Diabetes – of Sugar ‘n Spice and all things nice – Chawm Ganguly

chawmTrends from the world of Diabetology

One in eleven adults suffers from diabetes. To put things in the proper perspective, that is 415 million people around the world. By 2040, this will aggravate further, with one in every ten – 642 million – suffering from the silent killer. Every 6 seconds, a person dies from diabetes (that is 5 million deaths) and what is even more worrying, is that one in seven births is affected by gestational diabetes. If that is not chilling enough, then consider this: in Africa, more than two thirds of people with Diabetes are undiagnosed, forget about treatment.

Contrary to popular belief, Diabetes is no longer classified as one afflicting the rich in the advanced west, brought about by their sedentary lifestyles and conspicuous consumption. On the contrary, if current trends are to be believed, the maximum number of diabetics is located in the low and middle-income economies, with, you guessed it right – China and India leading the charts. As for India, there is more bad news: it is now more or less established that certain features in Asian Indians make them more prone to diabetes and coronary artery diseases which include increased insulin resistance and greater abdominal adiposity.

Diabetology, as a branch of medical science has made rapid strides in the recent past, yet, the current trends indicate the rise in premature death, posing a major threat to global development as the average age at which the disease manifests itself is becoming alarmingly lower.

However, doctors dealing with the affliction are optimistic. Scientific and technological advances have witnessed the development of newer generation of drugs like sulphonylureas, biguanides, alpha glucosidase inhibitors, and thiazolidinediones with significant efficacy in reducing hyperglycemia leading to significant improvement in treatment procedures and their effectiveness.

Entirely new classes of therapeutics like Incretin mimetics, Amylin analogues, GIP analogs, Peroxisome proliferator activated receptors, and dipeptidyl peptidase-4 inhibitor have been developed which hold great promise for diabetes treatment in the near future, which doctors believe will significantly aid them in prescribing necessary medication with a view towards arresting the march of the menace.

Another area that holds a lot of promise for the future, specialists opine, is the advancements in the field of nanotechnology in the treatment of diabetes which is opening newer horizons for glucose measurement and insulin delivery. It has already been conclusively demonstrated that there are significant advantages of glucose sensors and closed-loop insulin delivery approaches in treating diabetes to make it effective in both type 1 and type 2 diabetes.

Statin therapy, despite some side effects, too, have made a good amount of progress in the treatment of diabetes and related conditions in the near past and results emerging from studies in the field are encouraging to put things mildly.  Stem Cell Technologies too are promising to offer an innovative approach to the treatment of Diabetes.  As a matter of fact, concepts of removing the defects in pancreatic β cell or enhancing the sensitivity of the body cells to the action of insulin are already well within the realms of possibility. This promises to open new encouraging possibilities as β cell replacement strategies will offer hope especially in situations where existing strategies aiming at islet cells and pancreas transplantation are limited due to shortage of donor organs.

Types of Diabetes

Diabetes Mellitus (DM), commonly referred to as diabetes, is a group of metabolic diseases in which there are high blood sugar levels over a prolonged period. Symptoms of high blood sugar include frequent urination, increased thirst, and increased hunger. If left untreated, diabetes can cause many complications, including among others, diabetic ketoacidosis and nonketotic hyperosmolar coma. Serious long-term complications include cardiovascular disease, stroke, chronic kidney failure, foot ulcers, and damage to the eyes.

Diabetes occurs is due to either the pancreas not producing enough insulin or the cells of the body not responding properly to the insulin produced.

On the basis of insulin deficiency, Diabetes is classified as:

Insulin Dependent Diabetes Mellitus (IDDM)

It is also known as juvenile onset diabetes or type 1 diabetes, which accounts for about one in ten patients, resulting from cellular-mediated autoimmune destruction of the pancreatic cells. The disease can affect people of all ages but usually occurs in children or young adults. Regular supply of insulin injections is essential for the control of glucose level in blood.

Idiopathic Diabetes

A minor number of patients having type 1 diabetes, mostly of Asian and African ancestry, have no etiologies. These are prone to Ketoacidosis and have permanent insulinopenia. The occurrence of ketoacidosis is in episodes and the level of insulin deficiency between episodes fluctuates. Idiopathic diabetes has genetic predisposition and an absolute need for insulin replacement therapy depends on the condition of the patient.

Noninsulin Dependent Diabetes Mellitus (NIDDM)

It is also referred to as adult onset diabetes, which accounts for an overwhelming number of all diabetes. Major metabolic syndromes like obesity, insulin resistance, and dyslipidaemia have led to an epidemic of type 2 diabetes. The treatment of this type of diabetes is through oral hypoglycemic drugs, dietary in nature.

Gestational Diabetes Mellitus (GDM)

It is defined as any degree of glucose intolerance resulting in hyperglycaemia of variable severity that is diagnosed during pregnancy. GDM, or impaired glucose intolerance which is first diagnosed during pregnancy, is a major type affecting a good number women during pregnancy.

Catamenial Hyperglycaemia

Diabetic Ketoacidosis (DKA) is a comparatively rare condition, arising due to infection, inadequate insulin or poor insulin compliance, acute pancreatitis, stroke, drugs, metabolic disturbances within the body, or negligence with the treatment.

The piece was originally written for the Express Health Guide 2016