India is often called the “Diabetes capital of the world”, ever since India became the country with highest number of people suffering with Diabetes.
Diabetes is a chronic medical condition. It affects the way body metabolizes sugar, body’s important source of fuel. Insulin is a hormone that is needed to allow sugar (glucose) to enter in to cells to produce energy. Insulin is secreted by a gland called pancreas located in our abdomen, behind the stomach.
In Type 1 Diabetes, body produces little or no Insulin. Type 1 Diabetes usually appears in young children and adolescents, but can appear in adults. Type 1 Diabetes treatment involves insulin injections from the time of diagnosis.
In Type 2 Diabetes the body resists the effects of insulin or doesn’t produce the required amount of Insulin to maintain normal glucose level. Type 2 Diabetes usually presents in adulthood, but with increasing childhood obesity, it can appear in young children and adolescents. Type 2 Diabetes can be managed by medications for some time but eventually may need insulin injections.
In the last 3 decades, number of people suffering with Diabetes is steadily increasing in India. This increase can be attributed to urbanization and change in lifestyles of people.These changes include increased caloric intake in diet and decreased physical exercise. Smoking and alcohol intake along with Diabetes are also contributing to development of complications. Diabetes along with Hypertension, abnormal lipid profiles is contributing to coronary artery disease, which is the leading cause of death for people of India.
Urban rural divide is decreasing gradually as prevalence of Diabetes is increasing in rural India. Many people are unaware of their elevated blood sugars; take no measures towards control of blood sugars which leads to long term complications that are known to occur due to Diabetes.
The impact of Diabetes is more on people of low socioeconomic status as they have poor access to medical care and lack of affordability for testing and medications.
Not all type 2 Diabetics in India are overweight. Indians have increased risk of having Diabetes at a lower BMI compared to their western counterparts. Indians also are affected with Diabetes at a younger age
November 14 th is the world diabetes day dedicated for raising awareness about diabetes all over the world. The day is marked on the birthday of  Frederick Banting one of the scientists who discovered insulin for the treatment of Diabetes, along with other scientists Charles Best and Macleod.
While type 1 Diabetes which is the less common and accounts up to less than 10% of total Diabetes, cannot be prevented with the current knowledge, we can prevent Type 2 Diabetes by taking some measures.
What can you do to decrease your risk of type 2 Diabetes?
  • Maintain a healthy weight
  • If you are overweight, take measures to lose few kilos in a steady manner.
  • Include fruits and vegetables in your diet
  • Cut down diet high in calories, like processed foods and fast foods.
  • Include physical exercise in your daily routine. To begin with any activity is better than no activity.
  • As you are increasing your physical activity gradually, aim for at least 30 minutes of moderate physical activity daily and 45 minutes of vigorous activity per week. Check with your doctor before starting any high intensity physical activity.
  • If you have a family history of type 2 diabetes, your chance of getting type 2 diabetes is more. Get your blood sugars checked at regular intervals.
  • As you age, your chance of getting type 2 diabetes goes up.
  • Women having Polycystic ovarian syndrome are at increased risk for type 2 diabetes.
  • Women who had gestational diabetes (diabetes diagnosed during pregnancy, which usually resolves after childbirth) are at increased risk for getting type 2 diabetes.
  • If you have hypertension, get your high blood pressure under control.
  • If you have lipid abnormalities, discuss with your doctor about measures to take to bring them to desired levels.
Watch for these symptoms of Diabetes and seek immediate medical care
  • Frequent urination
  • Dryness of mouth and increased thirst
  • Frequent skin infections; frequent urinary and vaginal infections in women
  • Weight loss
  • Weakness and fatigue
  • Blurry vision
  • Some people with type 2 diabetes have patches of velvety dark skin at the back of the neck and skin folds. This condition is a sign of possible insulin resistance and is called acanthosis nigricans.
Long term complications from uncontrolled blood sugars are
  • Heart problems, causing angina, heart attack
  • Brain stroke
  • Kidney problems leading to end stage kidney disease
  • Eye problems sometimes leading to vision loss
  • Damage to nerves causing causing nonhealing  ulcers of the limb leading to lower extremity amputations.
  • People with Diabetes are more prone to depression.
If you are diagnosed with Diabetes, what can you do to avoid long term complications from Diabetes
  • If you are diagnosed with Diabetes, talk to your doctor if there are concerns. This helps in accepting the diagnosis, as denial and lack of follow up can worsen blood sugars and lead to long term damage to organ systems.
  • Discuss the management plan with your doctor. Remember that you are part of the team and need to share your concerns and limitations with your doctor for him to be able to help you with all possible choices.
  • If you are started on medications by your doctor, take them regularly as suggested by the doctor.
  • Have a plan for sick days and travel days by talking to your doctor.
  • Maintain regular follow ups as advised by your doctor.
  • Schedule eye check up yearly once and more frequently if the ophthalmologist suggests so.
  • Stick to the diet plan advised by the doctor. If you have concerns about the choices and the quantity of the food items, consider asking your doctor to refer to a nutrition expert who can give you some more choices and tips.
  • Always carry a high glucose snack or a juice carton with you for those instances when you experience symptoms of low blood sugar. It is common for every diabetic to have low blood sugars at sometime or the other.
References
  1. http://diabetes.diabetesjournals.org/content/63/1/53
  2. http://www.sciencedirect.com/science/article/pii/S0168822711001161
  3. http://www.heart.org/HEARTORG/Conditions/More/Diabetes/UnderstandYourRiskforDiabetes/Understand-Your-Risk-for-Diabetes_UCM_002034_Article.jsp
  4. http://apps.who.int/iris/bitstream/10665/204871/1/9789241565257_eng.pdf

    – Dr. Lavanya Aribandi, Chief Medical Officer, eKincare

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