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14 November is World Diabetes Day and India is among the top three countries with an ever- growing diabetic population, according to a 2016 Lancet study.The number of cases in India has risen from 11.9 million in 1980 to 64.5 million in 2014; up 50% among men and 80% among women, as per Lancet data.

Diabetes has become a lifestyle epidemic. According to the World Health Organization (WHO), the number of adults suffering from diabetes has shot up- from 4.7% of the total population in 1980 to 8.5% in 2014. In fact, in 2013, more than half were  in Asia and the Western Pacific, where 90-95% of cases were classed as Type-2 diabetes.There were 382 million people living with diabetes, globally, in 2013 and this number is expected to rise to 592 million by 2035.

It’s a silent killer in a silent population’, said Professor Juliana Chan, of the Chinese University of Hong Kong, in an interview for BBC, UK. Renal failure, cardiovascular disease, strokes and blindness are common complications that often, suddenly and out of the blue occur, without the sufferer knowing anything about it. Or being prepared for it.There is a complicated interplay between genetics, lifestyle and environmental factors – and a population,trapped by stigma, poverty and misinformation, more often than not,don’t seek help until the disease reaches advanced stages.

Diabetes is a disease of paradoxes,” saidProfessor Chan. “It is typically an ageing disease, but the data shows that the young and middle-aged are most vulnerable. It is prevalent in obese people but emerging data suggests that for lean people with diabetes the outcome can be worse.”

What causes diabetes?

This dreaded disease is a result of the inefficient functioning of the hormone insulin. Produced by the pancreas, insulin helps the body’s cells convert glucose, obtained from the food we eat, into energy. Insulin also helps muscles, and other organs, to absorb glucose from the bloodstreamfor the body’s daily metabolic activity.Essentially, diabetes is a result of insulin resistance – condition which occurs when the body’s cells fail to respond to insulin signalling and/or an insufficient amount of insulin is produced by the pancreas.

There are two common kinds of diabetes: type 1 and type 2.

In type 1 diabetes, a chronic autoimmune condition usually affecting children and young adults, the body’s immune system destroys the beta cells of the pancreas that produce insulin – basically a malfunctioning of the body’s immune system.

Type 2 diabetes, which accounts for almost 90-95% of diabetes cases, occurs because of insulin resistance and progressive insulin secretory defect. Plus, a genetic predisposition and factors such as obesity and lack of exercise can lead to type 2 diabetes. So, how do we go about keeping diabetes at bay?

Make healthier lifestyle choices

In people diagnosed with type 2 diabetes, insulin resistance is a result of unused and elevated blood glucose levels. Over time, this leads to heart disease, hypertension, elevated cholesterol levels, neuropathy, diabetic foot ulcers, retinopathy, impaired kidney function, and a host of other complications. While diabetes cannot be reversed or cured, it can be kept in check by modifying your lifestyle choices, thus lowering the levels of insulin resistance.

Get check-ups regularly: According to the American Diabetes Association (ADA), adults over 45 years old, overweight, with a body mass index (BMI) more or equal to 25, waist measurements of over 35 inches (for women) or 40 inches (for men), or have a family history of diabetes, are pre-disposed to get diabetes. Assess your diabetes risk regularly. If you’ve been diagnosed with diabetes, get a self-monitoring kit to monitor your blood glucose level. Daily.

Start a sensible diet: Cut down on junk food, cold drinks and juices. Reduce additional sweetener intake to not more than two teaspoons per day. Choose natural sweeteners – such as maple syrup. Concentrate on complex high-fibre foods such as oats, ragi, bajra, brown or black rice, and low-fat poultry preparations.

Focus on seafood like Indian salmon (rawas) and mackerel at least twice a week. Have 50-100g of cooked leafy greens daily; snack on two tablespoons of almonds or pumpkin seeds. If you are vegetarian, increase intake of foods fortified with vitamin D, iron and vitamin B12, such as fortified juices and whole-grain cereals.

Exercise regularly: Doctors recommend at least 150 minutes of moderate-to-vigorous exercise over at least three days a week. Exercise should include aerobic exercises, which help decrease insulin resistance, improve circulation and lower blood glucose levels.

After being diagnosed with diabetes, managing and controlling your lifestyle and getting regular check-ups, is key to staying healthy. For those who are pre-diabetic, healthy lifestyle choices and  habits, can actually prevent the onset of diabetes.i


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