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Emerging Diabetes in the Young Indians

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Dr MV Jali, Belagavi    31 January 2018

  1. The overall global prevalence of type 2 diabetes is rising steadily. Previously, type 2 diabetes was predominantly a disease of middle-aged and older people. In recent decades, the age of onset has decreased, and type 2 diabetes is being reported in young people and children worldwide,1 particularly in high prevalence populations. The average age of onset of diabetes in Indians is a decade earlier than other races. Many are in the late 20s.2 Risks of emerging rise in prevalence of diabetes mellitus in young Indians are gaining fast momentum. Additional CV risk factors are often associated with type 2 diabetes in the young. It has profound societal cost implications that are high and escalating. The data on the pathophysiology in the young are sparse, but there is no evidence to suggest differences from adults with diabetes.
  2. The incidence of type 2 diabetes in the young is rising in parallel with the prevalence with overweight and obesity, suggesting a possible causal relationship, mainly when the obesity is central and in relation to decreased physical activity. Other factors include family history, gestational diabetes in the mother and low birthweight.1
  3. It is further observed that young, ambitious Asians and especially Indians, are getting diabetes sooner, and dying younger. Several lines of evidence show that genetic mechanisms are robust in Indian diabetic population,‘the Asian-Diabetes Phenotypes’. It remains controversial whether the decrease in β-cell function is due to an inevitable consequence of “early biological aging” or environmental and lifestyle variables apart from the Asian Diabetes Phenotype. Prevention must be the primary strategy for the future. Strategies for the prevention of type 2 diabetes in children need to involve government and societal, as well as individual change. Programs should focus on the prevention of obesity through increased physical activity and promotion of healthy living (eating),1 and to save young Indians from getting diabetes.

References: 1http://care.diabetesjournals.org/content/27/7/1798.short?27/7/1799&cited-by=... 2Gupta R, Misra A et al.2009.

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