Heart Disease
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Diabetes
2.65 What is Diabetes? – It is a metabolic disorder of the chemical reactions that are necessary for proper utilisation of food along with inadequate or lack of insulin. Normally, pancreas release insulin proportional to the amount of food you eat for utilising the glucose in the blood to produce energy. Excess glucose is stored in the liver and muscles as glycogen (reserve energy). In between meals, when the cells need energy, glycogen is converted back into glucose and used by the cells. Glucose that cannot be stored as glycogen reaches the adipose tissue and is converted into triglycerides which is stored in the form of fat leading to weight gain and obesity.
2.66 Broadly there are two types of diabetes:
(i) Type-I Diabetes (Insulin Dependent Diabetes Mellitus – IDDM) results if your pancreas cannot make enough insulin to help glucose get inside your cells for providing energy. Type-I diabetes is also called Juvenile Onset Diabetes because normally people develop Type-I when they are children or teenagers;
(ii) Type-II Diabetes (Non-Insulin Dependent Diabetes Mellitus – NIDDM) results because the cells in the liver, muscles and fat are unable to use insulin properly. In Type-II, also known as Adult Onset Diabetes, the body does not produce enough insulin or what it does produce is defective and does not work properly or the cells ignore the insulin.
2.67 Type II diabetes is usually associated with lifestyle disorders such as bad diet, sedentary lifestyle and lack of exercise leading to obesity. About 90% of diabetics have Type-II diabetes and about 10% have Type-I diabetes. Lifestyle changes, dietary regulation, exercise and regular monitoring can help control or avoid the onset of diabetes.
2.68 There is broad consensus among diabetologists that normal fasting (10-16 hours, usually overnight) blood sugar level should be between 80-120 mg per 100 ml; a level between 120-140 mg indicates initial (pre-diabetic) stage of diabetes and level above 140 mg (confirms presence of diabetes). In post-paridial test (after 2 hours of a meal), blood sugar level of 140 mg per 100 ml is considered normal; a level between 140-200 mg indicates pre-diabetic stage; and level above 200 mg confirms diabetes.
2.69 Pre-disposing Factors for Diabetes – There are many causative factors individually or collectively, for the onset of diabetes. The two major ones are (i) Obesity – Excess weight increases body’s demand for insulin due to larger fat cells in obese people, especially with abdominal obesity. Diabetes and obesity are so strongly linked that the physicians have coined a new combined term for describing these conditions as diabesity; (ii) Syndrome X or Insulin Resistance – This is a term to describe a cluster of symptoms, including high blood pressure, high triglycerides, decreased HDL (good cholesterol) increased LDL (bad cholesterol) and abdominal obesity, which tend to appear together in some individuals and indicates a pre-disposition to diabetes and heart disease. Unfortunately, Indians and Asians have genetically high degree of abdominal obesity and are prone to Syndrome X symptoms.
2.70 Other causatives factors for the onset of diabetes include sedentary lifestyle and lack of exercise, stress, unhealthy diet, malnutrition, pancreatic inefficiency, viral infections and injuries, certain medicines such as steroids, anti-depressants and for blood pressure control, age and ethnicity.
