Diabetes is a common condition. The progressively increasing number of people with diabetes is worrying. Changes in diet and living conditions are some of the reasons behind the rising diabetic population. Better and easily available diagnostic facilities help us to reach more people with diabetes and help them to fight it. Recently I came across one post on social media which claims that the diabetes is being over-diagnosed because of influence by pharmaceutical companies.This post has tried to sound like a fact based but it is just another conspiracy theory. I felt annoyed with it, because such posts misguide patients and make them feel fooled .
Diabetes is broad term. There are many types of diabetes. Two important types are Type 1 Diabetes Mellitus and Type 2 Diabetes Mellitus. Type1 diabetes is characterized by deficiency of insulin hormone. Insulin is one of the important hormones secreted by the pancreas . Insulin tries to reduce the blood sugar level while other hormones try to increase the blood sugar level. The balance between these two forces keep the sugar level in control. In type 1 diabetes, secretion of insulin from pancreas is reduced significantly. Due to this the blood sugar level is very high. This diabetes is usually seen in young age and often diagnosed when the patient develops symptoms . The blood sugar level can be so high that it might not be recorded on glucometer. These patients need admission in hospital and diagnosis of diabetes is often made during such admissions. These patients need insulin injections to keep up with the deficiency of insulin in the body.
Now let us look at type 2 diabetes which is more common. This condition develops gradually and has many stages before it can manifest as diabetes.This condition develops because of many factors. Some of these factors are correctable like excess weight, lack of exercise and faulty diet while some of the factors are unavoidable. This condition starts with resistance to the action of insulin on cells of our body. Thus there is unopposed action of other hormones and blood sugar level tend to increase. Body tries to correct this by increasing secretion of insulin. In this early stage, the patient’s blood sugar level remains in normal range and there are no symptoms. Gradually, the resistance to the action of insulin increases to a level where it is not possible for the body to compensate and blood sugar level starts rising. In this stage , fasting blood sugar level could be in between 100 mg/dl to 125 mg /dl . This stage is called as pre-diabetes. This stage is not diabetes but the person is at risk of developing diabetes. Doctors do not prescribe any medication for this stage.
In the next stage, the fasting blood glucose level rises to 126 mg/dl or more. The resistance to insulin continues and pancreas get fatigued by continuously trying to compensate; due to this the insulin level starts going down while the sugar levels after meals tends to rise more . If a glucose tolerance test (GTT) is performed at this stage, which involves checking blood sugar levels 2 hours after consumption of 75 gm glucose , then the results are more than 200 mg /dl. Doctors prescribe a medication called Metformin which helps to reduce the insulin resistance. There are some more tablets which increase insulin secretion and can be used as needed. As diabetes grows older , these medicines cannot keep up the insulin levels and sugar levels are not controlled. This is the next stage of the condition and insulin injections are needed in such situation.
Over last few decades, our understanding of TYPE 2 Diabetes has improved. Obviously, the better understanding of the disease leads to changes in practices by doctors. New approaches and strategies are introduced. Some of these strategies turn out to be excellent and revolutionary while others are discarded over time. We have understood recently that the pre-diabetes stage is really important. Studies have shown that if people in pre diabetic phase reduce around 7% of their body weight or exercise half an hour daily, then they can reduce the chances of developing diabetes. This is the only possible way of avoiding diabetes and medication. Once the condition is advanced we have to take medication to control it. Why would pharmaceutical companies give us a chance to avoid medication by promoting diagnosis in early phase! As I have mentioned earlier, doctors will not treat pre diabetes with medicines. A diagnosis of pre-diabetes (fasting blood sugar 100mg/dl to 125 mg /dl ) thus does not help pharma companies but helps us to try and avoid or at least slow down the process of diabetes. This social media post has used only partial information to scare and misguide people.
This conspiracy theory post also gives a feel as if doctors diagnose diabetes based only on sugar level. Even the discussion in my post has eventually been about the blood sugar levels. Just to clarify this , the diagnosis of diabetes made by any qualified doctor is usually a combination of patient`s symptoms and laboratory results. If the blood sugar levels exceed the normal limits and the patient has symptoms of diabetes, then the diagnosis is easy. But if the sugar levels are in doubtful range then the doctors weigh the symptoms, signs, family history and associated conditions. If necessary the doctors can ask for a test called HBA1C which gives an idea about blood sugar level control over the last few months. A glucose tolerance test is conducted to check patient`s response to a glucose load. Sometimes doctors choose to wait for few weeks to re-check sugar levels before starting treatment.
Diabetes has many aspects apart from blood sugar levels. Many patients show great courage and determination to change their diet and lifestyle to fight with diabetes. Social media posts like the mentioned post and advertisements try to portray modern medicine as a villain. They attack doctors for their malpractice, pharma companies for their profit oriented attitude and medicines for their side effects. Many patients have insecurities and such misleading posts add to those those insecurities and fears by quoting half-truths and lies. Products like effortless weight loss remedies and treatments for diabetes without medication are the examples where businesses thrive on the insecurities of patients.
This article is just an attempt to show how truth is twisted in some media posts and advertisements. This also gave me an opportunity to discuss about the basics of diabetes. Please comment, share and discuss any doubts or thoughts you have!