Diabetes Mellitus, commonly known as diabetes, affects about 9% of the world’s total population. As per the IDF Diabetes Atlas Ninth Edition 2019, there would be a whopping 700 million diabetics across the world by 2045. If we consider the cases that are never reported, it is almost an epidemic undercover. Not only adults but this disease also affects children and adolescents alike.
India is only second to China in having 77 million diabetics. Every 1 in 6 people diagnosed with diabetes is an Indian. The global health expenditure on diabetes alone in 2019 was USD 760 billion which is almost 10% of the total global health expenditure. This article attempts to understand this health menace which is creeping into our lives every single second.
Meaning of Diabetes Mellitus
In layman’s language, Diabetes Mellitus simply refers to increased sugar in the body. To be precise, it is a metabolic dysfunction in our body that impairs its ability to process blood glucose, commonly known as blood sugar, and turn it into energy. Glucose is a very important component of our overall health. It fuels our brain. Glucose when broken down effectively by our body provides energy for the cells that make up our tissues and organs. Diabetes disrupts this ability of the body to process glucose into energy.
Types of Diabetes
Type 1 Diabetes
This type of diabetes is generally found in children and adolescents. It is considered to be an autoimmune condition. In simpler terms, this means that the beta cells produced by the pancreas, that are responsible for producing insulin, are mistakenly attacked by the immune system and destroyed. Since no insulin is produced by the body, the body is unable to convert glucose into energy and thus the bloodstream contains high levels of sugar.
It is also known as insulin-dependent diabetes as insulin needs to be injected in the body from external sources using syringes, insulin pens that come with pre-filled cartridges and a thin needle, jet injectors, or even pumps.
Type 2 Diabetes
Traditionally this type of diabetes affected adults, but of late it has started affecting teens as well because of obesity. In this form of diabetes, the pancreas produces some amount of insulin but that is not enough to process all our sugar intake. Hence, the process of breaking glucose into energy slows down and there is an upsurge of sugar in the blood.
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The major difference between Type 1 and Type 2 diabetes is the production of insulin. While In Type 1, the body does not produce insulin at all, in Type 2 the production of insulin is not sufficient to meet the needs of the body. About 90% of people suffering from diabetes in the world have Type 2 diabetes. Type 2 diabetes is less deadly than Type 1 but if left untreated over a long period may cause damage to the eyes and kidneys.
Prediabetes
A lesser talked about form of diabetes that exists is called prediabetes. When the blood sugar is higher than normal but not high enough to diagnose it as diabetes, the condition is known as prediabetes. It serves as a warning to an individual to take appropriate steps before it becomes a full-blown disease. Prediabetes is generally reversible. In India, if your fasting sugar levels are between 100 -125 mg/dL, you are considered to be prediabetic. Since prediabetes generally has no symptoms, the majority of the cases go unreported.
Gestational Diabetes
This form of diabetes is linked to pregnancy and is mostly reversible if appropriate treatment is undertaken. It is generally developed during the 24th to 28th week of pregnancy and if not correctly managed might increase the risk of complications during delivery.
Types of Tests
There are various tests to confirm the existence of Diabetes. A doctor might ask the patient to undertake one of the tests, as deemed appropriate by him.
TYPE 2 Diabetes
For type 2 diabetes, the most common test asked to perform is the HbA1c test. It measures the attachment of glucose molecules to hemoglobin. This test result indicates blood sugar levels averaged over a period of 3 months. It does not need any kind of fasting.
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Another test usually done to ascertain diabetes is the Fasting Plasma Glucose Test which involves fasting for at least 8 hours before the blood sample is taken. If the result of this test is 126 mg/dL or higher on two separate occasions, Type 2 diabetes is confirmed.
A blood sugar test post 2 hours of eating a meal or a very sweet drink is also conducted. If the result is more than 200 mg/dL, the person is considered to be suffering from Type 2 diabetes.
TYPE 1 Diabetes
Detecting Type 1 diabetes can be tricky. All the tests performed for Type 2 Diabetes are repeated in this case also. Apart from that, the doctor can also advise tests like C-Peptide which is a measure of a kind of protein produced by the pancreas. Low levels of C-peptide in the test reports also suggest low levels of insulin. The test to check the presence of proteins that target insulin and destroy it can also be conducted to confirm Type 2 diabetes.
Cause of Diabetes Mellitus
Any specific cause of Type 1 and Type 2 diabetes has not been ascertained. However, doctors believe that genes play an important role in passing the disease from one generation to the other. If your parents are diabetic, it is highly likely that you will also contract this disease at some time of your life.
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Another major factor thought to be a cause of Type 2 is obesity. People having a weight which is more than 20% over their required BMI have an increased risk of developing Type 2 diabetes along with the other problems associated with it. Most often, obesity is a major cause of developing insulin resistance thus spiking blood sugars.
Why Indians Are More At Risk
As per the International Federation of Diabetes, approximately 77 million Indians have been diagnosed with diabetes. Add to this the number of unreported cases and you would know the magnitude of the situation. Why are Indians so susceptible to this disease? The answer lies in our genetic disposition.
Researches show that Indians have a greater degree of insulin resistance. This may have happened as a result of adopting modernisation and urbanisation in that section of society which went from being an agriculture-based to industrialised. Also, urban lifestyles have moved us away from physical activity.
Our traditional low-calorie diets have been replaced by high calorie ones especially in the urban setup. Both gave us the gift of fat deposited on our waistlines and diabetes. Our sedentary lifestyle is one of the major causes of the high precedence of diabetes in urban Indians.
Early Signs of Diabetes – When To Visit A Doctor
Early detection helps in controlling diabetes. If you are experiencing any of the following symptoms, it is advisable to get yourself tested as soon as possible:
- Increased urination
- Wounds take time to heal, even minor cuts and injuries heal slowly
- Weight loss for no other ascertainable reason
- Excessive hunger and thirst
- Fatigue or the feeling of being tired all the time.
Different Types of Diabetes Treatment
Diabetes has to be controlled as a combination of medication and lifestyle changes. Generally, diabetes is a lifestyle disease. If lifestyle is modified early on, the onset of this disease, esp. Type 2, can be completely averted or at least postponed.
Medicines: Insulin is an important part of the treatment of Type 1 diabetes. As the body is unable to produce insulin, it needs to be injected externally. In the case of Type 2 diabetes, if lifestyle changes are unable to manage it, non-insulin medicines are prescribed. At a later stage, it might be necessary to inject insulin as well.
Dietary Changes: Eating the right food is necessary to control diabetes. Sugar, sweets, baked foods, pastries and cakes, food made from All-Purpose Flour are a strict no. A diet low in carbs and high in fiber is advisable. Eating fruit in moderation instead of juices or diet soda is recommended. Care should be taken not to eat anything sweet even if it contains natural sugars empty stomach in the morning as that can shoot up the blood sugar levels.
Physical Activity: Obesity is another major cause of diabetes. Hence losing those extra pounds is definitely going to help in controlling this disease. Exercises, Yoga, meditation should form part of the daily routine. Walking is an excellent exercise to manage diabetes. Exercise is known to control blood sugar levels and make our body more sensitive to insulin.
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Prediabetes and Gestational diabetes can be completely reversed with the help of lifestyle changes. Even Type 1 and Type 2 diabetes can be well managed with a combination of these. So what are you waiting for? Get up and get going! Adopt a healthy lifestyle today!!