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Understanding Diabetes

Understanding Diabetes

  • Diabetes is broadly classified as Type 2 diabetes (T2DM) and Type 1 diabetes (T1DM). Type 2 account for more than 90% of the diabetes worldwide. For the sake of simplicity the term diabetes will be used throughout this document to denote T2DM.
  • Diabetes is growing at a pandemic scale and is associated with a rapid increase in its complications such as cardiovascular disease (CVD).1
  • India, together with China and the Middle East, are now considered the “hot spots” of diabetes, with a projected  doubling in incidence and prevalence of the disease over the next 20 years.2
  • The prevalence of diabetes in South Asians ranges from 2% in rural areas up to 16-20% in those residing in North America or the United Kingdom.3-5
  • Diabetes is not one but rather several diseases with one common denominator: a problem with insulin. This critical hormone, produced in the pancreas, helps glucose enter cells so that it can be used as a source of fuel. Without insulin to open this cellular pathway, glucose stays in the blood resulting in high levels of blood glucose (“blood sugar”).
  • The actual cause of diabetes is unclear; however, most experts believe that both genetics and lifestyle or environmental factors contribute to its development. There is a strong hereditary link for diabetes. If you have relatives with diabetes, especially “first-degree” relatives such as a parent or sibling, your risk of developing diabetes is more than double.
  • In most cases 50-80% beta cell function is lost by the time of diagnosis of diabetes. It is the progressive loss in beta cell function that is primarily responsible for the development of diabetes.6
  • High blood sugar damages nerves and blood vessels leading to a variety of complications including heart attacks, blindness, stroke, kidney disease, and amputation. Complications from diabetes are much more common and dangerous in women than in men.(see Diabetes Complications)
  • The majority of diabetes cases can be prevented and prevention costs to the government are far less than treating diabetes and its complications. Healthy diet, regular physical activity, maintaining a normal body weight, and avoiding tobacco use can prevent or delay the onset of diabetes (at least 10-20 years).
  • Although the news is bad but we have the solutions. Most diabetes can be prevented or delayed. Investment in prevention makes economic sense. Effective, low-cost treatments and care exist for diabetes that cannot be prevented. With early diagnosis and effective management, people with diabetes can live long, healthy, and productive lives. Besides, health systems can save on expensive complications such as kidney failure, blindness, and amputations (see Diabetes Prevention).7

Sources

1. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. May 2004;27(5):1047-1053.

2. Unwin N, Gan D, Whiting D. The IDF Diabetes Atlas: providing evidence, raising awareness and promoting action. Diabetes Res Clin Pract. Jan 2010;87(1):2-3.

3. Ramachandran A, Ma RC, Snehalatha C. Diabetes in Asia. Lancet. Jan 30 2010;375(9712):408-418.

4. Mohan V., Venkatraman JV, Pradeepa R. Epidemiology of cardiovascular disease in type 2 diabetes: the Indian scenario. J Diabetes Sci Technol. 2010;4(1):158-170.

5. Raji A, Seely EW, Arky RA, Simonson DC. Body fat distribution and insulin resistance in healthy Asian Indians and Caucasians. The Journal of clinical endocrinology and metabolism. 2001;86(11):5366-5371.

6. Defronzo RA. Banting Lecture. From the triumvirate to the ominous octet: a new paradigm for the treatment of type 2 diabetes mellitus. Diabetes. Apr 2009;58(4):773-795.

7. http://www.idf.org/webdata/Call-to-Action-on-Diabetes.pdf. 2010 November. Accessed January 15,2011.

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