Young Indians falling prey to diabetes

Dr Deep Dutta

Rajesh Singhal (24) had just begun with his career as a management executive in a multinational company in Delhi. He suddenly started feeling fatigued, losing weight despite increased hunger pangs and was always thirsty. This continued for six months. On diagnosis, doctors found that Rajesh had Type 2 diabetes (T2DM). 

Rajesh is one of the many young Indians who have been diagnosed with Type 2 diabetes. Because of the growing number of diabetes cases among youth, the Indian Council of Medical Research (ICMR) decided to establish the Registry of People with Diabetes with Young Age at Onset (YDR) in 2006. It reported that over 25 per cent of the enrolled patients have Type 2 diabetes. This increasing burden of Type 2 diabetes in the second, third and fourth decade of life is unique to the Indian subcontinent. The steadily decreasing  age of the onset of the disease is worrying, as currently about one-third of India’s working age population is between 15-64. India with its massive population is among the top two countries in the world facing the diabetes burden. 

Harmful practices

Childhood obesity, sedentary life, and poor dietary practices are leading to an increasing incidence of Type 2 diabetes in young people. Increasing dependence on  mobiles and computers and modern lifestyle practices are reducing time for outdoor activities for children and young adults. A recent Global Nutritional Report suggested 16 per cent of adult men and 22 per cent of adult women are overweight in India, making them vulnerable to diabetes and related diseases. Also the onset of Type 2 diabetes in India is two decades earlier than the west. Correspondingly, heart attacks and sudden cardiac death also occur two decades earlier in Indians than Caucasians. High-blood glucose in Type 2 diabetes is due to the inability of insulin produced in the body to work properly, resulting in damage to heart, eyes, and kidneys among other organs.

Weighty issues

The National Family Health Survey of 2015–2016, reported 35 per cent women and 24 per cent men in the age-group 15-49 years in national capital territory are overweight. Due to the urban 

work life and modern lifestyles, the physical movement has become limited.  Combined with unhealthy dietary habits, alcohol and smoking the crisis is only increasing. 

Childhood diabetes classically had been Type-1 diabetes till a decade back. Type-1 diabetes is due to absolute deficiency of insulin production in the body, has a genetic and autoimmune basis, where the body immune system self-destructs the pancreas (which produces insulin). It is incurable and can be managed only with daily insulin injections. 

Type-2 diabetes, in contrast, is an acquired disorder, where although there is enough insulin production in the body, it is unable to work because of obesity and increased body fat, leading to high blood glucose levels which can damage the whole body. The main job of insulin is to store the extra glucose obtained from meals in liver, muscles and fat tissue. Deficiency or resistance to insulin action leads to inability of the body to store glucose in the body, leading to high blood levels of glucose.

One in 10 Indians is diabetic and one in five is pre-diabetic. With India’s growing population and rapid urbanisation, it is important for us to focus on non-communicable diseases (NCD), which are a leading cause of death. As per WHO estimates, approximately 63 per cent of annual deaths in the world are due to NCDs in India. 

— The writer is an endocrinologist, Venkateshwar Hospital,  New Delhi

Risk factors  

• Sedentary lifestyle, lack of exercise
• Overweight or obesity
• Family history | Unhealthy eating habits

Symptoms 

• Frequent urination | Excessive thirst
• Unexplained weight loss
• Fatigue | Blurred vision

Preventive measures

• Know your risk factors and take action | Eat healthy | Stay active
• Maintain a healthy weight | Avoid tobacco and limit alcohol | Go for regular check-up for early diagnosis | If diagnosed with diabetes, take prescribed medicine regularly