One in every four of India’s youth suffer from deadlier type 2 diabetes

People under the age of 25 are increasingly at risk of type-2 diabetes, but they do not need insulin to survive. However, they are at greater risk of life-threatening complications, such as kidney damage and heart disease than people with insulin-dependent diabetes.
Young people with type-2 diabetes don’t need insulin to survive. However, that does not diminish the health risks one faces, and must be taken seriously.(Stock Photo)
Young people with type-2 diabetes don’t need insulin to survive. However, that does not diminish the health risks one faces, and must be taken seriously.(Stock Photo)
Updated on Nov 14, 2017 04:26 PM IST
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Hindustan Times, New Delhi | By

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.”

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  • ABOUT THE AUTHOR

    Sanchita is the health & science editor of the Hindustan Times. She has been reporting and writing on public health policy, health and nutrition for close to two decades. She is an International Reporting Project fellow from Paul H. Nitze School of Advanced International Studies at the Bloomberg School of Public Health and was part of the expert group that drafted the Press Council of India’s media guidelines on health reporting, including reporting on people living with HIV.

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