As the world observes World Diabetes Day on November 14, read how it has taken a toll on the health of many Indians.
What is Diabetes?
Diabetes is a medical condition that is caused due to insufficient production and secretion of insulin from the pancreas in case of Type-I diabetes and defective response of insulin for Type-2 diabetes. Under normal body circumstances, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level.
When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas to normalize the glucose level. In patients with diabetes, the absence or insufficient production of insulin causes hyperglycemia.
Prevalence in India
Diabetes is primarily a lifestyle condition that has increased alarmingly across all age groups in India, and the prevalence among the younger population has also increased above 10%.
The prevalence of diabetes in India has increased by 64 percent over the quarter-century, says a November 2017 report by the Indian Council for Medical Research, Institute for Health Metrics and Evaluation, and the Public Health Foundation of India.
About 98 million Indians could have diabetes by 2030 — these projections come from the International Diabetes Federation and the Global Burden of Disease project.
Worryingly, in India, a large number of children are also impacted by diabetes. Children are developing obesity and metabolic syndrome early because of the change in diets to more processed and fast foods.
While there are several health conditions that Indians are combating, diabetes is one of the most important. This was clearly shown by the Covid-19 pandemic where it was those with comorbidities like diabetes who had worse outcomes including the dreaded mucormycosis or the black fungus.
With the country having the highest number of diabetic patients in the world, the sugar disease is posing an enormous health problem to our country today.
According to a World Health Organization (WHO) fact sheet on diabetes, an estimated 3.4 million deaths are caused due to high blood sugar in the world.
Why Indians are more prone to diabetes
The current exponential rise of diabetes in India is mainly attributed to lifestyle changes. The rapid change in dietary patterns, physical inactivity, and increased body weight, especially the accumulation of abdominal fat are some of the primary reasons for increased prevalence.
Ethnically, Indians seem to be more prone to diabetes as compared to the Caucasians, although the precise mechanisms are not well known.
The epidemic increase in diabetes in India along with various studies on migrant and native Indians clearly indicate that Indians have an increased predilection to diabetes which could well be due to a greater genetic predisposition to diabetes in Indians.
At the same time, the increased ‘westernization’, especially in the metros and the larger cities, has led to a drastic change in our lifestyle with changes in our traditional diets and decrease in physical activity.
With the increasing availability of machines to do our work, there’s also a substantial drop in day-to-day activities. The rural migration to urban areas also does play a role. Stress, of course, does play a role, but it’s difficult to quantify.
Currently, India is undergoing a rapid epidemiological transition with increased urbanization. The current urbanization rate is 35% compared to 15% in the 1950’s and this could have major implications on the present and future disease patterns in India with particular reference to diabetes and coronary artery disease.
Environmental and lifestyle changes resulting from industrialization and migration to urban environments from rural settings may be responsible to a large extent for this epidemic of Type 2 diabetes in Indians.
Obesity, especially central obesity and increased visceral fat due to physical inactivity, and consumption of a high-calorie/high-fat and high sugar diets, thus become major contributing factors.
Another factor that is not under our control is that we Indians have a greater degree of insulin resistance which means our cells do not respond to the hormone insulin. And when compared to Europeans, our blood insulin levels also tend to rise higher and more persistently when we eat carbohydrates.
Managing Diabetes
India has a challenge to face undoubtedly. However, medical experts feel that timely detection and right management can go a long way in helping patients lead a normal life.
Though a chronic medical condition, Diabetes can be curbed at the initial level by introducing lifestyle changes and controlled after its incidence through medicines in early stages and administration of external insulin in advanced stages. But it would not be wrong to say that it cannot be cured completely and lasts a lifetime.
An individual diagnosed with diabetes should adopt lifestyle changes which include maintaining ideal body weight, regular physical activity, cessation of tobacco smoking, stopping/ minimum alcohol intake. Beyond that, regular visits to the doctor are important to assess sugar control and assessment/ prevention of complications related to the disease.
