Diabetes: Do we know enough?

India is the world capital of diabetes, with 101 million people in the grasp of this ancient yet brand new epidemic. Most of us know diabetes increases blood sugar. So stay away from carbs, follow strict protein and keto diet, and you are good. But sadly, the real villain is far more sinister.

Diabetes is known to us since the clinicians of Egyptian civilization identified it and Ayurvedic clinicians discovered its association with raised blood sugar. Yet today , not only is it the most common non- communicable disease of India, but also the foremost player of metabolic syndrome. Hypertension, high cholesterol and diabetes together form a vicious cycle where one condition enhances the risk of other. Diabetes leads to jeopardized glucose metabolism, increased lipid formation, less utilisation of free fatty acid and glucose by body. Bypassing exhaustive clinical details, we can say that this ultimately leads to widespread inflammation in all the organs. Inflammation decreases insulin, that aggravates diabetic status and another vicious cycle ensues.

Diabetis leads to blood vessel injury which manifests through a wide range of syndromes, from chronic excruciating pain in limbs to kidney failure and retinal damage. Diabetic inflammation destroys autonomic nervous system that leads to diabetic neuropathy and non healing ulcers in skin. Diabetes causes deranged lipid metabolism and high triglycerides and LDL, which damages coronary circulation and leads to myocardial infarction. Since diabetes is a pan-systemic inflammatory condition, it decreases efficiency of immune system, causes malabsorption of gut and even cerebral conditions like brain stroke.

Even more surprising fact is, conditions like Alzheimer’s disease and Parkinson’s disease predispose to uncontrolled diabetes. Even vague mood swing, depression, anxiety are at a treaty with this culprit where one enhances the other. So we need more than our own dietary plan to combat diabetes. Just regular estimation of blood sugar level isn’t enough. We have to estimate HbA1c level, which shows how much controlled our blood glucose was in past 3 months. We have to fix a balanced lifestyle and dietary habit and stick to it no matter what. With these and advanced medications available now, we can keep this silent sweet killer at bay.