India faces a major healthcare challenge with diabetes. While type II diabetes, linked to lifestyle and sugar intake, gets a lot of attention, type I diabetes, which is more genetic, often goes unnoticed. Recent research in Mumbai showed that over half of those tested had antibodies linked to type I diabetes, especially those showing symptoms. This highlights the need to rethink how we approach type I diabetes, focusing on early testing and better management to help those affected.
Understanding Type 1 Diabetes: Type 1 diabetes is a complex disease where the immune system attacks insulin-making cells in the pancreas. This leads to a lack of insulin, which is crucial for controlling blood sugar levels. Unlike type II diabetes, which is often caused by lifestyle factors, type I is mainly due to genetic factors and immune system issues.
What Causes Type 1 Diabetes: We're still figuring out all the causes, but family history plays a big role. If someone in your family has type 1 diabetes, you're at a higher risk. Certain viruses can also trigger the immune system to attack the pancreas. Type 1 diabetes can happen at any age, but it's most common in kids and teens. Other autoimmune diseases, like thyroid or celiac disease, can also raise the risk.
Antibody Testing for Type 1 Diabetes:
Unlike type II diabetes, which can be identified through simple glucose tests, type I diabetes often eludes early detection unless clinical symptoms manifest. In the early stages, conventional tests like glucose and HbA1c levels may not reliably predict diabetes onset. Here, antibody testing emerges as a pivotal diagnostic tool. These tests, targeting specific autoantibodies associated with type 1 diabetes, include glutamic acid decarboxylase (GAD)-65 antibody, islet cell antibody (ICA)-512, IA2 insulin antibodies-protein tyrosine phosphatase, Zn transporter 8 antibody, and insulin antibody. The presence of these autoantibodies signals an ongoing autoimmune process targeting pancreatic beta cells, with the risk of developing type 1 diabetes escalating with the number of different autoantibodies detected. Individuals harbouring multiple autoantibodies face a substantially higher risk, with some studies indicating near certainty of diabetes development over time.
The study conducted at the Global Reference Laboratory, Metropolis Healthcare Ltd, unveiled critical insights into the prevalence of type 1 diabetes antibodies among Indian individuals. Out of 547 patients tested, 30 per cent exhibited positivity for a single antibody, while 23 per cent tested positive for two or more antibodies. Surprisingly, 46 per cent of the individuals tested negative for any antibodies, suggesting the presence of other factors contributing to diabetes development. These findings underscore the importance of early detection through antibody testing, enabling targeted interventions to mitigate disease progression.
Managing Type 1 Diabetes:
To manage type 1 diabetes well, we need to do a few things. Eating healthy, exercising, and getting enough sleep are important. Medications like insulin help control blood sugar levels. Researchers are also looking into new treatments that could slow down the immune system. Also, education and support for people with diabetes and their families are crucial.
To tackle type 1 diabetes, we need to work together. Governments can set up programs to test people who might be at risk. More research funding can help us understand type 1 diabetes better and find new treatments. And we need to make sure doctors know how to spot the signs of type 1 diabetes early.
Beating type 1 diabetes in India means being aware, testing early, and managing it well. With the latest research and everyone working together, we can make a real difference in the lives of those with type 1 diabetes. Let's spread knowledge, support each other, and push for better policies to make India healthier for everyone.
The author is Associate Vice President and Scientific Business Head – Clinical Chemistry, Global Reference Laboratory, Metropolis Healthcare Limited, Mumbai.
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