Understanding Diabetes

The Foundation of Your Journey

1. What Is Diabetes—Simply Explained

Diabetes is often misunderstood as simply "having too much sugar in the blood." While high blood sugar is the result, the cause is a breakdown in how your body handles energy.

Think of it like a locked door

Your cells are like rooms requiring energy (sugar). Insulin is the key that opens the door. In diabetes, either you don't have the key (Type 1) or the lock is jammed (Type 2).

Diabetes Is Not Just "High Sugar"

When sugar stays in your blood instead of entering your cells:

  • Starvation: Your cells lack energy, making you tired.
  • Toxicity: The excess sugar in the blood acts like a slow poison, damaging blood vessels and nerves over time.

Deep Dive: The 2024/2025 Indian Reality

The ICMR-INDIAB Study (2023-2024 update) has revealed alarming numbers that every Indian must know:

  • 101 Million: The number of people in India living with diabetes.
  • 136 Million: The number of people with Pre-diabetes. This is the "waiting list" for diabetes.
  • The Shift: It is no longer just a "rich person's disease". Urban prevalence is ~26%, but rural areas are catching up fast.
  • Younger Onset: Unlike in the West, Indians often get diabetes a decade earlier, in their 30s and 40s (prime working age).

Source: ICMR-INDIAB National Study Findings.

2. Types of Diabetes (It's Not Just One Disease)

Type 1: The Autoimmune Attack

The body's defense system attacks the pancreas, destroying the cells that make insulin. It is not caused by diet or lifestyle. People with Type 1 need insulin injections to survive.

Type 2: The "Overworked" Pancreas

The body makes insulin, but cells don't respond to it (Insulin Resistance). The pancreas works overtime to compensate until it eventually gets exhausted. This is strongly linked to genetics, weight, and lifestyle.

Gestational Diabetes (GDM)

This occurs during pregnancy. Hormones from the placenta block the action of the mother's insulin. While it usually resolves after delivery, it is a strong warning sign: both mother and child have a higher risk of developing Type 2 diabetes later in life.

3. Diabetes in India: Why Are We So Vulnerable?

The "Asian Indian Phenotype"

Indians are genetically unique. We tend to have:

  • Higher Body Fat Percentage: Even at a lower weight ("Thin Fat Indian").
  • More Visceral Fat: Fat stored around the belly and organs, which is metabolically dangerous and drives insulin resistance.
  • Lower Muscle Mass: Muscle is the biggest consumer of glucose in the body. Less muscle means less sugar is burned.

Urban Lifestyle and Food Transition

Rapid urbanization has led to a "nutrition transition." We have moved from traditional high-fiber diets to diets rich in refined carbohydrates (white rice, maida) and sugars, coupled with a sedentary lifestyle. This creates a "perfect storm" for diabetes.