Sweet Poison

MUMBAI: Sweet sixteen turned out to be quite bitter for Jay Trimabake. When a perpetually tired and sluggish Jay was taken to hospital by his concerned mother, both were in for the shock of their lives.

“After several rounds of tests, he was found to have 256 mg of sugar in his bloodstream, whereas the normal is 110 mg,” says his mother. “The doctor diagnosed type 2 diabetes. We were shocked. At such a young age how can he have diabetes?”
Over time, for Jay and his family the shock has subsided, but they still find it astounding that diabetes can catch hold of someone so young.

Not so for the researchers of the premier Diabetes Research Centre (DRC) in Delhi. “In our study across ten Indian cities, we found that type 2 diabetes has increased by over 35 per cent in the age group of 10-18 in the last 10 years,” says Dr Ashok K Jhingan, diabetologist and chairman of DRC.

What’s more, the study found the prevalence of obesity — defined as Body Mass Index (BMI) of 30 and above — had doubled in the same age group in the last decade. “About 85 per cent of children diagnosed with type 2 diabetes are overweight or obese,” adds Jhingan.

And Jay is part of the 85 per cent mentioned above and overweight. “Due to diabetes he feels lazy, gets tired too soon and does not feel like studying,” says his mother.
A couple of decades back, type 2 diabetes used to be identified with people above the age of 55. But now even ‘seen-it-all’ doctors are becoming alarmed at the rate at which adolescents and teenagers are falling prey to type 2 diabetes.

“Type 2 depends on obesity and lifestyle. The correlation between being overweight and getting diabetes is 300 per cent,” says Dr Deepak G Dalal of Bharatiya Arogya Nidhi. “With youngsters not getting enough exercise and eating a lot of junk food, they are becoming prone to obesity and by extension diabetes.”

Anuskha Kelaskar was born a healthy child. By the time she was 13, her lifestyle of ‘school-burger-tuitions-TV-chips’ had taken a toll on her health and weight.

“In medical terms I was close to being classified obese,” she remembers. “I was depressed and when mom took me to a doctor he recommended a diabetes test. Both of us thought he had lost it.”

But when the results came out the mom and daughter duo were shocked. “She was diagnosed with type 2 diabetes,” says her mother Shobha. Anuskha is 21 now, has lost oodles of weight by regular exercise and eats right. “If I want to be healthy I need to keep a check on myself. I am still a diabetic and I remember that always,” she says.

Indians need to more careful

Doctors say that Indians are genetically pre-disposed towards obesity and diabetes. “Our genetic make-up is such that even mild obesity leads to diabetes. And since these days everyone’s calorie intake is increasing and physical activity is close to zero the cases are increasing,” says Dr Tushar Pandgar, diabetologist and endocrinologist at KEM hospital.

But what is causing more alarm among the experts is that type 2 diabetes in the age group of 10-18 rarely comes with symptoms regularly associated with the onset of diabetes like excessive thirst and urination. Experts say the lack of symptoms is due the way our body reacts.

“Till 85 per cent of the beta cells - ones that produce and release insulin (a hormone that controls the level of glucose in the blood) - are not dead, symptoms of diabetes do not occur,” says Jhingan. “It is only when the 15 per cent reserve comes into play that they start developing symptoms.”

Experts are also concerned with the direct co-relation between obesity and diabetes. “Until recently most children and adolescents with diabetes had type 1. But type 2 diabetes mellitus (T2DM) is being increasingly reported in children from several parts of the world. The increase in diabetes is related to the simultaneous increasing prevalence of obesity,” says diabetologist Vinod Methil, who is a consultant with several leading Mumbai hospitals.

Kids don’t play and that’s a problem

With competition coming in early, kids today are faced with stress levels that could hobble an adult. And experts say that stress only worsens the situation. “When a person goes through stress then there are hormones that are secreted that work against the insulin. When this hormone is at its peak and insulin is less, in this case the enemies of insulin are very high,” says Dr. Dalal.

A child in age group of 10-18 suffering from type 2 diabetes causes harm to the body equivalent to a person having his first heart attack. “When a child is diagnosed with diabetes, it is equal to a person who has his first heart attack. People tend to take it lightly, which is a wrong attitude and is harmful. Type 2 diabetes, especially among children, is slowly becoming an epidemic,” warns Dr Pandgar.

More often than not, due to the lack of regular symptoms, diagnosis is delayed. “If not diagnosed within a few weeks or months when they develop diabetes they don’t live enough to develop theses complications. In the past, kids have died because of this,” reveals paediatrician Aspi Irani of Nanavati Hospital.

The effect is psychological too

A child diagnosed with diabetes often suffers psychological problems, at times permanently. “The child goes through depression, loses self esteem and it becomes difficult for them to deal with it. Small things like not being able to eat a birthday cake at a friend’s party can also affect them,” says psychologist Anuradha Prabhudesai.

Nine-year-old Zain Lookmanji has managed the transition very well. Diagnosed with type 1 diabetes when he was four and a half years old, Lookmanji needs to take insulin shots every now and then. “I can inject insulin myself. It took time for me explain to my friends, but now they all understand why I can’t eat sweets,” he says.

“It is an autoimmune disease, in which the immune system kills the beta cells which produces insulin. In the process no glucose is utilised leading to high blood glucose in the body,” explains Dr. Dalal. “People who have type 1 diabetes have to be dependant on insulin for life.”