70 million Indians to suffer from diabetes: Doc

Kolkata, May 24: India has the dubious distinction of being the Diabetes Capital of the World with 51 million (7.1pc ) of its adult population suffering from diabetes though recently China has attained this distinction.

This number is predicted to rise to almost 70 million people by 2025, said Dr Samar Bannerjee, Professor, Dept of Medicine, Vivekananda Institute of Medical Science, here.



"The condition may be even worse than estimated. The need of hour is to understand diabetes mellitus and manage it properly, so that person with diabetes can live a normal life," said Banerjee.

In diabetes, the body either does not respond properly to its own insulin or does not make enough insulin or both. Insulin is a hormone produced by beta cells in our pancreas. Insulin enables body cells to absorb glucose obtained from (Carbohydrates) food and turn it into energy.

When there is lack of absorption of glucose, it tends to accumulate in the blood and this condition is called Diabetes. Diabetes is classified as type 1 when there is absolute insulin deficiency due to complete destruction of pancreatic beta cells by auto-immune antibodies. Type 2 diabetes is characterized by relative insulin deficiency due to resistance to insulin action and continuous decline in pancreatic beta cell number.

The main goal of diabetes treatment is to lower blood glucose to normal levels as constantly High Blood Sugars are harmful to the body. This does not mean diagnosis of Diabetes means end of the Road. By having a good control of Diabetes, these complications can be successfully prevented. Appropriate medication, monitoring, diet and exercise are all essential in the management of Diabetes.

In most cases, good blood glucose control can be achieved by either lifestyle changes or effective anti-diabetic drug treatment or a combination of both. Anti-diabetic tablets are a commonly used in diabetes treatment. They reduce blood glucose either by increasing the production of insulin or by reducing the amount of glucose produced and/or helping insulin to work better in the body. Another typical treatment option is insulin therapy.

Ninety per cent of all people with diabetes have type 2 diabetes. In most people, type 2 diabetes often coexists with at least one of the other high-risk conditions like high blood pressure, abdominal obesity and abnormal blood lipids (increase in triglycerides and decrease in the 'good' cholesterol HDL-c).

These conditions add to the complications of Diabetes. Three out of four people with type 2 diabetes have high or increased blood pressure. Decreasing blood pressure can reduce the risk of cardiovascular disease and related death.

"Weight gain is one of the biggest challenges in managing type 2 diabetes, as most people with type 2 diabetes are obese. Obesity also contributes to high serum cholesterol. People with diabetes are at a higher risk of heart attack and stroke, which is complicated by the elevated cholesterol associated with type 2 diabetes," Banerjee said.

Incretin-based therapies represent a new class of treatments for type 2 diabetes; which offer better prospects. Incretins are hormones in our gut that help the body process sugar properly by increasing insulin secretion. One key incretin hormone, called GLP-1 (Glucagon-like peptide 1), is impaired in people with type 2 diabetes and this may be one reason why these people are at risk for abnormally high blood glucose levels.

So, what is GLP-1? - GLP-1 is a natural hormone present in our intestine. GLP-1 is synthesized is secreted in response to the ingestion of a meal.

GLP-1 is known to stimulate insulin release when blood sugar levels are high (after eating a meal). In addition, GLP-1 also has other beneficial effects in the body that are useful in the management of type 2 diabetes. These include reducing appetite, lowering blood pressure and improving beta cell and heart function.

To utilize GLP-1 therapeutically GLP-1 analogues have been developed. GLP-1 analogues are injectable but they are not insulin. They help in lowering blood glucose levels by stimulating the release of body's own insulin when glucose levels become too high (after eating a meal), thus lowering HbA1c. GLP-1 also helps in lowering blood glucose through the slowing of gastric emptying in the gastrointestinal tract.

As GLP-1 slows gastric emptying it reduces hunger, thus actually helping in body weight loss and reducing body fat mass. GLP-1 also helps in lowering systolic blood pressure and improving blood flow to heart muscle.

It also lowers serum glucagon concentrations (Glucagon is a hormone that acts in the liver which lead to increased levels of circulating glucose in blood), thus helping in good control of blood sugar levels. With treatment from GLP-1 chances of hypoglycemia (low blood sugars) is almost nil as these drugs act only when blood sugar levels are high.

GLP-1, with its ability to lower HbA1c, systolic blood pressure, lipid levels and body weight without inducing hypoglycemia make it a good choice for people with type 2 diabetes to control diabetes and reduce complications.