Knowledge is power – know your risk and spread the word

14th November is World Diabetes Day. It is a global observance that was created in 1991 by the International Diabetes Federation with support from the World Health Organisation. It became an official United Nations day in 2006. 

The campaign aims to educate the public about diabetes, to mobilise political will and resources to address the challenges in care of the diabetic population, while at the same time celebrating and reinforcing the achievements in tackling diabetes so far.

Being diagnosed early is very important in diabetes to avoid medical emergencies and life-threatening complications in the long run. 

Presently, around 589 million adults are affected with diabetes worldwide, and 4 in 5 adults with diabetes live in low and middle-income countries.

In 2024 alone, diabetes was responsible for around 3.4 million deaths worldwide. The total number of people living with diabetes is estimated to reach 853 million by 2050.

These data underscore an urgent need for global action to tackle diabetes. Unfortunately, India is home to the world’s second-largest adult diabetes population and addressing diabetes with urgency and compassion is the need of the hour.

November 14th was chosen because it is the birthday of Sir Frederick Grant Banting, a Canadian physician and scientist who along with Dr.Charles Herbert Best in 1921 discovered Insulin, a hormone of critical importance in regulating blood sugar levels.

The Nobel Prize in Medicine was awarded to Banting and John James Rickard Macleod in 1923. Banting is the youngest Nobel laureate for Physiology/Medicine. They shared their award with Best and James Collip, respectively. 

The day is represented by a blue circle logo, which signifies the unity of the global diabetes community. The theme of the World Diabetes Day 2025 campaign is ‘Diabetes across life stages’.

Activities will focus on providing comprehensive, equitable and high quality care across all life stages including childhood, the reproductive years, working age and older adulthood.

Diabetes is a chronic disease in which a person has high blood glucose(sugar) either because they are not producing enough insulin or because the body does not respond properly to insulin.

Insulin is a hormone produced by the pancreas. Type 1 diabetes is characterised by a lack of insulin production, while Type 2 is caused by the body’s ineffective use of insulin.

The former which develops quickly and is usually diagnosed in children, teens and young adults constitute 5-10 % while the latter which develops over many years and is usually diagnosed in adults constitute 90-95%. 

Elevated levels of blood glucose over time lead to serious damage to the heart, blood vessels, eyes, kidneys and nerves. Gestational diabetes develops in pregnant women, which usually goes away after the baby is born.

However, it puts the mother at risk for Type 2 diabetes later in life. Prediabetes is potentially reversible and happens when blood glucose levels are higher than normal but aren’t high enough to be called diabetes.

Risk factors for type 1 diabetes are not clear except for a family history, while risk factors for prediabetes and type 2 diabetes include family history, age 45  and above, overweight or obesity, smoking, physical inactivity, heavy alcohol consumption, high blood pressure and unhealthy diet.

Symptoms of diabetes may include excessive thirst, frequent urination, constant hunger, losing weight without trying, feeling tired and weak, feeling irritable or having other mood changes, having blurry vision, having slow-healing sores or cuts, having frequent infections, etc.

Type 2 diabetes may be silent, and many patients may remain undiagnosed till they develop complications. There are several types of blood tests that can help diagnose diabetes. Random blood sugar test checks blood sugar at any time of the day.

Fasting blood sugar test, checks blood sugar after an overnight fast(not eating). The A1C test is a measure of the average blood sugar levels over the past three months.

Glucose tolerance test measures blood sugar before and 2-3 times after the consumption of glucose. In type 1 diabetes, the blood is checked for autoantibodies while the urine is checked for presence of ketones. Depending on the type of diabetes, treatment includes oral drugs, insulin and blood sugar monitoring.

Keeping a healthy weight through a healthy diet and exercise plan is very important in diabetes management. The diet should be rich in nutrients and low in fat and calories with the key elements being fruits, vegetables and whole grains.

Aerobic exercises like walking, cycling, jogging and swimming are beneficial. Yoga and meditation are also useful. However, both diet and exercise plans should be tailored to meet the specific needs of each individual.

Diabetes causes severe and several health impacts over time if not treated and controlled. Diabetes makes it harder to control blood pressure and cholesterol, leading to heart attack and stroke.

It can cause blindness by damaging the blood vessels in the retina. Uncontrolled high blood sugar damages the tiny blood vessels in the kidneys, impairing their ability to filter waste.

Nerves get damaged causing pain, burning and tingling sensation. In addition to a weakened immune system, diabetes increases the risk of dementia and bone diseases, including osteoporosis.

Diabetes and anxiety have a bidirectional relationship, and living with a chronic disease is mentally challenging. 
Better diabetic education and knowledge to control and treat diabetes at the right time can minimise the chances of developing complications and thus reduce morbidity and mortality, in addition to reducing the overall economic costs of diabetes.

A patient centred approach can reduce long term diabetes complication with the timely involvement of trained diabetes caregivers,proactive physician participation and an easily accessible healthcare system dedicated to diabetes care.

Medications and devices to check blood sugar should become affordable to all.Diabetes is more prevalent in low-income communities, where healthy food choices may be limited or unaffordable.

General physicians especially in rural areas who are the primary contact of diabetes care for patients should receive training so that they have UpToDateknowledge and can practise evidence based medicine and refer patients to Endocrinologists and other specialists whenever required.

The healthcare system should be patient friendly and the recommended treatment should be wallet friendly.

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