One in every four of India’s youth suffer from deadlier type 2 diabetes
Type-2 diabetes that normally afflicts older adults is striking young Indians and it’s striking them harder.
Though young people with type-2 diabetes do not need insulin to survive, they are at greater risk of life-threatening complications, such as kidney damage and heart disease, than people with insulin-dependent diabetes.
One in every four (25.3%) people under 25 with diabetes in India has adult-onset type-2 diabetes, which, by definition, should strike only older adults with a family history of diabetes, obesity, unhealthy diets and inactivity, data from the Indian Council of Medical Research’s (ICMR’s) youth diabetes registry shows.
“Youth-onset type-2 diabetes is no longer rare. Family history is strong and obesity, metabolic syndrome and acanthosis nigricans (dark, velvety skin patches) are usually seen in young patients with type-2 diabetes,” says Dr Tanvir Kaur, deputy director general, ICMR.
Type-2 diabetes in the young is more aggressive than in adults, the registry shows. “In the young, it is a different beast altogether. The risk of complications for younger persons with type-2 diabetes is twofold to threefold higher than type-1 diabetes,” says Dr Nikhil Tandon, professor and head of endocrinology and metabolism, All India Institute of Medical Sciences, which is partnering in the registry.
There are 70 million adults in India with diabetes, which affects 422 million people worldwide. Type-1 diabetes is an autoimmune disease where the immune system destroys the cells producing insulin in the pancreas, necessitating the use of insulin to survive. “Adult-onset” type-2 diabetes occurs when the body cannot use insulin produced efficiently because of metabolic reasons, forcing the pancreas to overwork and finally stop production.
“People believe that just because young people with type-2 diabetes don’t need insulin, it is less sinister than type-1, but it’s not so. It’s not an aesthetic issue about weight or a mild metabolic disease. It needs immediate attention and treatment because complications are two to three times higher than for young people with type-1 diabetes,” says Dr Tandon.
Diagnosis is often late and disease management is poor, which leads to people landing up with complications in a hospital emergency.
The registry data shows 56.1% of the registered young diabetics have been hospitalised at least once for acute diabetes-related complications. One in seven (14.1 %) had at least one complication or “co-morbid” condition, such as hypothyroidism, dyslipidaemia (unhealthy blood fats such as cholesterol and triglycerides), hypertension, tuberculosis, or sepsis.
An unhealthy lifestyle – high calorie diet, inactivity and obesity – clearly plays a role, with urban registries recording more type-2 diabetes cases than rural ones.
What’s most important is keeping blood glucose within a healthy range according to Dr Tandon. “Poorly controlled blood glucose in young people with type-2 diabetes means looking at frequent hospitalisation and higher co-morbidities and complications like kidney failure in the 30s.”