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Tsunami induced hyperglycemia and diabetes mortality--two studies from south India.

Stress induced hyperglycemia is a well-known feature of “General Adaptation Syndrome” (arousal, resistance, exhaustion), but it is known to reverse. If a subpopulation of Tsunami (or earthquake) affected persons turns diabetic after PTSD, then further studies are warranted to study affected/non affected groups with reference to anxiety-depression scale. Earthquake survivors, terrorism affected and such groups can be subjected to retrospective cohort studies. The neuroendocrine response to stress now is well studied and is a complex interplay of neuro peptides, cortisol-cortisone axis, epinephrine and other catecholamines as well as several other hormones. Currently there are more than 150 published papers of ‘stress’ and ‘hyperglycemia’ which have yielded variable results. Stress still remains an poorly studied component in Asian Indian population and the current study needs a long term follow up to know its long term effects. Traditionally Indian systems like yoga has always aimed at stress modulation and need to be revisited. Asian Indians have higher prevalence rates of diabetes, premature coronary artery disease [CAD] and cardiovascular disease [CVD] mortality compared to other ethnic groups.5 Diabetes is one of the leading causes for morbidity and mortality worldwide. In recent years India has witnessed a rapidly exploding epidemic of diabetes.6 At present there are over 32 million diabetic individuals in India and these numbers are predicted to increase to nearly 80 million by the year 2030.7 Environmental and lifestyle changes resulting from industrialization and migration to urban environment from rural settings may be responsible to a large extent, for this epidemic of Type 2 diabetes in Indians. In addition, there is also strong evidence that Indians have a stronger genetic predisposition to diabetes.8 It is also been shown that a typical Asian Indian phenotype with higher percentage of body fat and increased waist to hip ratio or any given body mass index (BMI) which predisposes to diabetes and the metabolic syndrome.9