Diabetes: Types, Symptoms, Causes, Treatment, Exercises & Diet

Diabetes Mellitus is a chronic condition characterized by high levels of glucose in the blood. India has the second-highest number of people with diabetes globally, with estimates of over 74 million diagnosed cases in 2021. There are two main types of diabetes - type 1, which is diagnosed in childhood, and type 2, which is more common in adults and is usually linked to lifestyle factors such as obesity and lack of exercise. Let’s find it’s symptoms, causes, treatment, prevention & more.

What Is Diabetes?

Diabetes is a chronic health condition characterized by higher levels of glucose (sugar) in the blood. It occurs when the body either does not produce enough insulin or cannot effectively use the insulin it produces. Insulin is a hormone that is secreted by the pancreas and plays a key role in controlling blood sugar levels, enabling cells to convert glucose into energy.

Types Of Diabetes

Diabetes Mellitus is a chronic health condition that affects the way the body processes glucose, leading to high levels of blood sugar. Diabetes can be categorized into two main types: type 1 and type 2. Each type has its causes, risk factors, and management approaches.

1. Type 1 Diabetes

This type of diabetes is less common in India, accounting for only 5-10% of all cases. According to the International Diabetes Federation (IDF), there were around 1,011,000 cases of Type 1 diabetes in India in 2019. Type 1 diabetes occurs when the immune system targets and destroys the cells in the pancreas responsible for producing insulin.

Insulin is a hormone that helps regulate blood sugar levels. Without enough insulin, the body cannot properly use glucose for energy, leading to high blood sugar levels. Symptoms of type 1 diabetes can develop quickly and may include excessive thirst, urination, hunger, weight loss, fatigue, and blurred vision.

 2. Type 2 Diabetes

This is the most common type of diabetes in India, affecting  90-95% of people with diabetes. According to the IDF, India had approximately 77 million adults aged 20-79 living with diabetes in 2019, and this number is expected to increase to 101 million by 2030 if preventive measures are not taken. Type 2 diabetes occurs when the body either has a decreased production of insulin or develops resistance to its effects. This can be caused by a combination of genetic and lifestyle factors, such as obesity, physical inactivity, and a diet high in unhealthy fats and sugars.  Symptoms of type 2 diabetes may develop gradually and can be mild for many years. Some individuals with type 2 diabetes may not exhibit any noticeable symptoms.

Diabetes Symptoms

Here are some of the common diabetes symptoms, according to studies by the National Family Health Survey (NFHS) which include frequent urination, increased thirst and hunger, unexplained weight loss, etc.

• Increased thirst and hunger: People with diabetes may experience excessive thirst (polydipsia) and feel hungry more often (polyphagia) even after eating because their bodies cannot use blood sugar effectively for energy.

• Frequent urination: The body tries to get rid of the excess blood sugar through frequent urination (polyuria).

• Unexplained weight loss: Even though you may be eating more, you might experience weight loss due to muscle breakdown and the inability of the body to use sugar for energy.

• Blurred vision: High blood sugar can affect the lenses in your eyes, leading to blurred vision.

• Fatigue and tiredness: Feeling tired and sluggish all the time can be a sign of undiagnosed diabetes.

• Skin infections and itching: High blood sugar levels can create a breeding ground for bacteria and fungus, leading to skin infections and itching, especially around the genitals.

• Tingling or numbness in hands and feet: High blood sugar can damage nerves, leading to a tingling or numb sensation in the hands and feet (peripheral neuropathy).

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What Causes Diabetes?

In India, diabetes is a significant health concern, with both genetic and lifestyle factors contributing to its prevalence. Here are some key factors contributing to diabetes in India.

• Genetic Predisposition: Indian populations have a genetic predisposition to type 2 diabetes, which increases the risk of developing the condition. Individuals with a family history of diabetes are at a higher risk.

• Lifestyle Changes: Rapid urbanization and adopting a sedentary lifestyle have led to increased obesity rates and decreased physical activity levels among Indians. These lifestyle changes contribute significantly to the rising prevalence of type 2 diabetes.

• Unhealthy Diet: Traditional Indian diets are rich in carbohydrates, particularly refined carbohydrates and sugars. With the increasing availability and consumption of processed and high-calorie foods, there's a higher intake of unhealthy fats and sugars, contributing to insulin resistance and diabetes.

• Obesity: Excess body weight, particularly abdominal obesity, is strongly associated with insulin resistance and an increased risk of developing type 2 diabetes.

• Stress: Modern lifestyles often lead to increased stress levels, which can affect hormonal balance and contribute to insulin resistance and diabetes. High-stress levels can also lead to overeating unhealthy foods.

• Urbanization: Rapid urbanization has led to changes in dietary habits, reduced physical activity, and increased exposure to environmental pollutants, all contributing factors to the rising diabetes in urban populations.

• Socioeconomic Factors: Socioeconomic factors such as lower education levels, limited access to healthcare, and poor infrastructure in rural areas can contribute to delayed diagnosis and management of diabetes, leading to worse outcomes.

• Age: With increasing life expectancy, the aging population in India is also at a higher risk of developing diabetes. Age-related decline in insulin sensitivity and beta-cell function contributes to the higher prevalence of diabetes among older individuals.

• Gestational Diabetes: The prevalence of gestational diabetes mellitus (GDM) is increasing in India due to factors such as maternal obesity, sedentary lifestyle, and genetic predisposition. GDM increases the risk of developing type 2 diabetes later in life for both the mother and the child.

• Lack of Awareness: Limited awareness about diabetes prevention, symptoms, and management among the general population, as well as healthcare providers, can lead to delayed diagnosis and inadequate control of the disease.

Diabetes Complications

Diabetes is a long-term health condition that impacts a significant number of individuals in India. When blood sugar levels are not controlled over time, it can lead to serious complications throughout the body.

Some of the most common diabetes mellitus complications in India:

• Diabetic retinopathy: This is a leading cause of blindness in India. It causes harm to the blood vessels in the retina, which is the light-sensitive layer located at the back of the eye.

• Diabetic nephropathy: This is damage to the kidneys caused by high blood sugar. This condition has the potential to progress to kidney failure, necessitating treatments such as dialysis or kidney transplantation.

• Diabetic neuropathy: This is nerve damage caused by high blood sugar. It may result in discomfort, numbness, tingling sensations, and weakness experienced in the hands and feet. It can also lead to problems with digestion, urination, and sexual function.

• Foot ulcers:  Diabetic neuropathy can also lead to foot ulcers. These are sores that develop on the feet due to poor circulation and nerve damage. They can be slow to heal and can become infected.

• Cardiovascular disease: People with diabetes are at a higher risk of heart attack, stroke, and other cardiovascular problems.

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Diabetes In Pregnancy

Diabetes in pregnancy, including gestational diabetes mellitus (GDM) and pre-existing diabetes, poses significant risks to both the mother and the baby. 

Gestational Diabetes Mellitus (GDM)

GDM refers to diabetes that develops during pregnancy, usually in the second or third trimester, and resolves after childbirth. In India, the prevalence of GDM is relatively high due to factors such as genetic predisposition, obesity, and lifestyle changes. According to a study published in the Indian Journal of Endocrinology and Metabolism, the prevalence of GDM in India ranges from 3% to 21%, with higher rates reported in urban areas and among women with risk factors such as obesity and family history of diabetes.

Pre-existing Diabetes in Pregnancy

Women with pre-existing diabetes (type 1 or type 2) who become pregnant are at increased risk of complications such as congenital anomalies, macrosomia (large birth weight), and preterm birth. In India, pre-existing diabetes in pregnant women is also significant, especially among urban populations and those with poor access to healthcare services for diabetes management before pregnancy. According to a study published in the Indian Journal of Endocrinology and Metabolism, the prevalence of pre-existing diabetes in pregnancy in India ranges from 0.3% to 0.7% of all pregnancies.

Maternal Complications

Diabetes in pregnancy increases the risk of maternal complications such as preeclampsia, gestational hypertension, cesarean delivery, and type 2 diabetes later in life. Maternal complications related to diabetes in pregnancy contribute to maternal morbidity and mortality, particularly among women with poor access to antenatal care and diabetes management. According to the Indian Council of Medical Research (ICMR), diabetes-related maternal mortality is a significant concern in India, and efforts are underway to improve antenatal care and screening for GDM.

Fetal and Neonatal Complications

Babies born to mothers with diabetes during pregnancy are at increased risk of macrosomia, birth trauma, respiratory distress syndrome, hypoglycemia, and congenital anomalies.

In India, fetal and neonatal complications associated with diabetes in pregnancy contribute to infant morbidity and mortality rates. According to the National Family Health Survey (NFHS), macrosomia and birth trauma rates are higher among babies born to mothers with diabetes in India, highlighting the need for improved maternal and neonatal care.

Treatment Of Diabetes Mellitus

India has a significant diabetic population, with over 10.1 crore (101 million) people estimated to have diabetes according to a 2023 study by the Indian Council of Medical Research. Here are some of the diabetes treatments.

Lifestyle Management

• Diet: You can take a balanced diet like whole grains, vegetables, fruits, and legumes. Limiting the intake of processed foods, sugary drinks, and unhealthy fats is also crucial.

• Physical Activity: Regular exercise is essential for managing blood sugar levels and improving overall health. Aim for at least 30 minutes of moderate-intensity exercise most days of the week.

Medications

• Oral medications: These may include metformin, sulfonylureas, DPP-4 inhibitors, SGLT2 inhibitors, and others. The specific medication prescribed will depend on the severity of diabetes and individual factors.

• Injectable medications: If oral medications are not sufficient to control blood sugar levels, insulin injections may be necessary.

Other Treatment Modalities

• Blood sugar monitoring: Regularly monitoring blood sugar levels is essential for effective diabetes management. This allows for adjustments in diet, medication, or lifestyle as needed.

• Education: Patient education is crucial for successful diabetes management. This includes understanding the disease, following treatment plans, and recognizing and managing complications.

Diet For Diabetes Mellitus

Diet plays a crucial role in managing diabetes by helping to control blood sugar levels, manage weight, and reduce the risk of complications. 

Here's the diet for diabetes mellitus:

• Carbohydrates: Choose complex carbohydrates such as whole grains, fruits, vegetables, and legumes over refined carbohydrates. Common complex carbohydrates include whole wheat roti, brown rice, millets (such as bajra, jowar, and ragi), and lentils (dal).

• Fiber: Fiber helps regulate blood sugar levels and promotes satiety. Include fiber-rich foods such as fruits, vegetables, whole grains, and legumes in your diet. Fiber-rich foods include fruits like guava, pear, and papaya, vegetables like spinach, broccoli, and okra, and whole grains like barley and oats.

• Proteins: Include lean protein sources such as poultry, fish, tofu, legumes, and low-fat dairy products in your diet. Common protein sources include lentils (dal), chickpeas (chana), cottage cheese (paneer), fish, and chicken.

• Fats: Choose healthy fats such as nuts, seeds, avocados, and olive oil in moderation. Reduce the intake of saturated and trans fats commonly present in fried foods, processed snacks, and fatty meat selections. Healthy fats are commonly found in nuts like almonds and walnuts, seeds like flaxseeds and chia seeds, and cooking oils like mustard oil and sesame oil.

• Limit Sugary Foods and Beverages: Minimize consumption of sugary foods, desserts, sweetened beverages, and packaged snacks. Avoid sweets like Gulab Jamun, Jalebi, and Barfi. These should be consumed in moderation or as occasional treats.

• Hydration: Maintain hydration by consuming water regularly all day long. Unsweetened beverages such as herbal teas, buttermilk (chaas), and coconut water are good options in Indian cuisine.

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Exercise For Diabetes

Exercise plays a crucial role in managing diabetes by improving insulin sensitivity, lowering blood sugar levels, and reducing the risk of complications. 

Some recommended exercises for individuals:

• Aerobic Exercise: Aerobic exercises such as walking, jogging, cycling, swimming, and dancing help to improve cardiovascular health and manage blood sugar levels. The American Diabetes Association (ADA) recommends at least 150 minutes of moderate-intensity aerobic exercise per week for individuals with diabetes. Walking for 30 minutes most days of the week can significantly benefit individuals with diabetes.

• Strength Training: Strength training exercises using resistance bands, free weights, or weight machines help build muscle mass, increase metabolism, and improve insulin sensitivity. Yoga is a popular form of strength training that also provides additional benefits such as stress reduction and improved flexibility. Traditional Indian exercises like Surya namaskar (sun salutation) can also be beneficial.

• Interval Training: Interval training involves alternating between high-intensity exercise and periods of rest or low-intensity activity. Interval training has demonstrated benefits in enhancing cardiovascular fitness, insulin sensitivity, and blood sugar regulation.

• Group Exercise Classes: Group exercise classes, such as aerobics, dance fitness, or yoga classes, provide social support, motivation, and structure for individuals with diabetes. Participating in group exercise classes can help individuals stay consistent with their exercise routine and enjoy the benefits of physical activity. 

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Conclusion

In conclusion, understanding the different types of diabetes mellitus, recognizing the common symptoms, identifying the potential causes, and knowing the various treatment options, exercises, and dietary considerations can greatly improve the management of this chronic condition. By maintaining a healthy lifestyle, staying active, and following a balanced diet, individuals with diabetes can effectively control their blood sugar levels and reduce the risk of complications associated with the disease.