Lifestyle Disorders – Diabetes

About Diabetes

Diabetes is a situation that weakens the body’s capacity to process blood sugar levels. The high levels of blood sugar are a result of decreased insulin production and action. During the old times, it was connected to “sweet urine” (impaired insulin function will lead to excess sugar levels in urine) and heavy muscle loss. In general, sugar levels in blood are managed by a hormone called insulin produced by the pancreas. When the blood sugar rises after taking food, insulin gets released from the pancreas to neutralize by enhancing the absorption of glucose by body cells. Diabetes is a chronic lifestyle condition and is reversible. The most frequent types of diabetes are, Type 1 Diabetes (T1D) – Insulin-Dependent, also called juvenile diabetes and Type 2 Diabetes (T2D) – Non-Insulin-Dependent. Type 2 Diabetes (T2D), also called non-insulin-dependent is the most commonly found among all the types is characterized with elevated blood sugar levels. Decreased response to insulin by the body will lead to T2D. In people who are resistant to insulin, the body slowly fails to react to the insulin and results in high blood glucose levels. 

How Common Is It: 

As per the statistics of the International Diabetes Federation (IDF), 

• More than 425 million people in 2017 were diabetic, with an expected rise to 629 million by 2045
• 79% of people with diabetes are living in low-income and middle-income countries
• 1 in 2 individuals with diabetes stand undiagnosed
• 1 in 7 live births were caused due to gestational diabetes
• In the US alone, 12% of total spending on adults was focused on treating diabetes

Clinical Features:

•  Regular urination
• Increased thirst and hunger
• Improper vision
• Numbness in hands or feet
• Dry skin and sores that heal slowly
• Muscle wasting

Problem of Diabetes in India:

Diabetes is gaining the status of a likely epidemic at a faster rate in India; with more than 60 million individuals suffering from the disease. In 2000, India stood first in the world with the highest number of people with diabetes followed by US and China. A recent study by the International Diabetes Federation says that the prevalence of diabetes is estimated to double from 171 million in 2000 to 366 million by 2030. In India, the aetiology of diabetes is multivariate and contains genetic factors linked with environmental players like obesity, urban migration, increase in the living standards, and modern-day lifestyle changes. Currently, there’s an unbalanced allocation of healthcare resources between rural and urban areas. On the top of it, factors like poverty, food insecurity, poor hygiene, illiteracy and heavy prevalence of communicable diseases play a huge role in challenging the policy makers and the governments to put-forth a quality healthcare management system in place. To decrease the burden of diabetes in the country, suitable government interventions and collaborative efforts from the shareholders and stakeholders are needed. Clinicians and healthcare personnel should be aimed at promoting implementation of screening and detection programs, management of diabetes and self-management counselling. Assertive medical measures with regards to early insulin initiation and relevant lifestyle modifications will have a long-term positive effect on the management of disease. 

Factors Contributing To Diabetes:

Of the various factors that contribute to diabetes, sedentary lifestyle and improper intake of food constitute the major ones. Type 1 Diabetes is usually caused by autoimmune reactions and Type 2 Diabetes is said to be multifactorial. The following below are the risk factors and complications of diabetes.

Risk Factors and Complications:

• Unhealthy Lifestyle – Obesity, Sedentary lifestyle, Improper intake of food
• Dietary Factors – Low intake of whole grains, High intake of sugar
• Family History – Diabetes, Blood pressure, Polycystic ovary syndrome (PCOS)
• Clinical History – Preterm birth, Metabolic syndrome, Gestational diabetes
• Clinical Traits – Vitamin D deficiency, Elevated homocysteine, Elevated HDL levels 

Do Genes Have Anything To Do With It?”

Type 1 Diabetes (T1D):

Variants that are genetic risk factors for T1D have been recognized as 6p21 (plays a role in immune response), PTPN22 (regulates T-cell signalling and apoptosis), 11p15 region, CLEC16A gene (regulates beta-cell and insulin response), IF1H gene (regulates autoantibody production), 16q23 and 1p12 regions. These variants in the genome affect the development of autoimmunity.

Type 2 Diabetes (T2D):

Genetic variants that influence cellular metabolism, insulin metabolism were identified as markers for the advancement of T2D. Wide-reaching genome-wide studies have accepted strong genetic indicators of T2D, in genes that play a huge role in regulating sugar levels of blood through various mechanisms; fat levels and fat storage, metabolic profile,  food intake and energy balance, insulin ratio, pancreatic beta-cell functioning and preprandial plasma glucose, metabolic profile, proliferation of beta islet cell, potassium channel current, insulin exocytosis, caloric intake and expenditure, weight regulation, transport and metabolism, energy balance and adipose metabolism.

Managing Diabetes Risk -Diet and Lifestyle:

Many a research report has documented the impact of air pollution, walkability and food and physical activity in diabetes management. A new term” Geoenvironmental Diabetology” has been coined to study environmental interactions with a patient suffering from diabetes. Research studies reported that high levels of physical activity and green space are linked to lower T2D risk and high levels of noise and air pollution to greater T2D risk. Natural events like earthquakes and extreme weather can create extra stress in patients with T2D. Environment will have a huge impact on factors like quality of life, mortality, metabolic control, and healthcare utilization. (Cook, Curtiss B et al, 2011). The incidence and rate of increase of T2D can be prevented by the following measures.

• Adopt a healthy diet, avoid skipping meals, and include foods like soluble fibre, antioxidants like berries, and those which will maintain insulin sensitivity.
• Consume fewer amounts of processed foods and sugar, read food labels.
• Exercise regularly and maintain a healthy weight.
• Include aerobic and resistance training exercises in your regular workouts for optimal insulin sensitivity.
• Keep yourselves physically active lifestyle throughout the day for better metabolism.

An interesting fact about all these lifestyle disorders is that they are reversible and if identified early, can be treated well. To overcome the impending burden of epidemic-turning diseases like diabetes, one should adapt themselves to a positive lifestyle with a clear balanced diet, giving up on alcohol and smoking, including fruits and vegetables, whole grains, lean meats in your daily diet, regular physical activity and more importantly, monitor your blood glucose levels on a frequent basis. On the top of it, understanding your genetic predisposition to specific health conditions helps you plan for better treatment procedures and aid in the speedy recovery. 

How Can MapmyGenome Help you: 

At Mapmygenome, our focus is mainly on predictive risk assessment, maintaining a proper diet, adapting to a healthier lifestyle. A comprehensive wellness assessment like Genomepatri will give an insight into the weaknesses of your immunity, genetic predisposition to specific health conditions, drug efficiency and helps in pre-empting most of these risks. Genetic counselling is therefore recommended to obtain authenticated reviewing and recommending testing/screening options, diet/lifestyle interventions and as educational and emotional support. 

Tapping into your genes will assist you to know the real ‘YOU’. Genomepatri helps you find the best-suited route for yourself, and reiterates the importance of not following the crowd but forging a unique way of leading quality life. It is personalized, predictive, participatory, preventive, and POWERFUL!!!

References:

1. Cook, Curtiss B et al. “Geoenvironmental diabetology.” Journal of diabetes science and technology vol. 5,4 834-42. 1 Jul. 2011, doi:10.1177/193229681100500402
2. Dendup T, Feng X, Clingan S, Astell-Burt T. Environmental Risk Factors for Developing Type 2 Diabetes Mellitus: A Systematic Review. Int J Environ Res Public Health. 2018;15(1):78. Published 2018 Jan 5. doi:10.3390/ijerph15010078
3. Kaveeshwar, Seema Abhijeet, and Jon Cornwall. “The current state of diabetes mellitus in India.” The Australasian medical journal vol. 7,1 45-8. 31 Jan. 2014, doi:10.4066/AMJ.2013.1979
4. Wild, Sarah, et al., “Global prevalence of diabetes: estimates for the year 2000 and projections for 2030.” Diabetes care 27.5 (2004): 1047-1053.