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Diabetes is a condition in which the sugar (glucose) level in the blood is high.

• The body gets glucose from the food consumed (primarily carbs).
• When we eat, the body breaks down the food into glucose.
• This glucose is carried by the blood to the cells to provide energy.
• However, to get into the cells, a hormone called insulin produced by the pancreas is essential.
• If this hormone is either not produced in sufficient amounts by the pancreas, or the body is unable to utilize the insulin produced, the glucose stays in the blood resulting in high blood sugar and the condition that we call diabetes.

Types of Diabetes

There are many types of diabetes. The most common types are:

• Type 2 Diabetes: This is the most common form of diabetes. It happens due to the reasons previously mentioned – reduced or non-production of insulin, or insulin resistance in the body.
• Type 1 Diabetes: Around 10% of people with diabetes have this type. Type 1 diabetes is an auto-immune condition in which the immune system harms the cells in the pancreas that produce insulin. With the insulin-producing cells compromised, the person develops type 1 diabetes.
• Pre-Diabetes: This is a condition in which a person has increased blood sugar, but the level is not high enough for the condition to be called diabetes. However, if not treated, pre-diabetes will lead to diabetes.
• Gestational Diabetes: This type develops during pregnancy and usually goes away after delivery. But women with gestational diabetes should stay on guard as their chances of developing diabetes later in life are high.

The Indian Scenario

India has seen a shocking rise in diabetes cases. The number of people living with diabetes was estimated to be around 32 million in the year 2000. That number has now jumped to an alarming 101 million, with reports suggesting that this figure could be even higher. This jump is attributed to many reasons:

• Changes in Dietary Pattern: Studies suggest that starting from the 1960s and 70s, Indian people started to slowly shift from whole grain cereals (hand-pounded rice, whole grain wheat, etc.) to polished rice and wheat. This was accompanied by a corresponding increase in restaurant food. Further, with the introduction of western fast food, the carbohydrate, fat, and sugar content of the food consumed spiked sharply. This eventually led to the body becoming unable to produce enough insulin to handle the increased blood sugar that resulted from this unhealthy diet.
• Reduced Physical Activity: Changes that were slowly brought about by advancing technology to make life easier resulted in reduced physical activity – be it the use of elevators/escalators instead of stairs, the use of public transport instead of walking/cycling, or the use of tractors in farming instead of manual ploughing techniques – all had the unfortunate effect of reducing physical effort. This combined with the above-mentioned changes in diet, slowly but surely increased the number of people with diabetes in our country.
• Other Factors: Newer risk-factors are now coming into light. These include irregular sleep hours due to work demands, demanding work that leads to stress, pollution, etc. all of which have been linked to diabetes incidence.

Setting the Record Straight

Diabetes is a silent condition – its initial stages are symptomless. As a result, many people maybe suffering from diabetes without knowing it.

Despite healthcare industry leaders stressing on the urgent need to control diabetes, the number stubbornly refuses to stop climbing. The reasons range from lack of awareness to misinformation and myths. Separating the myths from the facts will help people understand what they have to guard against.

           1. Myth: “I do not have a family history of diabetes; hence, I cannot develop diabetes.”

Fact: While family history does increase risk of diabetes, it is not the only factor. There are many people with diabetes who do not have a family history. Unhealthy lifestyle choices along with being obese play a huge role irrespective of family history.

           2. Myth: “I am thin. So, I need not bother about diabetes.”

Fact: While obesity is a definite risk factor, being thin does not protect a person against diabetes. 10-15% of people diagnosed with diabetes are thin, with BMI less than 25. These people are said to have lean diabetes. People with lean diabetes usually have severe insulin resistance, with research suggesting that people who suffered from malnutrition in childhood are more likely to get the condition.

          3. Myth: “I have only borderline diabetes – I don’t have to worry.”

Fact: The official name for borderline diabetes is prediabetes. Prediabetes refers to sugar levels that are above normal but not high enough to be called diabetes. Prediabetes seriously increases the risk of developing diabetes. However, eating healthy, exercising and losing weight can decrease the risk.

          4. Myth: “People with a diabetic condition have to be on a special diet.”

Fact: There is no special diet – people with diabetes need to be on a healthy, balanced diet which is what is recommended for everyone to stay healthy. However, for people with a diabetic condition, there is more stress on getting the needed carbs from non-starchy sources, and monitoring salt and sugar consumption.

5. Myth: “My sugar levels are under control – I don’t have to go for further reviews.”

Fact: Many people (who are diagnosed with diabetes) are able to control their sugar levels by eating a healthy diet and exercising. However, diabetes is a progressive condition and there are chances of blood sugar increasing even with a healthy lifestyle. Hence, it is essential to keep monitoring sugar levels as recommended by the treating physician.

6. Myth: “People with diabetes should avoid sports.”

Fact: Exercise is extremely beneficial for people with a diabetic condition. However, it is always good to consult a doctor before starting a new sport as he/she can evaluate your condition, take into account any complications, and help with any doubts regarding safety.

7. Myth: “People with diabetes should avoid fruits.”

Fact: Fruits are rich in vitamin and minerals. They are high in fibre and low in fat content. Glycemic index for most fruits is low or medium. Further, they protect against heart attack and also have anti-cancer properties. Hence, the key is not to avoid fruits because of their sugar content but to focus on low-GI fruits, portion control and distributing fruit consumption through the day.

8. Myth: “Only older adults are at a risk of diabetes.”

Fact: While older adults are at a higher risk, no age group is protected from diabetes, including children.

9. Myth: “I am taking medication for diabetes; so, I can eat what I want.”

Diabetes management involves a combination of medication, diet and exercise. Just medication is not enough.

10. Myth: “I have only mild diabetes.”

There is no such thing as mild diabetes. All types are serious and need effective management to prevent complications.