Finding out a Reason for Your Diabetes: Is It Important?

Finding out a Reason for Your Diabetes: Is It Important?

Amidst the pandemic of COVID-19, the management of already prevailing pandemics like diabetes mellitus, obesity and other non-communicable diseases are taking a backseat. Consequently, a significant proportion of our diabetic patients have uncontrolled blood glucose levels requiring dose escalation of their anti-diabetic medicines or initiation of insulin therapy. Also, we are encountering several individuals developing diabetes following their recovery from COVID-19 infection.

When a person is newly diagnosed with diabetes based on his/her blood glucose level, the first question which comes to our minds is “What is the reason?”. It is common knowledge that the most common cause for diabetes is Type 2 diabetes which occurs due to a combination of genetic and environmental factors. The mainstay of treatment for Type 2 diabetes is lifestyle modification measures and anti-diabetic medications in case the measures fail to control the blood glucose levels.

On the other hand, Type 1 diabetes, which is the most common form of diabetes found in children and adolescents, occurs due to autoimmune damage to the beta cells of the pancreas. Insulin therapy is the only approved life-saving treatment for Type 1 diabetes.

A small percentage of diabetic patients might have acquired the disease secondary to some other disorder like hormone imbalance (excess secretion of thyroid hormones, steroids or growth hormone), pure genetic cause (MODY) or after prolonged intake of certain drugs. Since around 8% of our population has diabetes, this small percentage would translate into a few lakhs of people who might be having a diabetes other than Type 1 or Type 2 diabetes (secondary diabetes).

Identification of the cause of “secondary diabetes” might be helpful in some patients:

• To decide on the selection of appropriate anti-diabetic agents among the list of drugs available.
• If the patient is diagnosed to have a kind of diabetes called maturity onset diabetes in young (MODY Type 2), treatment might be required only during pregnancy. In other situations, following lifestyle measures is enough. This is a really “sweet” news for a diabetic patient.
• Treatment of underlying causes might reverse diabetes in the early stages. For e.g., cure for thyroid disorder or growth hormone excess might also cure diabetes.

Based on a detailed clinical evaluation combined with blood tests, a physician or an endocrinologist will be able to identify the subtype of diabetes which might help in decision-making. The concept of “Reversal of Diabetes” which was once considered a myth has become a reality now, especially in the early stage of the disease. Subtype identification can help several diabetic patients lead a disease-free life.