Diabetes mellitus Type 1 (also known as Type I diabetes, T1D, T1DM, IDDM, juvenile diabetes) is an auto-immune disease that results in the destruction of insulin-producing beta cells of the pancreas.
Thus far, such destruction has been permanent, but there is informed speculation that reversing the immune system malfunction may allow recovery of beta cell function. The lack of insulin causes an increase of fasting blood glucose (around 70-120 mg/dL in healthy people) that begins to appear in the urine above the renal threshold (about 190-200mg/dl in most people), thus connecting to the symptom by which the disease was identified in antiquity.
The prevalence of Type 1 Diabetes in India is 10.1-10.6 per 100,000. According to various studies conducted over the years, this population is prone to developing chronic complications and is exposed to various risk factors.
Diabetic patients are at increased risk of atherosclerosis and its clinical sequel, and according to the New Delhi-based Diabetes Care Foundation of India, premature atherosclerosis can be caused by changes in plasma lipid profile as also poor metabolic control.
The foundation's head and Director, Dr. Vikas Ahluwalia, says he is particularly concerned about the fact that diabetic children and adolescents having significant disturbance in lipid metabolism, both qualitative and quantitative, and adds that in his experience, most of them end up being insulin dependent for their entire lives, and therefore, he and his foundation is keen to address the ailment head-on with the launch of insulin banks.
Type 1 is lethal unless treated with exogenous insulin. It is not exclusively a childhood problem, and according to Dr. Ahluwalia, currently there is no clinically useful preventive measure to counter the onset of the disease.
He and other experts, however, admit that a vaccine has been proposed and anti-antibody approaches are also being investigated.
The cause of Type 1 diabetes is still not fully understood. Some theorize that it is generally a virally triggered autoimmune response in which the immune system's attack on virus infected cells is also directed against the beta cells in the pancreas. Others suggest that deficiency of Vitamin D3 might be an important pathogenic factor. It can be inherited genetically.
As of 2009, there is no known cure for Type 1 diabetes in the modern clinical sense. With over 35 million diabetics patients, India is sitting on a volcanic diabetes epidemic, the scale of which far surpasses anything previously witnessed. According to a World Health Organization (WHO) estimate, India will have around 80 million diabetes patients by 2030.
With a huge level of urban migration, poverty and the socio-economic transition that has taken place over the last decade, people have experienced tremendous lifestyle changes.
New statistics indicate that diabetes is now becoming far more common among poor and needy children and women who are in gestation. The most worrying aspect is increasing prevalence of diabetes in poor children in India.
In the new millennium that has been characterized by a life that is more frenetic and fast-paced, children have stopped enjoying physical activity and have no time for sports and games. A majority of their time is taken up by academics and any free time that they do get, is spent in front of a television or a computer.
Their food habits have gone from bad to worse. Home-cooked and healthy meals have given way to calorie-rich junk food. Childhood obesity is on the rise and so is childhood Type 2 diabetes, or non-insulin dependent diabetes.
According to one study conducted in Chennai, there has been a ten-fold increase in Type 2 diabetes in the last 20 years. But, according to Dr. Ahluwalia of the Diabetes Care Foundation, children suffering from Type 1 diabetes i.e. kids who are insulin dependent, cannot be ignored and do also need equal if not more attention and care.
And, it is in this context, that the Diabetes Care Foundation of India, which has been at the forefront of organizing diabetes care camps in the Delhi and the NCR region for the last couple of years, feels that an insulin bank would benefit kids suffering from this life-threatening disease.
Dr. Ahluwalia believes that in setting up an insulin bank, children who are not well-off or poor, or don't have social insurance support, can be treated more effectively free of cost.
The pre-requisite for availing this free treatment would be a BPL Card or a letter from an authorized government office.
The basic objective, he says, is focused on providing primary, secondary and tertiary prevention at all costs, as the disease is assuming dangerous levels among kids.