World Diabetes Day: Diabetes has mostly silent symptoms; high blood sugar can even affect the kidneys, eyes

India faces a high burden of diabetes and hypertension – it has about 77 million diabetics. The country has the second highest number of cases in the world, and experts believe this could affect 134 million in another three decades.

A sedentary lifestyle combined with increased fast food consumption has advanced the onset of diabetes. It is no longer a condition limited to the 40s only.

Dr. Harish Kumar, Professor and Head, Center for Endocrinology and Diabetes, Amrita Hospitals, Kochi, lists the main causes behind the rising diabetes graph in India. He also recommends some lifestyle changes to keep diabetes at bay.

Question: There is a reported increase in diabetes that is also becoming a health problem among young people these days. What is the main reason behind it?
Dr. Harish Kumar: Diabetes is definitely becoming a bigger problem among the younger people. We see type 2 diabetes in young people and even in younger children. This is due to lifestyle changes that have made everyone live very sedentary lives today. On top of that, they also tend to eat fast food. Such a combination is called a diabetogenic environment. So if you already have a genetic predisposition to develop diabetes, and then you grow up in this environment, it will cause your blood sugar to rise. In such cases, diabetes manifests itself much earlier than the period it would have had if you had lived a healthy life, eaten a good diet, exercised regularly and been physical.

active. Then it would have come up at the age of 45 or 50. But we are seeing more and more children developing diabetes due to obesity and high cholesterol. They are on an unhealthy diet and do not exercise.

Q: What trend have you noticed among young diabetics recently?
HK: Most young diabetic cases are of type 1 and among younger children and adolescents. These cases have been increasing over the years. But now we are also seeing an increase in the number of type 2 cases. Insulin is usually required in type 1 cases. But we also see it in type 2 cases.

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“In India, 50% of people with diabetes are not even aware that they have the disease”

Question: Is it possible to dampen it in the early stages?
HK: The answer is definitely yes. Numerous trials have been conducted around the world showing that reversal is possible if you target people with pre-diabetic disposition, get them to exercise aggressively on a regular basis, control their diet properly and make them lose some weight.

One-third of patients remain in the pre-diabetes stage, and one-third develop diabetes in most cases. So, definitely, if you implement lifestyle changes, it will make a difference, stop diabetes and help you go back to a stage where you have never had diabetes.

Q: What is the difference between low sugar levels and high sugar levels? What situation is the worst for a diabetic patient and can lead to some dangerous consequences if left untreated?
HK: The condition with low blood sugar is called hypoglycemia and the condition with high blood sugar is called hyperglycemia. In general, short-term hypoglycemia is definitely far more dangerous because if your blood sugar level drops, you may lose consciousness. It is potentially deadly. Hyperglycemia causes long-term damage. You may have a very high blood sugar level for a long time and still be unaware of it. In fact, many patients may not even know they have a high blood sugar level. That is why diabetes is such a dangerous condition. The symptoms are largely silent. But over a period of time, this high blood sugar will affect the heart, leading to heart attacks. It can even affect the kidneys, eyes and other organs.

Dr.  Harish KumarAgencies

Dr. Harish Kumar, Professor and Head, Center for Endocrinology and Diabetes, Amrita Hospitals, Kochi.

Hyperglycemia is more associated with long-term complications. Particularly in type 1 diabetic patients, and occasionally in type 2 patients, blood sugar levels can rise and lead to a situation called diabetic ketoacidosis, which is a life-threatening situation. But it is a rare condition.

Q: What lifestyle changes do you recommend people start implementing at an early age to avoid getting the disease later in life?
HK: Lifestyle management is the most important thing in the treatment of diabetes, especially for people who are prone to developing the condition. If you have a family history of diabetes and a tendency to gain weight, then you definitely have a high risk of developing diabetes.

Other than that, all of humanity should eat healthy food and exercise regularly. The third important component is to reduce stress. Stress is a major contributor. You will find that people living in cities have a much more stressful life than people living in rural areas. The incidence of diabetes is threefold in urban areas compared to those in rural areas.

Q: Have you noticed diabetic patients facing problems due to Covid?
HK: The overall effect of Covid has been the effect of the shutdown as far as diabetes is concerned. The patients stayed at home for a long time and did not get their regular health check done. This has resulted in a general worsening of diabetes control almost across the board. During the shutdown, people did not step out of their houses. They were sedentary. The training plans stalled and people mostly spent a lot of time preparing and eating food with their families. All this has resulted in the general condition getting worse.

(Edited by Ram Mohan)

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