Diabetes is a global disease. The disease has almost taken form of an epidemic in developing countries; its occurrence exponentially increasing with factors such as age and obesity.
Being diagnosed with Diabetes Mellitus has a profound effect on many people. Early-onset Diabetes/ Insulin-dependent Diabetes/Diabetes Mellitus Type 1, which often occurs in children and teenagers represents their premier experience of disease. Even in adults, diabetes brings along a wave of other complications – cardiovascular diseases, diseases related to the eyes, frequent non-healing injuries, to name a few.
The most challenging task is to cope with the knowledge that diabetes is incurable, life-long and a slow killer.
It is much like an attention-seeking toddler: you have to keep an eye on it all the time, you have to sacrifice your preferences to take care of it, and you can never tell what it will grow on to become.
While the entire world faces the risk of growing diabetes, we Indians need to take special precaution. Here’s why:
1. At the beginning of the 21st century, India was the leading country in number of diabetics, according to research by WHO.
At the beginning of the 21st century, India topped the world with the highest number of people with diabetes mellitus (31.7 million), followed by China (20.8 million) and the United States (17.7 million) in second and third places respectively. Although the country has now been overtaken by China in the top spot, Diabetes currently affects more than 62 million Indians, which is more than 7.1% of the world’s adult population.
2. 88% of all South East Asians affected by diabetes are Indians.
Out of 78 million people affected by diabetes in the South East Asia Region, 69.1 million = 88.5% cases were prevalent in India ALONE.
3. Indians are genetically predisposed to a condition called Insulin Resistance.
Genetic predisposition to Diabetes plays a major role in why diabetes is one of the leading diseases in our country. The occurrence of Type 2 diabetes in Asian Indians is higher mostly because they have a greater degree of insulin resistance compared to Caucasians. This increased insulin resistance arises from the Asian Indian phenotype consisting of higher rates of abdominal obesity and increased visceral fat.
4. Even newborns of Indian origin show higher susceptibility than other newborns.
Studies also showed that Indian new-borns have lower insulin levels and greater adipose content even at birth when compared to Caucasians. The hypothesis is that small Indian babies have smaller abdominal viscera and low muscle mass, but preserve body fat during their intrauterine development, which may predispose to an insulin-resistant state.
5. Diabetes is more common amongst South Indians.
In a study conducted by National Urban Diabetes Survey (NUDS), the prevalence of diabetes in the population of the southern part of India was found to be higher:
Chennai – 13.5%
Bangalore - 12.4%
Hyderabad - 16.6%
Kolkata – 11.7%
New Delhi – 11.6%
Mumbai - 9.3%
6. A higher family income could mean a higher risk of diabetes.
Studies show that the prevalence of Insulin Resistance in the middle-income group (18.7%) was significantly higher compared to the low income group (6.5%).
7. If both your parents are diabetic, your risk of being diabetic is as high as 55%.
In the Chennai Urban Population Study (CUPS), the prevalence of diabetes was higher among subjects who had positive family history of diabetes (18.2%) compared to subjects without a family history of diabetes (10.6%). The overall prevalence of glucose intolerance (Diabetes + IGT) among subjects with two diabetic parents was significantly higher (55%) than those who had just one diabetic parent (22.1%), or if both parents were non-diabetic – 15.6%.
8. There exists a considerable amount of social stigma in India for young adults with DM Type 1; especially for girls.
Many parents try to hide their child’s condition from teachers, friends and relatives. Often, family members, especially parents resort to shaming or neglecting their diabetic child, causing ineffective insulin therapy and increased danger of complications. In case of girls, the main concern of most such parents tends to be, “Who will accept my diabetic daughter in marriage?” Even though type 1 diabetes in more common in girls than boys, the percentage of young-adult diabetic girls (ages 20-28) showing up for regular check-ups and treatment is only 50% as compared to boys. Social stigma surrounding diabetes is evidently higher in India for women than for men, and revolves around other gender-related social and cultural superstitions.
9. What can we do to prevent Diabetes?
Regular and adequate exercise, healthy diet and maintaining mental and emotional health are the most important aspects of preventing diabetes.
Young adults tend to be careless about their health, resulting in a cascade of problems in their early 40’s. It’s important to understand that the actions taken by a young body will always reflect the reactions on their older selves.
In addition to above points, you should know what can you do if you already have diabetes?
It is quite evident from all the conclusive studies that Indians, as a people, have a greater tendency to suffer from diabetes. However, thanks to technology, it is quite easy to routinely keep track of one’s own blood sugar using self-help devices such as Glucometers, Ketone Strips, Insulin Injections. Routine appointments with doctors should help to improve prognosis.
In case of an emergency where the diabetic patient has been rendered unable to help himself/herself, such as during a hypoglycemic attack (fainting, blurred vision), it’s important to let others know about his/her condition by keeping a Diabetes Wallet Card. This card contains all essential details about the diabetic patient, such as his/her name, age, residential address, emergency contact numbers, doctor’s name and contact number, insulin dosage. This will also help paramedics during the emergency to quickly tend to the patient.
Article by: Saylee Gokhale
Nizhny Novgorod State Medical Academy, Nizhny Novgorod, Russian Federation.