Wednesday, November 17, 2010
World Diabetes Day
Today is World Diabetes Day. All the monuments are lit in blue light. There are posters here and there. Diabetes has increased a lot in India. I saw several patients with diabetes in the Medical OPD.
I wonder why diabetes has increased so much. One reason is that some Indians are eating too much!! That is too much for an Indian person. Still a lot less then a Texan .
The second reason in that the “SINK TEST’ has been replaced by an easy mechanical blood strip test. This needs some explanation. When I was an intern here in this hospital, we used a special test called a sink test to see if a patient was diabetic or not. We would collect the patient’s urine and take it to the lab. There we would throw the urine in a sink and look at the splatter pattern. Based upon the splatter, we would write down that there was no glucose in the urine. And lord behold, everyone was negative for diabetes! Therefore, the incidence of diabetes in India was low at that time!
Before you get on your high horse and condemn me and my fellow interns you should know the reasons for the sink test. (By the way we employed the sink test for other tests too, like blood test for anemia. More on that later.) To test the urine for glucose we had to heat the urine in a test tube until it came to a boil. Then we added a chemical called ferrous sulphate. After five minutes of boiling, if the color changed from blue to orange the test was considered positive. We could do only one test tube at a time. Try doing that on fifteen patients. At ten minutes per patient, it would take a person two and half hours. Then we were supposed to test for protein and specific gravity of urine and then do some blood tests. Did I mention that we had to see patients, take and record histories, order treatment, draw blood, and start I/Vs?
One day during rounds, a professor examined my patient. He looked in the eyes of the patient. The patient was pale in color and was obviously anemic. The professor asked me what the patient's hemoglobin was. I said very confidently that the hemoglobin was 8.5 gm% (Normal being 14-16, the lower the number the more anemic you are). The professor said, “To me it looks like it is 7 gm%.” I said, “Professor I used the same test as you did, and the result came out a little different!”