98% of diabetics are of type-2 variety in India. It starts around the age of 40, but in recent past this trend has shattered. We are seeing lots of cases in 20 to 30 age group too.
The carbohydrate that we eat becomes glucose and goes into the blood. To reach this body (cell), a hormone called insulin is needed. Without insulin, glucose cannot flow from the blood into the cell. It is secreted by beta cells of the gland called pancreas. Usually in genetic predisposed family , faulty eating and lack of physical exercise, the ability of the insulin cells to secrete insulin is lost. Then the insulin is lacking in the body. Glucose then increases in blood but cannot penetrate into the cells. This is the stage of diabetes.
Diabetes is mainly of two types.
Type – 1:
In this, the beta cells of the pancreas are completely destroyed and thus the formation of insulin is not possible. Beta cells are destroyed in childhood due to genetic, auto immunity and some viral infections.
This disease mainly occurs in the age of less than 12 to 25 years. Type-1 diabetes has a great effect in Sweden and Finland. Type-1 variety is found only in 1% to 2% of cases in India. There is no way to treat such cases except Insulin injection.
Type – 2:
Up to 98% of diabetic patients in India are of type-2 variety. And this is our main problem. In such patients, beta cells make some insulin. Some built-in insulin becomes insensitive due to lack of physical inactivity and other factors,known as Insulin Resistance. There are many types of medicines available for such treatment of such patients. But sometimes even insulin has to be given.
Can children have type-2 disease?
These days, due to lack of exercise and fast food culture, children have started getting type-2 disease.
• It is especially happening in India.
• People under 15, especially 12 or 13 year olds are having it.
• The rate is high for girls.
• Especially among obese people whose BMI is over 32.
• In 60 to 70% of the cases, there is a special dark colored stain over back of neck called Acanthosis nigricans, which indicates insulin resistance.
• There is a history of diabetes in the family (more than 95%).
The following tests are done to distinguish this type of disease from type-1.
1. C-peptide level: In type-2 variety it is greater than 0.6 pmol / ml.
2. Serum Insulin Level: It is more in type-2.
3. Gad 65 antibody test: Positive in type-1and is negative in type-2.
Other types of diabetes:
1. MODY 1 to 4 – This is called maturity onset diabetes of young. This is due to specific genetic effects.
2. MRDM – Malnutrition related diabetes malitus It is found in some parts of Orissa, Bengal and Jharkhand due to malnutrition.Type 3c Diabetes is due to Pancreatic diseases.