Hyderabad, Jul 23 (IANS): With rapid urbanization, sedentary lifestyles, and changes in dietary patterns, the prevalence of diabetes has escalated dramatically in recent years.

India is currently facing a diabetes epidemic, with the country being home to the second-largest diabetic population globally, after China. According to recent statistics, more than 77 million Indians are affected by diabetes, with the number expected to rise significantly in the coming years. The burden of diabetes extends across all age groups, affecting both urban and rural populations, says Dr Ravindra Kumar, diabetologist at Hyderabad’s Amor Hospitals.

According to him, several factors contribute to the escalating diabetes rate in India. Rapid urbanization has led to lifestyle changes, including reduced physical activity and increased consumption of calorie-dense, processed foods. Additionally, genetic predisposition, obesity, stress, and gestational diabetes also contribute to the rising prevalence of the disease. The Indian diet, rich in carbohydrates and unhealthy fats, further exacerbates the risk.

He believes that addressing this grave health concern requires a multi-faceted approach, focusing on prevention, awareness, and accessible healthcare services. By prioritizing diabetes prevention and management, India can alleviate the burden of this chronic disease and pave the way for a healthier future for its citizens.

Excerpts from an interview with Dr Ravindra Kumar.

GROWING BURDEN OF TYPE 1 DIABETES

The increasing incidence of Type 1 diabetes is a complex issue influenced by a combination of genetic, environmental, and immunological factors.

While the exact cause remains unclear, several factors are believed to contribute to the rise in Type 1 diabetes cases. Advancements in research have led to new treatments that aim to improve the management and outcomes for people living with Type 1 diabetes.

Type 1 diabetes has a strong genetic component. People with certain genetic markers are more susceptible to developing the condition. However, genetics alone cannot explain the increasing incidence, as the genetic pool remains relatively stable over time.

Type 1 diabetes is an autoimmune disease where the body's immune system mistakenly attacks and destroys insulin-producing beta cells in the pancreas. Environmental triggers, such as viruses or other infections, may initiate or accelerate this autoimmune response in genetically susceptible individuals.

Exposure to certain environmental factors, such as viral infections (e.g., enteroviruses), dietary factors, or toxins, might play a role in triggering the autoimmune response in susceptible individuals. However, the specific triggers are still being studied.

Some researchers propose that reduced exposure to infections and a more sanitized environment in early childhood might alter the immune system's development, increasing the risk of autoimmune diseases like Type 1 diabetes.

Type 1 diabetes incidence varies significantly with geography, suggesting that environmental factors may be at play. Regions with higher incidences have prompted investigations into possible environmental triggers.

The new treatments for Type 1 diabetes include Continuous Glucose Monitoring (CGM). This system allows individuals with Type 1 diabetes to monitor their glucose levels continuously, providing real-time data that helps in making immediate treatment decisions and adjustments.

There is insulin pump therapy. Insulin pumps deliver a continuous supply of insulin, allowing for more precise insulin dosing and offering greater flexibility in managing blood sugar levels.

The treatments include Artificial Pancreas System. Also known as closed-loop systems, artificial pancreas systems combine CGM and insulin pump technology to automate insulin delivery based on real-time glucose data, offering improved glucose control and reducing the risk of hypoglycemia.

There are Immunomodulatory Therapies. Some experimental treatments aim to modify the immune system's response to prevent or slow down the destruction of insulin-producing cells in the pancreas.

Another treatment method is Islet Cell Transplantation. It involves transplanting insulin-producing islet cells into the pancreas to restore insulin production. Although still considered experimental, this treatment shows promise in certain cases.

Research is ongoing to find ways to stimulate the regeneration or replacement of damaged beta cells in the pancreas.

The increasing incidence of Type 1 diabetes is a multifaceted issue influenced by genetic, environmental, and immunological factors. Understanding these factors is crucial for developing preventive strategies.

Advancements in diabetes research have led to new treatments that aim to improve glucose control, enhance quality of life, and ultimately find a cure for this chronic condition. As research progresses, the hope is to continue advancing diabetes care and management to better support individuals living with Type 1 diabetes.

JUNK FOOD AND DIABETES

An increase in the consumption of junk food is indeed one of the significant factors contributing to the rising incidence of Type 2 diabetes. Junk food, also known as fast food or highly processed food, is typically high in unhealthy fats, added sugars, refined carbohydrates, and sodium, while being low in essential nutrients.

Consuming junk food regularly can have detrimental effects on overall health, leading to various health problems, including an increased risk of developing Type 2 diabetes.

Junk food is calorie-dense and can lead to excessive calorie intake. Regular consumption of these energy-dense foods contributes to weight gain and obesity, a well-established risk factor for Type 2 diabetes.

Diets high in unhealthy fats and added sugars can lead to insulin resistance, a condition in which the body's cells become less responsive to insulin's actions. As a result, glucose cannot enter the cells effectively, leading to elevated blood sugar levels.

Junk food tends to cause rapid spikes in blood sugar levels due to its high glycemic index and low fiber content. Consistently elevated blood sugar levels can strain the body's insulin-producing capacity, eventually leading to Type 2 diabetes.

Junk food lacks essential nutrients, such as vitamins, minerals, and fiber, which are vital for maintaining overall health and metabolic processes. Deficiencies in these nutrients can contribute to various metabolic imbalances, increasing the risk of Type 2 diabetes.

Sedentary lifestyle, genetic predisposition, aging, gestational diabetes, ethnicity and race and stress and sleep deprivation are the other causes.

TECHNOLOGICAL ADVANCES

Technological advances in diabetes treatment have significantly improved the management and quality of life for individuals living with diabetes. These innovations continue to evolve rapidly, providing more effective ways to monitor blood glucose levels, deliver insulin, and manage the condition.

Some of the notable technological advancements in diabetes treatment include Continuous Glucose Monitoring (CGM), Insulin Pumps, Closed-Loop Systems (Artificial Pancreas), Smart Insulin Pens, Mobile Apps and Diabetes Management Platforms, Artificial Intelligence (AI) and Data Analytics, Smart Insulin, Implantable Devices and Non-Invasive Glucose Monitoring.

GESTATIONAL DIABETES

The rise in gestational diabetes cases in India can be attributed to a combination of factors related to lifestyle, genetics, and changes in maternal health. Some of the key causes contributing to the increasing prevalence of gestational diabetes in India include obesity and sedentary lifestyle, unhealthy dietary patterns, genetic predisposition, age and pregnancy at a later stage, lack of physical activity, gestational weight gain, urbanization and stress, lack of awareness and screening, limited access to prenatal care, poor maternal health and cultural practices.

It is crucial to address these causes through public health interventions, education, and prenatal care to reduce the incidence of gestational diabetes in India. Raising awareness about healthy lifestyle practices, promoting regular physical activity, and encouraging balanced diets during pregnancy are essential steps in managing and preventing gestational diabetes.

Additionally, early and regular prenatal screenings for gestational diabetes can aid in early detection and appropriate management, reducing the potential risks for both the mother and the baby.

COCKTAIL OF CHRONIC ILLNESSES

Diabetes can significantly worsen chronic illnesses like heart diseases and kidney diseases due to its effects on blood vessels, nerves, and overall metabolic health. Uncontrolled diabetes can lead to a cascade of complications that exacerbate these pre-existing conditions.

Diabetes increases the risk of atherosclerosis, a condition where fatty deposits (plaques) accumulate inside the blood vessels, narrowing and hardening them. This reduces blood flow and oxygen supply to the heart, increasing the risk of heart attacks and strokes.

Diabetes can lead to hypertension (high blood pressure), putting additional strain on the heart and blood vessels, increasing the risk of heart disease.

Prolonged exposure to high blood sugar levels can cause damage to the heart muscle, leading to diabetic cardiomyopathy, a condition that weakens the heart's ability to pump blood effectively.

Diabetes can promote blood clotting, increasing the risk of blood clots that can lead to heart attacks and strokes.

Diabetic nephropathy is a common complication of diabetes where high blood sugar levels damage the small blood vessels in the kidneys. This damage impairs the kidneys' ability to filter waste products and excess fluid, leading to a build-up of toxins and fluid retention.

In diabetic nephropathy, the kidneys leak protein into the urine (proteinuria), which is a sign of kidney damage.

Kidney damage in diabetes can lead to hypertension, further contributing to the progression of kidney disease. If left uncontrolled, diabetic nephropathy can progress to end-stage renal disease, requiring dialysis or kidney transplantation for survival.

Insulin resistance, common in diabetes, can further worsen the metabolic health of individuals with heart and kidney diseases, making it difficult to manage these conditions effectively.

High blood sugar levels can lead to inflammation, oxidative stress, and tissue damage, which can negatively affect the heart and kidneys.

Diabetes often leads to dyslipidemia, an abnormal lipid profile with elevated levels of cholesterol and triglycerides, increasing the risk of heart disease.

Diabetes and obesity often go hand in hand, and excess body weight can worsen heart and kidney diseases.

Management of diabetes is essential to prevent or slow down the progression of heart and kidney diseases in individuals with diabetes. Proper blood sugar control, a healthy diet, regular exercise, and adherence to prescribed medications are crucial to reducing the impact of diabetes on chronic illnesses and improving overall health outcomes. Additionally, regular medical check-ups and early intervention can help identify and address complications before they become severe.