Diabetes is a huge and growing burden, 69 million adults were living with diabetes in 2015 in India and this number is expected to increase to around 100 million or one in ten adults by 2040.
Indians are known to develop type 2 diabetes at a younger age and at a lower body mass index (BMI). A trial published in the year 2014 called as the CINDI trial demonstrated that 46%, i.e., almost half of the patients with type 2 diabetes are diagnosed under the age of 40 years in India. This group of young patients were further examined (CINDI 2 trial) to find whether they were at risk for developing a heart disease at a young age and the results were published recently in Indian Journal of Endocrinology and Metabolism. The risk factors included were smoking, high blood pressure, abnormal lipid levels, and being overweight or obese. Results demonstrated that the risk of developing a heart disease was very high even in young patients with type 2 diabetes.
- One in every four patients was a smoker.
- One in three had hypertension (high blood pressure).
- Two out of three had abnormal lipid (fat) levels.
- Four out of five young patients were overweight (BMI >23 kg/m2).
Importantly, the young population with type 2 diabetes has higher risk for developing diabetes complications at an earlier age than the older population. This highlights the importance of screening for these risk factors as well complications in this young population.
According to Dr. R Srinivasan, Consultant Endocrinologist, G K N M Hospital, “One in two adults with diabetes is undiagnosed. Many people live with type 2 diabetes for a long period of time without being aware of their condition. By the time of diagnosis, diabetes complications may already be present. Up to 70% of type 2 diabetes cases can be prevented or delayed by adopting healthier lifestyles.”
He further pointed out “With increasing levels of poor nutrition and physical inactivity among children in many countries, type 2 diabetes in childhood has the potential to become a global public health issue leading to serious health outcomes.”
About 50% patients with diabetes do not know they suffer from it. These patients are at high risk to land up with complications of diabetes. Moreover, in spite of improvement in diabetes care in the recent past, the percentage of undiagnosed diabetes patients are around the 50% mark. A large proportion of patients do not even know the general information on diabetes. Diabetes is commonly understood as a disease of high blood sugar; however the long term effects of this high blood sugar affects various organs of the human body and majority of the people are unaware of this aspect of diabetes. Thus the awareness needs to be increased in these aspects of diabetes.
“The management of diabetes and its complications begins in primary health care and this should include screening for diabetic retinopathy. Early detection and timely treatment of diabetic retinopathy can prevent vision loss and reduce the impact of diabetes on individuals, their care givers and society”, pointed out Dr. R SivaGnanam, Consultant Diabetologist, Kovai Medical Center and Hospital.
There is a lot of evidence that lifestyle changes (achieving a healthy body weight and moderate physical activity) can help prevent the development of type 2 diabetes. Obesity, particularly abdominal obesity, is linked to the development of type 2 diabetes. Physical activity is one of the main pillars in the prevention of diabetes. Increased physical activity is important in maintaining weight loss and is linked to reduced blood pressure, reduced resting heart rate, increased insulin sensitivity, improved body composition and psychological well-being. A balanced and nutritious diet is essential for health. A healthy diet reduces risk factors for cardiovascular diseases. There is evidence of a link between depression, smoking and both diabetes and cardiovascular disease.
Both short (<6h) and long (>9h) sleep durations is associated with Type 2 diabetes .Sleep deprivation may impair the balance of hormones regulating food intake and energy balance. Long sleep durations may be a sign of sleep-disordered breathing or depression and should be treated appropriately. There is also a close association between obesity and obstructive sleep apnoea syndrome (OSA), the most common form of sleep disordered breathing, remarked Dr. R SivaGnanam.
Common myths about diabetes is that it is caused due to eating high amount of sugar, neither it means that “taking insulin means you have failed”. But the fact is starting on insulin will help you to better manage your diabetes which, in turn, lowers your risk of developing complications.
Gestational diabetes mellitus is increasingly becoming common in Indian women with prevalence in some areas as high as 20%. Gestational diabetes mellitus (GDM), is when a woman without diabetes, develops high blood sugar levels during pregnancy. This condition makes the mother and the child at high risk for developing diabetes in the future after delivery. Maintaining healthy weight with regular exercise and healthy diet may prevent or delay the development of diabetes in the mother. A study carried out at a tertiary care diabetes centre on Indian women with GDM demonstrated that three out of five women with GDM developed diabetes after delivery. Of these half developed diabetes within 5 years and over 90%, within 10 years of the delivery. Thus, women with GDM should take utmost care, maintain a healthy weight, exercise regularly, eat healthy diet and most importantly screen for diabetes on regular basis.
Most people think of diabetes as only a disease with high blood sugar. While that’s true, it is also important to know that uncontrolled high blood sugar increases the risk of developing a number of serious health problems such as heart disease, blindness, kidney failure. A lot of diabetes patients even lose their foot due to uncontrolled sugar. In addition, people with diabetes also have a higher risk of developing infections. Maintaining blood sugar levels at or close to normal can help delay or prevent diabetes complications.
People with diabetes need regular monitoring of blood sugar to keep it under control and regular check-up of body organs, especially eyes, kidneys and feet.