World Diabetes Day: Understanding Diabetes Epidemic In The Youth And Its Consequences

Diabetes is a complex disease with slowly progressive metabolic derangement that ultimately affects every body system. Post the pandemic world has changed, and so has the presence of this chronic disease. Previously thought to be restricted to older and obese age groups, we are now seeing its emergence in young and previously healthy people.

A more premature age of diabetes onset increases the long-term burden of the disease. These patients require intensive glucose control therapies and close monitoring to prevent end-organ damage.

Diabetes and Obesity are lifestyle diseases that are steadily growing in prevalence among the young urban population. Addressing the risk of young-onset diabetes and its long-term consequences is the need of the hour.

Diabetes: Understanding The Illness

Diabetes mellitus (Type 2), the common type or garden variety of diabetes seen in 95 per cent of affected patients, is not simply raised sugar levels. It is a multifactorial disease which is a result of a derangement in the way our body processes nutrients.

It involves the pancreas, gut, brain, kidney, fat and liver. Hormonal imbalance in the form of reduced insulin secretion and insulin action, high glucagon levels, high free fatty acid levels in the blood and a host of other processes begin to occur long before any laboratory derangements in blood sugar levels. Thus, once a clear-cut diagnosis of diabetes is made, the person is likely years in the phase of borderline high sugars, called the Prediabetes stage.

Why Is Youth More Prone To Get Affected?

It has been conclusively proven in many studies that even a healthy, non-obese Indian is at a higher risk for the development of diabetes compared to a similarly weighted individual from a Caucasian lineage.

Several theories can account for this paradox. Indians have a higher distribution of visceral fat for their weight, usually present around and in the liver, intestines, and other abdominal organs. It is different from the fat that lies immediately under our skin (subcutaneous fat). Its presence has been linked to a higher incidence of cardiac disease, stroke, and deranged cholesterol levels in the blood. It is a metabolically active fat that releases different types of hormones that cause low-grade inflammation, constrict small blood vessels, and ultimately lead to an increased risk of chronic diseases.

Changing habits of the population, a sudden shift of the populace from rural to urban areas, and significant availability of high-calorie, processed food have led to the emergence of lifestyle-related risk factors from diabetes as well. According to American Diabetes Association, a sedentary lifestyle with increasing time spent in front of the screen is also responsible for the sharp rise in diabetes prevalence in the young.

The COVID-19 pandemic further increased the effects of a sedentary lifestyle. Although not consistently proven, the covid infection itself induces long-term sequelae in the body. These range from nervous system dysregulation to inflammation and immune dysregulation. A sudden spike in cases of heart disease and newly detected diabetes in the young is now being attributed to post-corona sequelae.

Diabetes Effect On Health & Its Measures

Consistently deranged blood glucose levels for a long period directly affect small blood vessels in the eye, kidneys, and nerves. These effects are linked to the duration of diabetes, and the longer the course, the more likely it is that this microvascular complication will occur. Younger age at the onset of diabetes makes it more likely that these complications will emerge after 10-15 years of the disease. It is essential for all people with diabetes to yearly screen for these complications.

In addition, diabetes also increases the risk of heart attacks, paralytic stroke, memory loss, and loss of limb by amputation. Diabetics are up to 2-4 times more likely to have an undetected coronary artery blockage. They also had poorer outcomes when affected by the coronavirus.

It is prudent to attain rapid and early control of blood sugars, especially in younger age groups. High glucose levels in the blood in the early stage of the disease set the stage for more rapid development of complications. This increased risk persists even after adequate glucose control in the disease's later stages.

Medically called 'metabolic memory', this might result from changes in gene expression and changes in energy metabolism in sub-cellular organs of the body. Thus, early and rapid control and maintenance are critical to a healthy life with diabetes.

Also Read: In A Bid To End Body Shaming, Kerala Government To Create Awareness Among School Students