Once described as a ‘silent killer’, the numbers associated with diabetes are a loud wake-up call today. According to the International Diabetes Federation, 415 million adults have diabetes; India is home to 69.1 million of them. Deaths due to diabetes have increased by 50% in India between 2005 and 2015, and these fatalities have been primarily attributed to changing lifestyles.
What is diabetes?
Diabetes is a group of metabolic diseases in which a person has high blood sugar, either because the body stops producing insulin (Type 1) or is unable to respond to insulin (Type 2). It’s important to understand the cause and recognise the symptoms of diabetes because if there is too much sugar in the blood (a condition known as hyperglycemia), it can lead to a range of serious complications. Hyperglycemia can damage the vessels that supply blood to vital organs, which can increase the risk of heart disease and stroke, kidney disease, vision problems and nerve problems. Unchecked, hyperglycemia can be fatal.
Symptoms of diabetes include:
- Excessive thirst
- Frequent urination
- Hunger pangs
- Slow healing wounds and sores
- Dry, itchy skin
- Blurry eyesight
Broadly, symptoms of both Type 1 and Type 2 diabetes are the same. But that’s where the similarities end.
Type 1 Diabetes
How it impacts the body: Type 1 diabetes occurs when a person’s immune system attacks and destroys the cells in the pancreas that produce insulin. Without insulin, cells cannot absorb sugar (glucose), which they need to produce energy. Which is why Type 1 diabetics are clinically dependent on insulin to live.
Who is at risk: Though most cases are diagnosed between ages 10–14 – the peak age of diagnosis in India is 12 years – Type 1 diabetes can occur at any age. Reportedly, less than 10% cases diagnosed are people over 40 years of age.
What causes it: While genes do play a role, the exact cause of Type 1 diabetes is not known. What we do know is that it is not linked to modifiable lifestyle factors, it cannot be prevented and there is no cure.
Unique symptoms: While diabetes symptoms are similar for Type 1 & 2 (listed above), those unique to Type 1 diabetes include:
- Weight loss despite an increased appetite. This is because the body breaks down muscle and stored fat in an attempt to provide fuel to the hungry cells.
- Rapid heart rate.
- Reduced blood pressure (falling below 90/60).
- Low body temperature (below 97º F).
Type 2 Diabetes
How it impacts the body: Unlike Type 1 diabetes, most people with Type 2 diabetes can still produce insulin, but not enough to meet their body’s needs.
The condition originates in the body’s cells becoming insulin resistant. That is, the normal response to a given amount of insulin is reduced. As a result, higher levels of insulin are needed in order for insulin to have its proper effects, and the pancreas compensate by trying to produce more insulin. Over time, the pancreas can’t keep up and are unable make enough insulin when blood sugar levels increase, such as after meals. When the pancreas can no longer make enough insulin, the diagnosis is Type 2 diabetes.
Who is at risk: Unlike Type 1, Type 2 diabetes can develop at any age, but people over 45 are at greater risk because they tend to exercise less, lose muscle mass and gain weight as they age.
Overweight and inactive people, as well as those with a family history of Type 2 diabetes are more likely to develop the disease.
What causes it: Genetics and lifestyle play a big role. But while you may possess a genetic mutation that makes you susceptible, if you take good care of your body, you may not develop diabetes.
Lifestyle choices that can cause Type 2 diabetes include:
- Lack of exercise.
- Poor food choices.
- Excess weight. Although the connection is yet to be determined, we know fat cells make hormones that keep insulin from working at its best.
Unique symptoms: Many people with Type 2 diabetes tend to gain weight in addition to the symptoms mentioned above.
How to manage Type 1 & 2 diabetes
The first rule to successfully managing diabetes, be it Type 1 or 2, is to keep a check on your blood sugar levels. I’d recommend a blood sugar test once a year, as part of a routine blood panel as Type 2 diabetes can be pre-empted and reversed.
Oral and injectable medication can help manage diabetes, but it is only a support and must be accompanied by diet and exercise. Since the goal for both Type 1 and 2 is to manage blood sugar levels, the broad guidelines for diet and exercise remain the same. The specifics are determined by the amount of insulin a person is taking. Also, Type 1 diabetics are rarely overweight, so their diet doesn’t have to focus on foods that accelerate weight loss.
One common misconception people have is that they can lower their blood sugar levels just by eating less. What they don’t realise is that the body will just go ahead and make its own sugar. So first and foremost, anyone diagnosed with diabetes must eat small and frequent meals. Focus on protein, fiber and low glycemic foods, which are all digested slowly, and therefore release sugar at a measured pace into the bloodstream. You could try adding bran to your chapatti atta, salads before meals and snacking on fruits and other whole-grains to increase fiber intake. Or opt for dal, sprouts, eggs, chicken or fish for more protein. With regards to exercise, walking is an easy and effective way to reduce blood sugar levels.
Remember, don’t let a diabetes diagnosis get you down. With a few lifestyle changes, you can bring it under control.
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