Medical tourists who are going to South Asian countries for cheaper medical treatment risk picking up and spreading a new superbug.

This gene, known as New Delhi metallo-beta-lactamase, or NDM-1, was found in patients in Britain, who may have contacted it while receiving treatment in countries such as India and Pakistan.

The Lancet Infectious Diseases journal published a report this week claiming that researchers found this new gene to be common in India, Pakistan and Bangladesh.

NDM-1 is highly resistant to almost all antibiotics, including the most powerful class called carbapenems.

With increasing popularity of medical tourism, the scientists said they feared this new superbug could soon spread around the world.

Prof Timothy Walsh who led the research team, examined bacteria samples from hospital patients in Chennai and Haryana and also from patients referred to Britain’s national reference laboratory between 2007 and last year. They found 44 cases of NDM-1-positive bacteria in Chennai, 26 in Haryana, 37 in Britain, and 73 in other sites in Bangladesh, India and Pakistan.

Many of the infected British patients had travelled to these countries for different medical treatments, including cosmetic surgery, kidney or bone marrow transplants, dialysis, pregnancy care or burns treatment.

Reaction from the medical industry in India was expectedly strong.

The medical tourism industry in India has called this negative report an attempt to discredit a business that earned the country an estimated 20 billion rupees (US$423 million) last year.

Dr Yatin Mehta at Medanta, one of India’s best hospitals, dismissed these reports and claimed the hygiene standards in India’s hospitals are better than those of the National Health Service in Britain.

‘Multi-drug resistance can be found anywhere in the world,’ said Dr V.M. Katoch, Secretary for Health Research who also chairs the Indian Council of Medical Research. ‘It is unfair to blame India for that.’

This act of naming Superbug after New Delhi, while none of the samples collected was from Delhi and its presence in UK itself indigenously, appears a ‘Racially’ and commercially motivated act to malign Indian Medical tourism sector.” said Dr K M Kapoor, Senior Consultant, Cosmetic Surgery at Fortis Hospital, Mohali and a Medical Tourism exponent in India.

Looks like this “fingers pointing” will continue for a while.

People with diabetes detest the daily process of pricking their fingers to monitor their blood sugar levels. Despite this dreadful routine activity, it is necessary to manage and control this medical condition. Diabetes is a long-term illness characterised by high sugar levels in the blood. Patients either produce too little insulin to process the sugar or are unable to respond well to the insulin produced.

Fortunately there are now non-invasive methods to check your blood sugar levels.

Glucostat System, a Singapore company and Nanyang Technological University (NTU) have developed a prototype monitoring device using light to measure blood sugar readings.

Accordingly to the inventors, they accidentally discovered that light waveforms attached themselves differently to blood containing varying amounts of HbA1c, the sugar molecule that chemically attaches to the haemoglobin in the blood.

The more sugar in the blood, the more HbA1C will be present in the blood.

The device was made from a customised laser diode and all the patient needs to do is to place a finger over the probe for between 10 to 20 seconds. In May 2010, trials involving 30 people were carried, 19 of whom were non-diabetics. The remaining patients have chronic condition and whose blood sugar levels were badly controlled.

Blood was also taken at the same time to serve as a comparison and the results showed excellent correlation for both the high and low levels.

The inventors believe the test is presently one of the best ways to diagnose diabetes because it provides a more accurate reading of blood sugar levels. An average HbA1c level taken over time has also less variation than a one-off test.

The HbA1c test (also called glycolated haemoglobin) gives a result that shows how well the disease has been controlled over the previous six to 12 weeks. This will also show how effective the patient’s management plan is working. A non-diabetic’s HbA1c glucose reading is 5 per cent to 6 per cent and the goal in diabetes management is to reach 7 per cent or less. An HbA1c glucose reading of 8 per cent and above would mean the diabetes is badly controlled.

Some doctors said that while it is good to obtain the average HbA1c level without having to draw blood, a minute-by-minute or hour-by-hour blood-glucose monitoring may sometime be necessary. Patients need to be pricked three to four times a day, to ascertain whether the level is too high or too low under different conditions. This new prototype machine is still not able to give such live feeds. Also these readings may not be accurate due to fluctuations such as body temperature and blood pressure.

There are two other monitoring devices in the market namely skin testing and continuous glucose testing. There are disadvantages associated with both methods. Skin testing uses a special sensor pad which may irritate the skin and readings may be affected by sweat. Continuous glucose testing is expensive, costing up to $2000 and the sensory pad which is paced under the skin need to be moved periodically.

Despite these reservations these non-invasive screening technologies look promising and may radically change how diabetes could be managed in clinics and at home.