India wears a badge that is not-so-welcome and is not-so-great news. It has the second-highest number of diabetics in the world. Let that sink in! There are 77 million individuals with diabetes in India! And one in six people with diabetes in the world is from India! How did this happen and is there still something that can be done to change this alarming figure? Let’s find out.
Diabetes mellitus is a chronic condition that affects your body's ability to produce or use insulin or both, resulting in high blood glucose (sugar) levels. There are two main types of diabetes mellitus:
Type 1 Diabetes is an autoimmune disorder, where your immune system mistakenly attacks and destroys the β-cells in your pancreas that are responsible for producing insulin.
Type 2 Diabetes is a metabolic disorder characterised by insulin resistance in your cells and tissues, i.e. your cells are not able to utilise the insulin produced by your pancreas, which results in the glucose remaining in your blood.
In diabetes, your body is unable to effectively convert glucose into energy. This causes your body to rely on alternative energy sources, leading to a variety of symptoms. Some of the early signs include:
In India, the prevalence of diabetes has steadily increased in the past three decades and has reached epidemic proportions. India’s diabetic population now accounts for a sizable portion of the global diabetes burden. More than 77 million Indian adults are living with diabetes. Even with this sky-high figure, research suggests that 57% of diabetes cases in India remain undiagnosed. Type 2 Diabetes constitutes about 90% of all cases of diabetes, and thus, understandably, the majority of Indians with diabetes have Type 2 Diabetes. However, research suggests that Type 1 diabetes cases in India are also increasing by about 3 to 5% each year. The National Noncommunicable Disease Monitoring Survey (NNMS) released in 2021 also revealed that the prevalence of diabetes in urban India is double when compared to that in rural areas. The survey also reported that diabetes was more predominant among women when compared to men. According to the “India State-Level Disease Burden Initiative” undertaken by the Indian Council of Medical Research (ICMR) and partners in 2017, Tamil Nadu had the highest prevalence of diabetes in 2016, followed by Kerala, Delhi, Punjab, Goa, and Karnataka.
According to the World Health Organisation (WHO), the prevalence of Type 2 Diabetes is increasing drastically in low and middle-income countries. The increased prevalence of diabetes in India, WHO reports, is mainly due to urbanisation, industrialisation, and the resultant change in diet and lifestyle. These factors may contribute to the increased number of diabetics in India:
Not all bodies are the same physiologically. People of South Asian descent may have more visceral fat and a higher fat-to-muscle ratio when compared to people of European ancestry. This increases the risk for diabetes. In bodies with less muscle than fat, insulin stays in the body for longer. With higher sugar and fat consumption, and inefficient clearing of glucose from the body, metabolic load and insulin resistance increase, putting individuals at risk of developing diabetes.
There is a lack of awareness about diabetes and prevention strategies, mainly in the rural population. Due to the lack of resources, people in rural areas look to doctors as the only source of information. Short visits and check-ups may be unhelpful in providing helpful information about the condition to those affected.
Under the present circumstances, farmers tend to grow more commercially viable crops that are denser in calories and contain fewer nutrients. Indians are now consuming more processed polished white rice and refined sugar, which lack essential nutrients and fibre. The consumption of such foods causes a spike in blood glucose levels.
As part of Indian traditions, sweets are consumed during religious festivals and ceremonies. Additionally, sugary drinks and sweetened foods are also inexpensive and readily available, thus increasing the risk for obesity and Type 2 Diabetes.
Stress alone cannot cause diabetes. However, high levels of stress hormones might stop insulin-producing cells in the pancreas from working and reduce the amount of insulin they make. According to a 2020 study, 74% of Indians suffer from some form of stress. This stress is a potential contributor to diabetes. .
There has been a large increase in the availability of processed food across most parts of the country. Due to lifestyle changes, people are consuming more processed meat and fatty and sugary food. An unhealthy diet and a sedentary lifestyle are major contributors to the risk of developing diabetes.
Type 2 Diabetes is referred to as a lifestyle disease because it is primarily linked with the day-to-day life habits of an individual. A sedentary lifestyle with less exercise, more screen time, tobacco and alcohol use, and higher environmental pollution also contributes to the increased rate of diabetes in India.
If left untreated, diabetes can lead to the following complications:
Type 1 Diabetes: The treatment for Type 1 Diabetes involves insulin therapy, medication, and frequent monitoring of blood sugar levels. Type 2 Diabetes: Type 2 Diabetes can be managed primarily by:
Type 1 Diabetes is an autoimmune disease and cannot be prevented. Type 2 Diabetes can be prevented by developing a healthy lifestyle and eating habits. Here are a few tips on how you can prevent Type 2 Diabetes. Type 2 Diabetes can be prevented by developing a healthy lifestyle and eating habits. Here are a few tips on how you can prevent Type 2 Diabetes.
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