Anonna Dutt
A DIAGNOSIS of diabetes at a younger age can literally cut your life short, according to a recent paper in the journal 'Lancet Diabetes and Endocrinology'. Every decade of early diagnosis was associated with a loss of three to four years of life. So, people diagnosed at the age of 30 years died 14 years earlier as compared to those without diabetes. Those diagnosed at the age of 40 died 10 years earlier and those diagnosed at 50 years died six years earlier, according to an analysis of data from 19 high income countries.
Why does an early diagnosis lead to loss of years of life?
Dr Anoop Misra, chairman of Fortis C-Doc Hospital for Diabetes and Allied Sciences, finds two key reasons. "One, early diagnosis means early onset of complications. Diabetes takes 20 years to affect the organ systems. The organs of a person diagnosed in their 30s will get affected when they are 50 but for someone who is diagnosed at 50, the damage will happen at the age of 70 years when they have already lived most of their life. Two, the diabetes detected earlier in life is likely to be more severe resulting in more harm," he explains.
The study further links an early diabetes diagnosis with deaths due to conditions like heart attack, stroke, neurological conditions and even infectious diseases. "I do not want to discourage my patients by saying that they will die younger if they are diagnosed with the condition. If a person strictly controls their blood glucose levels, they are likely to live as long as their counterparts without diabetes," says Dr Misra. He says how diabetes is managed is a more important factor that the study does not take into consideration.
Are Indians more at risk of early onset diabetes?
Dr Misra adds that Indians are at an even higher risk of developing diabetes early on in life than Caucasian populations. "The Indian genetic makeup and body type is such that we are more prone to central obesity that increases the risk of diabetes at an ear- lier age. The disease is also known to progress faster among Indians," says Dr Misra. Another reason is that most people aren't able to keep their blood glucose levels in check. "Nearly 60 per cent of people living with diabetes in our country do not have it under control," he reveals.
Is it more difficult to manage diabetes that develops at a younger age?
There is a need to aggressively control the diabetes that has been detected earlier in life as it is not likely to be mild. "Those days are gone where you would prescribe a low dose medicine, wait for a year and then increase it as needed. We now know that we have to effectively treat diabetes from Day 1 so that it does not get the opportunity to cause complications," advises Dr Misra.
For young patients, more than one-two or sometimes three-diabetes medicines have to be used in combination to ensure that the levels remain under control.
How do the newer drugs help?
Several new classes of diabetes medicines such as SGLT-2 inhibitors and GLP-1 receptor analogues-the famous drugs Ozempic and Mounjaro that are also being used for curb- ing appetite and weight loss-are powerful. They tackle multiple pathways of diabetes and help in better controlling the condition. "The analysis probably does not look at data after treatment with the newer class of drugs. They help in controlling blood sugar levels better and are likely to further reduce any life years lost due to diabetes and its complications," Dr Misra says.
What should a person do to minimise this loss of years?
Dr Misra says it is important for anyone diagnosed with diabetes to control three pa- rameters-blood glucose, blood pressure and cholesterol levels. "Persons diagnosed with diabetes will have to be very disciplined -they have to eat right, work out regularly. keep checking their parameters regularly, and have regular follow-up with doctors. This has to be throughout life," he says.
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