On International Diabetes Day (November 14^th), it’s time to put the spotlight on diabetes that’s taking a toll on the health of young Indians. Over 78 million Indians today suffer from diabetes and the growth curve is steep. What’s more alarming is that the number of children who suffer from Type 1 & 2 diabetes is steadily climbing and this has alarmed the medical fraternity in India.

What are the reasons for this trigger? According to Dr. Chetan R Mundada, Senior Consultant Paediatrician & Lead Pediatric Intensivist, Yashoda Hospitals Hyderabad, “The diabetes incidence in children and adolescents is increasing in India and the world over. Environmental factors like viral infections, increased consumption of refined flours and sugars and a sedentary lifestyle in genetically susceptible individuals can lead to diabetes.

He further adds that in most cases (95%) of Type 1 diabetes mellitus are the result of environmental factors interacting with a genetically susceptible person. This interaction leads to the development of autoimmune disease directed at the insulin-producing cells of the pancreatic islets of Langerhans. These cells are progressively destroyed, with insulin deficiency usually developing after the destruction of 90% of islet cells.

The signs and symptoms of Type 1 diabetes in children usually develop quickly and may include increased thirst, frequent urination, possibly bed-wetting in a toilet-trained child.

Sharing his perspective on the subject, Dr Pritam Moon, consultant physician and diabetologist, Wockhardt Hospitals said, “earlier those who suffered from diabetes were above 50 years of age. This has progressively come down and today we have people in their 20s and 30s who are afflicted by this disease.’’ When asked about adolescent diabetes, he agreed that it was due to lifestyle choices amongst adolescents and children that has contributed to an increase in diabetes cases in the target group.’’

UNICEF in a report had stated that overweight and obesity, long thought of as conditions of the wealthy, are now increasingly a condition of the poor, reflecting the greater availability of ‘cheap calories’ from fatty and sugary foods around the world. They bring with them a heightened risk of non-communicable diseases, like Type 2 diabetes.

According to Dr Srishti Puri, PhD, CDE, Behavioural Expert and Patient Experience Manager at Breathe Well-being, a Diabetes solutions start-up, " one of the reasons for the rise in cases of Type 2 diabetes in children is the lifestyle changes amongst children. The first reason is our Indian diet that is mostly high in carbohydrates and low on protein and fibre which are very important for healthy living. Reduction in physical activity due to excessive dependence on electronic gadgets thereby leading to limited mobility.  Easy availability of fast food and an imbalanced diet full of fats and carbohydrates. Not to mention the family history of diabetes amongst many Indians. Those children have a high chance of developing Type 2 diabetes at an early age. A gestational diabetes patient during pregnancy can leave traces in children to develop Type 2 diabetes.’’

How does one prevent diabetes?

While Type 1 diabetes in children cannot be cured and supplemental insulin is needed lifelong, Type 2 diabetes can be managed. What is needed is lifestyle modifications. One can prevent Type 2 diabetes at an early age by following a healthy lifestyle and monitoring eating. Children should be encouraged to undertake outdoor physical activities for at least 60 minutes daily. Physical activity not only prevents obesity but also regulates hormones which in turn improves concentration and overall mental health.

Keeping sugar levels in control, eating in moderation and controlled proportion (a low calorie, fibre and protein-rich diet), appropriate amount of physical activity as well as keeping stress levels in control. In children, it's necessary to ensure moderation. It helps make sure a child doesn't develop behavioural issues.

Dr Puri adds, “since Type 2 diabetes is a lifestyle generated problem, it can be curbed by some brisk intervention and modification in lifestyle. Also, in children, it can easily be reversed. Early-stage diagnosis and treatment make an effective and long-term impact than finding it later. Parents should lead by example and inspire their kids.’’

However, Dr Moon thinks that diabetes cannot be reversed and can only be managed.

On the topic of the percentage of children diagnosed with diabetes, Dr Mundade said that around 3-5 per cent of the total diabetic patients being treated at Yashoda hospitals are children.

According to Dr Pradeep Mahajan, Regenerative Medicine researcher, StemRx Bioscience Solutions, “Type 1 is the most common type of diabetes found in children and young adults. From the total percentage of patients treated, 20% were type-1 diabetic.”

On the topic of a correlation between recovery from Covid-19 and diabetes, Mahajan said there is a greater chance of those recovered from Covid-19 contracting diabetes as the usage of steroids during Covid-19 treatment have made patients immunocompromised and second, the stress of recovery leads to unhealthy habits.

Overall the scenario in India is quite alarming as far as childhood diabetes is concerned. In 2015 a report stated that one in 10 kids in India suffer from diabetes and as we adopt unhealthy and sedentary lifestyles this disease is expected to increase much faster. Finally, India will continue to see a rise in diabetes cases and according to the IDF Diabetes Atlas India is at the second slot right after China in the number of diabetes patients right up to 2045. What’s scarier is that over 134 million Indians will be with diabetics in the next 25 years.