00:00In the last 15 years, there is a huge change in the incidence of type 2 diabetes.
00:07You know that type 2 diabetes is the commonest form of diabetes and it is basically related
00:11to the prevalence of obesity.
00:14So when there is obesity, especially abdominal accumulation of fat, over a period of time
00:21this results in type 2 diabetes.
00:24Why is type 2 diabetes important in India?
00:26Type 2 diabetes is very important in India, especially in Kerala where we come from.
00:34This is related to the heart attacks, strokes, the kidney failure and many many other complications.
00:42And type 2 diabetes is a huge burden for the family and for the nation.
00:49In terms of not only the money which is involved in the treatment of diabetes and its complications
00:55but also in relation to the loss of manpower, the number of hospitalizations, the number
01:03of complications.
01:06What is the average time of occurrence of type 2 diabetes?
01:10I would say that type 2 diabetes, the average age of occurrence earlier used to be around
01:1750 to 60 years.
01:19But in the last 10 years, there has been a phenomenal shift in the age of occurrence of type 2
01:26diabetes.
01:27In one of the papers along with Dr. Anu Mistra, we have suggested based on multiple studies
01:34and observations in India that screening for type 2 diabetes in our country should start from
01:4025 years.
01:42As early as 25 years, type 2 diabetes is now being diagnosed.
01:47And this also results from overweight and obesity.
01:52When you compare the surveys done by the government of India 15 years ago compared to the recent
02:00surveys, there has been a doubling of the occurrence of obesity rates.
02:06It's almost more than 40% now.
02:09And if you consider childhood obesity and that is age below 5 years, again in the last 15 years
02:17there has been a doubling from 1.9% to 4%.
02:23And this alarming statistics even in childhood indicates that the obesity rates are increasing
02:30across all age groups and the underlying obesity, especially the waist circumference, especially
02:40the deposition of ectopic fat in the liver, the fat deposition in the pancreas, the fat deposition
02:48in the skeletal muscles, all of these are resulting in more than 270 complications.
02:56And the diabetes is one among them and the diabetes results in directly many other complications.
03:03For example, more than 40 to 50% of chronic kidney disease requiring dialysis and renal transplantations
03:12are attributed to type 2 diabetes.
03:14So that is one of the major diseases now in the country.
03:20Type 2 diabetes or obesity is genetically related.
03:23Of course, there can be relationships with genetics.
03:28In some of the studies, it is said that 30 to 40% of diabetes and obesity is related to
03:35genetics and have a predisposition.
03:37But let me tell you something.
03:38These are modifiable factors.
03:42Most of them are modifiable factors even though there is a strong positive family history.
03:48It is possible that you can delay.
03:52You can keep on postponing the onset of type 2 diabetes with regular exercise and diet.
04:00But that is not that easy.
04:02You have to know your own numbers related to your height and now it is somewhat more modified.
04:10You have the body composition analyzers now available in the hospitals where we will provide the patients
04:15with the data on the amount of fat, the percentage of fat and also the percentage of skeletal muscle.
04:23So in many a time we have observed that the muscle mass is getting reduced and when a person is
04:30aging also
04:31there is a disproportionate I will say reduction in the mass and also function in the muscle which is called
04:38sarcopenia.
04:39So if you can have regular aerobic exercise to maintain the health of your lung and the heart and the
04:47muscles
04:48and if you can have regular muscle strengthening exercises, it is definitely possible to delay the onset of type 2
04:58diabetes.
04:58But the message is very very lucid.
05:01The message is you have to go for a regular lab and a medical check up at least once in
05:09one
05:09year starting from the age of 25 years onwards.
05:13And if there are early signals for the onset of diabetes such as a pre-diabetes or if there
05:21are early signals of a lipid abnormality or if there is early signals of a high blood pressure
05:28then aggressively treat it.
05:31You know it is impossible to treat all the lifestyle illnesses only with diet and exercise
05:38because diet and exercise might fail.
05:41So if it is failing don't delay it.
05:44Treat the risk factors and if required treat even the pre-diabetes.
05:49So that you can hit hard sufficiently very early in the natural course of progression of the disease.
05:57It is possible to prevent type 2 diabetes even though it is a genetically predisposed disease.
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