If you are Indian, and more so a woman, you are at a higher risk of developing Type-2 diabetes.
Every year, November 14 is observed as World Diabetes Day, a campaign focused on spreading awareness about a condition which affects an estimated 371 million people globally.
What makes women even more vulnerable are gender roles and power dynamics which impacts how they access healthcare services and their attitudes towards the condition.
According to the International Diabetes Federation, there are over 199 million women with diabetes at present around the world, a statistic which is expected to rise to 313 million by 2040. Additionally, for women, diabetes is the ninth leading cause of death around the world, causing 2.1 million deaths annually.
The campaign this year seeks to "promote the importance of affordable and equitable access for all women at risk or living with diabetes, to the essential diabetes medicines and technologies, self-management education and information they require, to achieve optimal diabetes outcomes and strengthen their capacity to prevent type 2 diabetes."
Who can get diabetes?
Anyone with a family history of the condition or leading a sedentary lifestyle is at risk.
Why are women at a higher risk of developing diabetes?
Experts say Asians, especially women and further those in the reproductive age group, fall in the high risk category.
Women go through several phases during their lifetimes, from puberty to child birth to menopause. Combined with other factors, women tend to gain weight after each of these phases, explains Dr Sanjay Reddy, a diabetologist with Fortis Hospitals in Bengaluru.
"This weight gain keeps on adding over the years, simultaneously increasing their Body Mass Index (BMI). This is unlike in the case of men where the weight gain is constant. And this gain contributes to an increased risk of diabetes," Dr Sanjay says.
Women suffering from Polycystic ovary syndrome (PCOS) and pregnant women are also more prone to getting diabetes.
What is gestational diabetes?
This condition affects women, without diabetes, and causes them to develop high blood sugar levels during their pregnancy.
Gestational diabetes is also very prevalent in India.
Dr Karthik Prabhakar, Consultant, Diabetes And Endocrinology, Manipal Hospitals, says, "More number of women today are delaying their pregnancies late into their 20s and 30s, a time when a high risk of diabetes already exists. And due to hormonal changes during pregnancy, plus other factors such as obesity, PCOS, Pre-diabetes or a history of diabetes, they get gestational diabetes."
Though a temporary condition which goes away after childbirth, it can affect both the mother and child if not controlled properly.
"Gestational diabetes is an even bigger problem than diabetes. In 80% of cases, it goes away after delivery, and then people tend to look away. This could later turn into proper diabetes in the next 10 years (if they follow an unhealthy lifestyle)," he adds.
"If you have diabetes, you can live well with diabetes. It is not a disease and it is a disorder. The idea is not to become a patient," states Dr Sanjay.
Diabetics need to be careful not to get complications related to the condition.
"As the condition affects several body parts including eyes, kidneys, heart and nerves, we don't want any of these to be affected. You need to keep your blood glucose level very much under control, HbA1c level less than 7, blood pressure around 138, cholesterol under control, not gain weight and be physically active. Take medicines and monitor your diabetes regularly, and check that you don't have complications," he adds.
While family history and genetics cannot be changed, Dr Karthik stresses that changes in lifestyle can go a long way in diabetes prevention.
Some steps include eating a balanced diet, exercising, getting adequate sleep, avoiding stress, maintaining a healthy BMI and regular blood tests for those with a family history of diabetes.
"What is important is right food in the right quantity. Quantity can be decided based on BMI, age, physical activity, etc." states Dr Karthik.
He advises to consume carbohydrates with fibres instead of refined carbs. "Eat unpolished rice over polished rice, brown over white, wheat also has more fibre. So does ragi and millets. Our bodies need around 50% carbohydrates and it should come from carbs that have fibres," he says.
Proteins (20-30%) can be got from animal sources such as eggs, milk meat, or vegetarian options like sprouts, pulses. The remaining consists of 'healthy' fats that are high in monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA).
"The remaining can be fibre, fruits and vegetables. Ensure you drink at least 3 litres of water every day. A balanced diet should be a mixture of different elements, one doesn't have to eat the same food every day. There are options. And one can always take advice from a nutritionist," he says.