Diabetes in Indian children: Emerging epidemic

Type 2, earlier referred to as non-insulin dependent diabetes, is steadily increasing in prevalence throughout the world. The largest number of patients with this disease is found in India, earning the country the unwanted sobriquet of the “Diabetic Capital” of the world. The most alarming thing about this epidemic is that it is now affecting individuals at younger and younger ages. Whereas it was rare to find a 20 year old person with Type 2 diabetes 10 years ago, nowadays people are developing the disease even in their teens, as in Ravi’s case.

Why are our children falling prey to this disease of middle age? Heredity does play a role. In Ravi’s case, his father and mother had diabetes and they could have passed the gene on to their son. Unfortunately, we still do not know the exact genes that cause Type 2 diabetes. Even if we did discover any of those genes, it might not be of much help in preventing or treating the disease. In any case, hereditary factors cannot explain the increased prevalence of diabetes in the last 30 years — after all, genes do not change in such a short time!

A more important reason for the epidemic of diabetes in India is the drastic changes in lifestyle that have occurred over the past 30 years. Nowhere has this been more evident than in our children, and especially in urban areas. Children nowadays have no time for sports and games. All their time is taken up by academics. Any free time that they get is spent in front of the TV or computer. Food habits have gone from bad to worse, with easy availability of calorie-rich junk foods. No wonder childhood obesity is increasing in prevalence, and along with it, childhood Type 2 diabetes. Studies at Dr. Mohan’s Diabetes Specialities Centre and the Madras Diabetes Research Foundation have shown a 10-fold increase in childhood onset Type 2 diabetes in the last 20 years. In addition to Type 2 and Type 1 diabetes, there are other forms of diabetes with affect children such as maturity onset diabetes of youth (MODY) and fibrocalculous pancreatic diabetes but as these are rarer forms of diabetes and do not have the danger of rising to epidemic proportions even in the future, they are not discussed further in this article.