Diabetes Mellitus (DM)

1.  India being Diabetes Capital of the World with 17% of the total number of diabetes patients in the world (nearly 10 crore people with diabetes in India), how serious are we – towards focusing on the lack of dietary diversity, dependence on high-carbohydrate and processes foods, lack of physical activity & air pollution?

2.  Nearly 50% of all adults with diabetes remain unaware of their illness @ global-scale. Why is it so?

3.  Even with significant medical advancements, why is that we still have more than 30 crore individuals living with undiagnosed diabetes @ global-scale, while, more than 60 crore individuals are just managing DM?

4.  Among the list of top 5 nations with the highest prevalence of diabetes in the world, the presence of China (150 million cases) & India (80 million cases) remains not surprising due to its population. However, US stands @ 4th position with nearly 35 million cases of diabetes. Then, what are we supposed to understand on the origin/cause of diabetes with reference to an individual’s overall dietary and life-style?

[China & India remains attached with traditional forms of living, while, US remains attached with modern forms of living: Is it not correct?]

5.  Is it necessarily characterized by persistently high blood glucose levels?

6.  When exactly the insulin production becomes inadequate?

7.  When does the body fail to utilize the produced insulin?

8.  Can a regular exercise prevent the autoimmune death of pancreatic beta cells (type 1 diabetes)?

9.  Whether Type 2 diabetes necessarily has a vital genetic component?

Is it always strongly linked to obesity and a sedentary lifestyle?

10.  Is it a precursor for Ischemic heart disease & Stroke?

11.  Is it true that nearly 50% of individuals who have succumbed to COVID-19 were afflicted with vascular & metabolic disorders including DM?

12.  Whether Type 2 DM be prevented or delayed with non-pharmaceutical strategies in the absence of practicing regular physical activity?

13.  To what extent, the delays in the detection and diagnosis of T2DM stemming from Impaired Fasting Glucose would lead to suboptimal disease management and an escalated predisposition to complications?

14. Are there any other critical clinical indicators towards identifying individuals as having an augmented susceptibility to DM, apart from obesity, hypertension, dyslipidemia and antecedent instances of aberrant glucose levels?

Suresh Kumar Govindarajan Professor (HAG) IIT Madras