Mari Ruddy Returns from India!
I’m back in Minnesota from India and what an amazing trip it was. I went with Medtronic Diabetes, big shout out and thank you to Medtronic Diabetes CEO Katie Syzman, Medtronic International Marketing Director Hiten Chawla and amazing endocrinologist Dr. Shashank Joshi of Mumbai, India for making my dream a reality.
One thing I understood intellectually but didn’t really get until I got there and felt all those people around me was the sheer population of India with 1.2 billion people. I was in four major cities: Mumbai, Chennai, Ahmedabad, and Bangalore. Of those 1.2 billion, about 63 million have diabetes. Of those, it is estimated that 97-98% have type 2 diabetes, while 2-3% have type 1. Of those who take insulin, only about 4,500 use an insulin pump. It’s not that people in India don’t want pumps, they do. From the warm reception and interest I got, I am glad that Medtronic is stepping up to the plate in such a big way. People with diabetes in India want the best care and the best health. After all, who doesn’t! I talked to a variety of audiences and I talked about three things: we are what we eat, the body is meant to move, and use the best technology to take care of yourself. I also listened, and people in India are up against a lot of obstacles.
The first obstacle is food. Food in India is really yummy, but not exactly ideal for people with the challenge of diabetes. This is because the Indian diet is very high in carbohydrates and fat. Carb counting is pretty young in India. Not many people do it, and those that want to have to really swim upstream to be consistent and accurate. I found that I needed to raise my basal rate by almost 15% to cover the higher carbs, higher fat/oil and the decrease in my physical activity. I also increased my carb to insulin ration a smidge. I also found that it was very helpful to use my square wave bolus at almost every meal.
The second obstacle is exercise. I was impressed with the work ethic in India. The work days are long and most people work at their jobs six days a week. India is very extended family centric and so, between work and family, that doesn’t leave much time for exercise. Unless exercise is built into the day, which for many people it isn’t.
Another obstacle is health insurance. Health insurance doesn’t exist in India. The government doesn’t provide health care for anyone, except a few special programs for the very lowest income people. If you’re uninsured and have diabetes, you pay for everything out of pocket - insulin, testing supplies, doctor visits, as well as insulin pumps and ongoing supplies. Think about that. According to doctors and patients, “the cost of consumables is one of the biggest barriers to greater acceptance of pump therapy.” If you don’t have health insurance that helps cover the expense, would you have a pump? Even if you knew that it was the best option for your health? These are very tough questions, and the answers aren’t easy.
I had been listening and observing during my time in India. I realized that the key might be for Indian people with diabetes to overcome the obstacles using their skills. Something of a strength-based approach to wellness, instead of focusing on illness as motivation.
I observed two phrases that people used often. First one was, “I suffer from diabetes.” Second was, “there are a lot of restrictions that come with having diabetes.” In my work as an executive coach, I love to do a re-frame. And I did one that last night with the group. What if, instead of saying “I suffer from diabetes” people started to say, “I live with diabetes.” Or “I’m learning to live well with diabetes.” Suffering tells your whole being that this is a bad situation. It’s not that diabetes is fun, easy or great, not by any means. Instead, “living well with diabetes” tells me, and why not tell the world at the same time, that you are AMAZING! You are taking on a huge, difficult challenge and you are doing it!
I especially want to acknowledge the India Team from Medtronic Diabetes for jumping into the fray and having the courage and passion to have the tough conversations about the conditions in India surrounding health care and diabetes in particular. There aren’t any simple or easy answers. There are big political and social issues to unravel. In the meantime, I send profound gratitude to everyone I met for hosting me, for opening your hearts and for sharing India with me. I look forward to my next visit.
IMPORTANT SAFETY INFORMATION
- Medtronic Diabetes insulin infusion pumps, continuous glucose monitoring systems and associated components are limited to sale by or on the order of a physician and should only be used under the direction of a healthcare professional familiar with the risks associated with the use of these systems.
- Successful operation of the insulin infusion pumps and/or continuous glucose monitoring systems requires adequate vision and hearing to recognize alerts and alarms.
Medtronic Diabetes Insulin Infusion Pumps
- Insulin pump therapy is not recommended for individuals who are unable or unwilling to perform a minimum of four blood glucose tests per day.
- Insulin pumps use rapid-acting insulin. If your insulin delivery is interrupted for any reason, you must be prepared to replace the missed insulin immediately.