Quaternary prevention and diabetes

Sixtyeight year old man, a farmer by profession, with diabetes for the past 10 years, experienced chest pain, and was referred to a cardiology centre in the city, after the family physician diagnosed coronary artery disease. The cardiologist suggested a coronary artery bypass graft (CABG), an expensive proposition for the middle class family. His wife borrowed the money from the village money lender, at exorbitant interest rates, in the hope that he would be cured. After the surgery, the gentleman can hardly walk 10 metres without getting breathless, and has had to stop farming, thus losing the only sustainable source of income for his family. He feels he could have prevented this state of affairs, had he paid attention to control of diabetes earlier.