Diabetes: Type 1 Diabetes & Type 2 Diabetes | Science & Technology for UPSC CSE PDF Download

Introduction

Diabetes mellitus, commonly referred to as diabetes, is a metabolic disorder characterized by elevated levels of blood sugar. The hormone insulin plays a crucial role in regulating blood sugar levels, facilitating the movement of sugar from the blood into cells for storage or energy utilization. When diabetes occurs, the body either fails to produce adequate insulin or cannot effectively use the insulin it produces. Left untreated, high blood sugar resulting from diabetes can cause damage to various organs, including nerves, eyes, and kidneys.

Types of Diabetes

There are several distinct types of diabetes, each with its own underlying causes and symptoms:

1. Type 1 Diabetes: Type 1 diabetes, also known as Diabetes Mellitus Type 1, occurs when the pancreas fails to produce sufficient insulin. The shortage of insulin leads to increased glucose levels in the blood and urine. Symptoms of Type 1 diabetes include excessive urination (polyuria), constant thirst (polydipsia), unexplained weight loss, changes in vision, and fatigue. These symptoms can appear suddenly. 
2. Type 2 Diabetes: Type 2 diabetes, also called Diabetes Mellitus Type 2, results from the body's ineffective use of insulin. Obesity and lack of physical activity are primary factors contributing to the development of Type 2 diabetes, particularly in individuals with a genetic predisposition. Symptoms of Type 2 diabetes may resemble those of Type 1 but are often less severe. Consequently, diagnosis may occur years after the disease onset, often when complications have already arisen.
3. Diabetes Insipidus: Diabetes Insipidus occurs when the body is unable to produce or respond to the Antidiuretic hormone (ADH), secreted by the hypothalamus. ADH helps regulate the body's water balance. Without this hormone, the kidneys excrete an abnormally large volume of odorless and dilute urine. 
4. Gestational Diabetes: Gestational diabetes is a condition that manifests in pregnant women, leading to elevated blood sugar levels without a prior history of diabetes. Typically, this condition resolves after delivery.

Prevalence and Impact

A National Diabetes and Diabetic Retinopathy Survey conducted between 2015 and 2019 by the Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, revealed significant insights into the prevalence and impact of diabetes:

• Diabetes Prevalence: The survey reported a diabetes prevalence rate of 11.8% in India over the past four years, with nearly equal percentages of men and women affected. The highest prevalence (13.2%) was observed in the 70-79 years age group, with males (12%) slightly exceeding females (11.7%).
• Diabetic Retinopathy: The survey found that nearly 16.9% of the diabetic population aged up to 50 years had some form of diabetic retinopathy (DR).
• Visual Impairment and Blindness: Among diabetics, 2.1% experienced blindness, while 13.7% suffered from visual impairment. Diabetes and diabetic retinopathy have emerged as significant contributors to ocular morbidity, potentially leading to blindness.
• Global Impact: In 2015, diabetic retinopathy accounted for 1.06% of global blindness and 1.16% of visual impairment. It is a growing concern on the global health landscape.

Scientific Advancements

• Recent scientific advancements have shed light on the role of the protein secretagogin (SCGN) in increasing insulin action in obesity-induced diabetes. SCGN is now recognized as a functional insulin-binding protein with therapeutic potential against diabetes. 
• It not only binds to insulin but also protects it from various stresses, enhances its stability, and amplifies its action. Interestingly, SCGN has been found in lower quantities in the brains of Alzheimer's patients, suggesting potential links between diabetes and neurodegenerative conditions.
• In conclusion, diabetes is a complex metabolic disorder with various types and far-reaching consequences for health. Understanding its types, prevalence, and the latest research developments is essential for effective management and prevention.