The World Diabetes Day (WDD) is celebrated every year on November 14 to raise awareness about diabetes. Every year, WDD is observed globally along with a focal theme. This year’s theme is “access to diabetes education.” This event commemorates the birthday of Dr Frederick Banting who (together with Dr Charles Best) discovered insulin in 1922 while working in a Canadian University (Banting and John McLeod shared the Nobel Medicine Prize in 1923).
What is diabetes?
Diabetes is a disease that occurs when the pancreas produces little or no insulin or when the body does not properly respond to insulin it produces.
Insulin is a hormone that lets glucose derived from the food we consume pass from the blood into the body cells to produce energy. All carbohydrate foods are broken down into glucose which builds up in the bloodstream. Insulin enables glucose to enter into the cells of muscles and other body tissues. If the “burning” of glucose in the body cells is prevented in any way, then diabetes (diabetes mellitus) results.
The global scenario
As of 2021, 537 million adults (age 20-79 years) are reported to be affected by diabetes. This amounts to nearly 1 in 10 adults living with this dreadful disease called diabetes. This number is projected to rise to 643 million by 2030 and 783 million by 2045.
The early signs of diabetes include:
- Frequent urination: more than 4-7 times in 24 hours (which is the average pattern in normal individuals)
- Dry mouth and itching in the skin
- Impaired eyesight
- Fatigue & excessive hunger.
Types of diabetes
There are mainly three types of diabetes: type 1 (T1D), type 2 (T2D), and gestational diabetes (GDM).
T1D can develop at any age but is predominantly found in children and adolescents. In this type of diabetes, the body produces little or no insulin. This means that the patient needs daily insulin injections to keep the blood glucose levels under control.
T2D occurs predominantly in adults and accounts for nearly 90 per cent of all diabetes cases. Affected individuals need to regulate body weight, lead a healthy lifestyle, consume a healthy diet (rich in plant fibers and low in red meat and processed foods), and have regular physical activity.
GDM happens in a subset of pregnant women. It usually disappears when the baby is born. Children born from GDM-affected women are at increased risk of developing T2D later in life.
The risk factors of T1D include:
- Having a family history of T1D
- Injury to the pancreas
- Presence of autoantibodies
- Physical stress (e.g., surgery or illness)
- Exposure to viral diseases etc.
The risk factors of T2D include:
- Family history of prediabetes or T2D
- Being Black, Hispanic, Native American, Asian or Pacific Islander
- Having obesity
- Having hypertension
- Having low HDL cholesterol (“good cholesterol”) and high triglyceride level
- Being age 45 or more
- Being a smoker
- Family history of heart disease or stroke etc.
The risk factors of GDM include:
- Family history of prediabetes or T2D
- Having obesity before your pregnancy
- Being above 25 years of age etc.
Complications of diabetes
The possible complications of long-term diabetes include:
- Cardiovascular disease: increased risk of angina, stroke and atherosclerosis
- Neuropathy: nerve damage leading to tingling, burning or pain, starting with the tips of fingers of toes, and gradually moving upwards
- Nephropathy: kidney damage
- Eye damage (retinopathy)
- Foot damage: nerve damage in the feet increase the risk of foot complications
- Skin and mouth conditions: diabetes may lead to skin conditions, including bacterial and fungal infections
- Hearing impairment
- AD: T2D may increase the risk of dementia, e.g., Alzheimer’s disease (AD)
- Depression: depression is more prevalent in people with T1D and T2D.
T1D cannot be prevented. However, the risk of T2D and GDM may be lowered by oping for healthy lifestyle choices such as:
- Eating healthy foods: consume foods lower in fat and calories and higher in fiber, e.g., fruits, vegetables, and whole grains
- Losing excess weight: if you are obese, losing just 7% of body weight may lower the risk of diabetes
- Getting more physical activity: brisk daily walk; or 150 minutes of aerobic exercise a week; or long daily workouts broken up into bouts of small sessions
- In some cases, administration of drugs such as metformin, sulfonylurea or Januvia may be recommended, besides exercise and healthy diet etc.