Context
Recently, the Indian Council of Medical Research (IMCR) released guidelines for the diagnosis, treatment, and management for type-1 diabetes.
What is Diabetes?
- Diabetes is a chronic (long-lasting) health condition that affects how your body turns food into energy.
- Most of the food you eat is broken down into sugar (also called glucose) and released into your bloodstream.
- When your blood sugar goes up, it signals your pancreas to release insulin.
What is type 1 diabetes?
- The exact cause of type 1 diabetes is unknown, but it is thought to be an auto-immune condition where the body’s immune system destroys the islets cells on the pancreas that produce insulin.
- Insulin is the hormone responsible for controlling the level of glucose in blood by increasing or decreasing absorption to the liver, fat, and other cells of the body.
- This is unlike type 2 diabetes — which accounts for over 90% of all diabetes cases in the country — where the body’s insulin production either goes down or the cells become resistant to the insulin.
- Type 1 diabetes is predominantly diagnosed in children and adolescents.
- Although the prevalence is less, it is much more severe than type 2.
How rare is it?
- The total number of people in India living with diabetes was 7.7 crore in 2019, according to the Diabetes Atlas of the International Diabetes Federation.
- There are over 10 lakh children and adolescents living with type 1 diabetes in the world, with India accounting for the highest numbers.
- Of the 2.5 lakh people living with type 1 diabetes in India, 90,000 to 1 lakh are under the age of 14 years.
- The guidelines, which distinguish type 1 diabetes from other less common forms, also talk about how increasing incidence of type 2 diabetes due to obesity in the younger population can lead to confusion.
- Among individuals who develop diabetes under the age of 25 years, 25.3% have type 2.
Who is at risk of type 1 diabetes?
- Genetic factors play a role in determining whether a person will get type-1 diabetes. The risk of the disease in a child is 3% when the mother has it, 5% when the father has it, and 8% when a sibling has it.
- The presence of certain genes is also strongly associated with the disease. For example, the prevalence of genes called DR3-DQ2 and DR4-DQ8 is 30-40% in patients with type 1 diabetes as compared to 2.4% in the general population, according to the guidelines.
