The Dangers of Diabetes

Become aware of the triggers and detect early symptoms to keep this silent killer at bay. Find out how small steps taken since childhood can prevent life-threatening diabetes throughout your life, says Reshma O. Pathare.

Have you been experiencing extreme fatigue, rapid weight loss or gain, frequent urination of late? Don’t brush them off as a passing summer season phenomenon. There might be a greater danger of diabetes lurking around the corner.
A silent killer, diabetes is now touted to be the cause for 35 per cent deaths in urban India. Dr Pradeep Gadge, chief diabetologist at Dr Gadge’s Diabetes Care Centre, Mumbai, explains, “In diabetes, blood sugar levels increase causing multiple complications like heart attack or stroke, blindness, problems during pregnancy and kidney failure. International Diabetes Federation (IDF) estimates that out of the 415 million people who have diabetes, approximately half are women. It results in high rates of mortality and morbidity.”
Dr Muhammed Majeed, founder-chairman, Sami Labs, Bengaluru, says, “Incidence of diabetes is on the rise among urban women in India. A recent study by the Department of Science and Technology (DST) shows that prevalence of the disease is 17.7 per cent in urban middle class women while it is 10 per cent in rural areas. The main cause for this is changing lifestyle and lack of exercise. Rural women engage in more physical activities than urban women. Incorrect eating habits make them gain weight, thus leading to several health problems, including diabetes.”

What are the triggers?
The triggers are so covert that women often do not realise they are diabetic until they reach the advanced stages. Apart from genetic history, a sedentary lifestyle, consumption of excessive junk food and high levels of stress are some common triggers. Diabetes starts off a series of complex problems that are often difficult to cure. Dr Altamash Shaikh, consultant endocrinologist, diabetologist and metabolic physician at Saifee Hospital, Mumbai, says,“Either women don’t get access to care or when they have it, they delay check-ups. In India, factors leading to diabetes are many—genetics, lifestyle and urbanisation.”

Who are at risk?
Dr Shaikh says,“With increasing obesity, young girls have higher chances of diabetes during puberty, pregnancy and menopause. They undergo hormonal changes at various stages, with insulin resistance in the background.” Dr Anil Bhoraskar, diabetologist at Fortis S. L Raheja Chair, South Asia Region, elucidates,“Precocious puberty or when a child’s body changes into an adult too soon, as well as puberty-related obesity cause diabetes. Girls still get sub-optimum medical attention compared to boys in many families. Sometimes pre-diabetes, which is completely curable is ignored till it gets difficult to treat. This state of affairs is compounded by poor nutrition in early childhood, junk food during adolescence, lack of sleep or social suppression resulting in severe mental stress. Polycystic ovarian disorder (PCOD) is also a forerunner to Type 2 diabetes.” It is essential to feed the right diet to the girl child, keep her free from undue social pressures and encourage her to get enough physical exercise and proper sleep.
Secondly, obese women are at a big risk. Dr Baburao Kate, consultant physician and diabetologist at Axis Hospital, Mumbai, explains,“Obesity is a major cause of Type 2 diabetes. More percentage of fat in the body makes it difficult for insulin to work. Type 2 diabetes develops when the body becomes resistant to insulin or when the pancreas stops producing enough insulin which is called insulin resistance.”
Thirdly, diabetes can develop during pregnancy.Gestational diabetes is temporary but it can also make a woman susceptible to diabetes later in life. It happens due to multiple hormonal changes that occurrs during pregnancy as all pregnancy supporting hormones are anti-insulin hormones which elevate the blood sugar levels.

What are the symptoms?
Dr Vimal Grover, director of obstetrics and gynaecology at Fortis La Femme, Delhi,lists these red flags:
– increased thirst and urination
– increased hunger
– excessive fatigue
– sores or injuries that do not heal or take long to heal, unexplained weight gain or weight loss, blurring of vision and numbness or tingling in limbs.

Apart from these, hereditary presence of diabetes, multiple pregnancies, PCOD, gestational diabetes, delivering a big baby, obesity, hypotension, high cholesterol, a stressful lifestyle coupled with low exercise and consumption of junk food are all reasons for women to undergo tests for diabetes, especially after the age of 45. Women also develop symptoms such as vaginal and oral yeast infections, urinary infections and female sexual dysfunction.

What complications arise?
Professor Satyan Rajbhandari, group medical director, Diabetacare, Bengaluru, cautions, “Long-term complications of diabetes develop gradually. The longer you have had uncontrolled diabetes, the higher is the risk of complication that may be disabling or even life-threatening.” These include:
– Cardiovascular disease (heart attack, angina, stroke, peripheral vascular disease)
– Nerve damage (neuropathy)
– Kidney damage (nephropathy)
– Eye damage (retinopathy)
– Foot damage (Ulcer and amputation)
– Skin conditions
– Alzheimer’s disease
Dr Sharda A, endocrinologist-diabetologist from Vikram Hospital, Bengaluru, adds that diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. It mostly happens to those suffering from Type 1 diabetes but can also be seen in other types of diabetes under certain circumstances. In DKA, the body cells do not get enough glucose they require for energy, due to lack of insulin.

What precautions can I take?
Dr Bhoraskar advises that since diabetes makes a covert entry, it is advisable to undergo the Glucose Tolerance Test and HbA1C test. If your HbA1C is less than 5.5 per cent and blood glucose level is less than 90 mg/dl after fasting and less than 140 mg/dl two hours after consuming 75 gms of glucose, you are not diabetic. It is better not to postpone testing for long since delay can raise several life-threatening complications that are often incurable. Heart-disease and depression are two major fallouts of diabetes in women which add to the misery. A good nutritional plan, reduction in omega 6 type fats, reduction of refined carbs and consuming adequate anti-oxidants as well as Vitamin D helps arrest diabetes. Reduction of screen time and more outdoor sports can help children beat obesity and diabetes. Dr Majeed gives helpful pointers to prevent and manage diabetes through the following pointers:
– Avoid snacks with excessive calories.
– Skip high-sugar beverages as they have a high glycemic load that increases the risk of diabetes.
– The types of fat in your diet can also affect the development of diabetes. Good fats, such as polyunsaturated fats found in liquid vegetable oils, nuts, and seeds can help ward-off diabetes.
– Eating red meat (beef, pork, lamb) and processed meat (bacon, hot dogs, deli meats) increases the risk of diabetes, even among people who consume only small amounts. Substituting them with healthier protein sources such as nuts, low-fat dairy, poultry, fish or whole grains lowers diabetes risk by up to 35 per cent.
– If diabetic, stick to your meal plan religiously.
– Turn off the TV or phone and get moving. Inactivity promotes diabetes. Working your muscles more often and harder improves their ability to use insulin and absorb glucose. This puts less stress on your insulin-making cells.
– Smokers are roughly 50 per cent more likely to develop diabetes than non-smokers.
– Make walking for 30 minutes an inevitable part of your daily routine.

Diabetes is a complicated and serious ailment, but it is also preventable via small measures taken early in life. Eating a healthy diet, keeping the body active, not smoking, and going for routine health check-ups are easy ways to prevent, identify and arrest diabetes. It is time to wake up to the presence of this life-threatening disease.