SIX A’S TO COMBAT DIABETES

We have taken this initiative of introducing Art of Living with Diabetes to bring about a paradigm shift in the diabetes management system by moving the deeply fragmented model to a 360-degree care model. We researched on the six major knowledge gaps that has made this disease take such deadly turns in our lives. These gaps are classified as six A’s.

· Awareness is low in India in the urban as well as the rural areas. Primary awareness about diabetes is unlikely if people are unaware about the risk factors like obesity, hypertension activity level and family history of diabetes. People rarely have the knowledge about the conditions and its complications. 

· Acceptability plays an important role post diagnosis in a diabetic patient. Usually, patients tend to go to the denial mode after diagnosis and social stigma also plays a role in it. It is important for the patient to accept his or her diabetic status and take the necessary steps immediately to avoid unnecessary complications.

· Access plays an important role in diabetes management and care. Due to lack of access to specialists in hospitals, patients tend to get diagnosed by a general practitioner who depend mainly on medication driven treatment rather than lifestyle intervention and other modern treatment options to manage the patients’ condition. Also, in most patients, use of insulin is delayed due to misconceptions, that its use may have adverse effects on health. 

· Adoption of a healthy diet and a daily exercise regime, apart from medication and monitoring is the key to significant lifestyle modification that aids in managing diabetes effectively. But most people with diabetes are not able to adapt to this new change due to the effort and discipline involved. Many youngsters, who have been newly diagnosed with diabetes, do not like to take their medication in public or reveal their condition to their friends primarily due to the social stigma attached to the condition when finding spouses. This attitude towards managing diabetes further worsens the condition. 

· Adherence to medication and regular monitoring is a key contributor to diabetes treatment outcome. Without regular blood sugar monitoring, control on blood sugar level becomes difficult leading to poor glycaemic control, which can directly raise the risk of complications and increase the cost burden. Improper adherence to the recommended guidelines of diabetes management is an issue present in India due to suboptimal knowledge, which leads to a delay in diagnosis and improper management of blood glucose levels 

· Affordability for treatment of diabetes and its associated complications is difficult for middle income families and mostly it is it is an out of pocket expense for patients. Since, it is a painless condition in the initial stage most people do not prefer to spend on its management. Hence, it can be considered that the financial burden borne by people with diabetes depends on their awareness level, economic status and social insurance policies available in their country.

Keeping all these aspects in mind, this course has been designed for common people which would help in combating this silent killer. Do remember, at times it is more than just medications that count in fighting a disease successfully.