With Type 5 Diabetes recognized as a distinct form of diabetes by the International Diabetes Federation, discuss some of the major types of diabetes. Give an account on the scenario of diabetes in India.
Diabetes is a long-term illness that happens when the pancreas doesn’t have enough insulin or when the body can’t properly use the insulin it produces which leads to almost fatal malfunctioning of various parts of the body. Type 5 diabetes has just been recognised as a distinct form of diabetes by the International Diabetes Federation.
Major types of diabetes:
Type 1
- Type 1 diabetes is caused by the body’s immune system mistakenly attacking the insulin-producing cells in the pancreas. This autoimmune reaction can occur at any age, from infancy through to old age.
- It is not linked to diet or lifestyle. Instead, it probably results from a combination of genetic predisposition and environmental triggers, such as viral infections.
- Treatment involves lifelong insulin therapy, delivered through injections or pumps.
Type 2
- Type 2 diabetes is the most common form of the condition and is often linked to having a high BMI (body mass index). However, it can also affect people of normal weight, particularly those with a strong genetic predisposition.
- Certain ethnic groups, including south Asians and people of African and Caribbean descent, are at higher risk – even at lower body weights.
- Boosting the body’s production of insulin can help to control blood sugar levels. Some drugs boost insulin production from the pancreas, while others improve insulin sensitivity.
Gestational diabetes
- This type of diabetes develops during pregnancy, typically between weeks 24 and 28. It is triggered by hormonal changes that reduce the body’s sensitivity to insulin.
- Risk factors include being overweight or obese, a family history of diabetes, and giving birth to a large baby in a previous pregnancy.
- This can be treated with diet and exercise, tablets or insulin injections.
Type 5
- This newly designated form is linked to malnutrition during early life. Type 5 diabetes is more common in poorer countries. It affects around 20-25 million people worldwide.
- People have low body weight and lack insulin. But the lack of insulin is not caused by the immune system. Instead, the body may not have received the correct nutrition during childhood to help the pancreas develop normally.
Rarer forms of diabetes
- There are at least nine sub-types of diabetes that include rare genetic forms, sometimes caused by a single genetic change. Others can be caused by treatment, such as surgery or drugs, such as steroids.
- Neonatal diabetes appears early in life. Some of the genetic changes affect how insulin is released from the pancreas. Some people still make their own insulin, so can be treated with tablets that help pancreas cells to push out insulin.
- Maturity onset diabetes of the young, or Mody, occurs later in life and is linked to genetic changes. There are several gene changes, with some affecting how pancreas cells sense sugar and others affecting how the pancreas develops.
- Type 3c diabetes is different. It is caused by damage to the pancreas. People with pancreatic cancer, for example, can develop diabetes after parts of the pancreas are removed. It can also develop after pancreatitis (inflammation of the pancreas).
- Those with cystic fibrosis are also at a higher risk of developing diabetes. This is called cystic fibrosis-related diabetes. The risk increases with age and is very common, with around a third of people with cystic fibrosis developing diabetes by the age of 40.
Scenario of Diabetes in India:
- A recent ICMR study states that India has 101 million people living with diabetes.
- India has the second-highest number of diabetes patients in the world, after China.
- There are an estimated 77 million people above the age of 18 years suffering from this disease in India.
- Nearly 25 million are prediabetics, which means they are at a high risk of developing this disease shortly.
- The prevalence of this disease in India has increased from 7.1% in 2009 to 8.9% in 2019.
- It is estimated that the number of patients with this disease in India will reach 100 million by 2030.
Initiatives taken to control and manage diabetes in India:
- The National Diabetes Policy, which was launched in 2017, aims to reduce the prevalence of this disease in India by 20% by 2025.
- The Pradhan Mantri Jan Arogya Yojana (PMJAY), also known as Ayushman Bharat, is a national health insurance scheme that provides free coverage for treatment to over 500 million people.
- Awareness Generations: The government has also launched a number of awareness campaigns to educate people about this disease and how to prevent it.
- The government of India uses different types of media like print, electronic, and social media to raise awareness in the community.
- The Food Safety and Standards Authority of India (FSSAI) promotes healthy eating habits.
- The Ministry of Youth Affairs and Sports leads the Fit India movement, and the Ministry of AYUSH organizes various activities related to yoga.
- The Health Department is starting a new initiative called the NCD Control program to screen the entire population for non-communicable diseases (NCDs) and their risk factors. They want to create a registry of people above 30 years old with NCDs to understand how many people are affected.
The challenge of tackling this disease in India is significant, but it is not insurmountable. Reduction in the incidence of this disease will require measures to promote physical activity and reduce obesity in adults and children, alongside programs to increase healthy infant and fetal growth with additional focus on traditional nutritious diet.