Diabetes in India: Some Eye-Opening Facts!!

What is Diabetes?

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

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

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. 

What are the Symptoms of Diabetes?

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:

• Fatigue
• Constant hunger (polyphagia)
• Excessive thirst (polydipsia)
• Frequent urination (polyuria)
• Unintended weight loss
• Changes in vision
• Frequent infections
• Slow-healing sores
• Tingling or numbness in the hands or feet
• Darkened skin areas

Prevalence of Diabetes in India

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.

Why is the Rate of Diabetes so High in India?

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:

Physiological Differences

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.

Lack of Awareness

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. 

Changes in Farming and Food Practices 

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.

Higher Consumption of Sweets

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.

Social Stress 

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. .

Increased Availability of Processed Food

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. 

Change in Lifestyle

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.

What are the Complications of Diabetes?

If left untreated, diabetes can lead to the following complications: 

• Heart disease
• Nerve damage
• Kidney damage
• Vision problems
• Infections
• Hearing impairment
• Sleep problems
• Dementia

How can you Treat Diabetes?

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: 

• Following a healthy and balanced diet
• Regular exercise
• Oral medication
• Insulin Therapy
• Stress Management
• Getting enough sleep
• Monitoring blood sugar levels

How can you Prevent Diabetes?

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.

1. Exercise for at least 30 minutes, 5 days a week. 
2. Maintain a healthy weight with a BMI (Body Mass Index) between 18.5 and 24.9.
3. Eat a well-balanced diet made up of fruits, vegetables, whole grains, nuts, and seeds. 
4. Quit smoking.
5. Cut down on alcohol.
6. Learn to manage stress with relaxing activities such as yoga and meditation.
7. Get at least 7 hours of sleep every night. 
8. Go for regular blood glucose level check-ups