization (WHO) estimates that 177 million people worldwide have diabetes, a figure that's expected to surpass 300 million by 2025. Dr. Paul Zimmet, director of the International Diabetes Institute (IDI) in Victoria, Australia, predicts that diabetes "is going to be the biggest epidemic in human history." It has also increasingly become an Asian disease. Today, some 89 million Asians are thought to be diabetic, and four of the five largest diabetic populations are to be found in Asian countries. India has an estimated 32.7 million people with diabetes, according to the IDI. China has 22.6 million, Pakistan 8.8 and Japan 7.1.

The disease is also spreading more rapidly in Asia than anywhere else. Asia's count is expected to hit 170 million by 2025, with India and China together accounting for almost 100 million victims. Most of Asia is hopelessly unprepared for this health crisis, which will inundate hospitals and place increasing pressure on national healthcare budgets. But the toll of this disease is ultimately more personal and painful than these numbers can convey. You may susceptible yourself—your kids, too.

Diabetes attacks the body slowly and stealthily, leading to a common misconception that it's a relatively benign condition. Initially, it produces only subtle symptoms such as excessive thirst and frequent urination, so the patient is often unaware that anything is wrong. "Half the people with diabetes don't know they've got it," says Zimmet. "It's a silent killer."

In a healthy body, the pancreas releases the hormone insulin, which transforms blood sugar into energy. Diabetes interrupts the process. Untreated or unrecognized, the disease causes excess blood sugar to build in the veins. It gradually clogs blood vessels, damages body tissue, wrecks the eyes, the kidneys, the heart. This invites a host of miserable fates: strokes, heart disease, high blood pressure, kidney failure, blindness, amputations due to the loss of circulation. "Mortality statistics seriously underestimate its impact," says Dr. Hilary King, director of the WHO's diabetes unit, "since most people with diabetes die from its consequences rather than the disease itself."

There are two varieties of diabetes. Type 1—insulin-dependent diabetes—is an inherited autoimmune affliction wherein the pancreas doesn't produce insulin. In the old days, children who were forced to inject themselves with insulin before school each day were nearly all in this group: they were born with the disease, and they will die from it if they do not take insulin regularly. Arun Elayaperu-mal, a 16-year-old from Chennai, India, was diagnosed as Type 1 when he was barely three, though his family apparently had no prior history of the disease. "My wife and I were completely shattered," says Arun's father, Elayaperumal, who works at a zoo on the city's outskirts. The family couldn't afford insulin, but a local hospital gave it to Arun for free. Even so, his vision began to fail, and he went blind at 12. "I still remember climbing trees and playing cricket, and the colors of the animals," says Arun. He has thrived in a special school for blind and deaf children and now hopes to be a teacher. But his family was jolted anew when his sister, Elakkiya, was also diagnosed with Type 1. She was only two-and-a-half years old.

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