Diabetes and the family factor

According to a recent study, there are over 73 million adults in India who have been detected with diabetes and unfortunately, one in two persons having diabetes do not even know they have this condition.

Diabetes, a condition commonly known as ‘sugar diabetes’ and medically as ‘Diabetes Mellitus’ is a health problem which is associated with increased blood glucose/sugar levels. Major symptoms of the condition includes increased thirst, frequent urination, unexplained weight loss, fatigue, boils on the skin, delayed wound-healing etc.

Fortunately, diabetes can be kept at bay if measures for preventive care rather than curative are taken. Detection rates can be improved by raising awareness of the problem/symptoms and providing better screening opportunities to ‘high-risk’ individuals with overweight/obesity, sedentary lifestyle, bad food habits, family history of diabetes, high BP, women with previous gestational diabetes, polycystic ovaries, elderly, etc.

The theme for World Diabetes Day 2018 is ‘The Family and Diabetes’. It is well recognised that any form of diabetes not only affects the patient but also impacts the psycho-socio-economics of the family. A supportive family is known to improve health outcomes of the diabetes patient. Education and raising awareness about diabetes in the family can positively contribute to ‘team effort’ at beating diabetes. Some prominent diabetes that can affect a family are:

Childhood Diabetes: Type 1 Diabetes previously referred to as ‘juvenile diabetes’, generally occurs in the first and second decades of life. Over one million children and adolescents across the world have this condition; around 1,00,000 of them live in India. They need insulin every day for survival.

Insulin is administered as injections, with newer devices like insulin-pens making the process easier. Glucometers aid in monitoring glucose readings with fingerprick, and together with diabetes education and awareness about diet and physical activity, patients with Type 1 diabetes can lead an active life.

In childhood, parents play a significant role in managing diabetes. Support from educational institutions is essential too. In recent years, with the epidemic of childhood obesity, Type 2 Diabetes, previously associated with adult life, is affecting obese children and adolescents too — one in 10 children in India are at risk of this condition.

Gestational Diabetes (GDM): Occurring during pregnancy, this diabetes generally disappears after delivery. Indian women have an 11-fold higher risk than Caucasians of experiencing elevated blood sugar levels during pregnancy; nearly 90% is due to GDM. Risk factors for GDM include being overweight, having a family history of diabetes, Indian descent, having had a large baby previously, previous GDM, PCOS, or being over 25-years-old.

GDM is a risk for both mother and baby if not detected or well-controlled. For instance, the baby might get too big making delivery difficult. Also, the baby may have problems like low blood sugar, jaundice and low calcium, and subsequently, the child may be at higher risk of being overweight and developing diabetes when it gets older. A GDM mother may be at a higher risk of Caesarean section, and also of developing type 2 Diabetes in the future.

Prediabetes: This condition is diagnosed through blood tests, wherein blood glucose level is more than normal, but not high enough to be called diabetes. In simple terms, it is ‘borderline diabetes’, and an early warning of getting full-blown diabetes over the next few years if left unchecked. It provides a window of opportunity to intervene with lifestyle measures, and medications if required, to reduce the risk of progression to Type 2 diabetes

Type 2 diabetes is increasing across the world, owing to rapid urbanisation, easy availability of high-calorie food, sedentary lifestyle, lack of adequate exercise, ageing population, genetic risk, stressful/hectic life with unhealthy eating patterns, etc. All is not lost though! Scientific research has shown that in prediabetic patients and high-risk individuals, weight loss through an active, healthy lifestyle can reduce the risk of diabetes.

There is a need to control the symptoms to make everyday life better, while reducing the risk of complications to eyes, kidneys, feet, heart, etc. Promoting a healthy, supportive environment at home, and a good lifestyle and diet will benefit both adults and children. Awareness about diabetes symptoms among family members can ensure that ‘undetected’ cases are spotted early, and lower the risk of delayed treatment or complications. Regular clinical and lab assessments are necessary to ensure diabetes control is achieved and maintained.

(The writer is Consultant Endocrinologist & HOD, Manipal Hospitals, Bengaluru)