Expert Explains Measures & Preparation Before Diabetes Strike; Role of Testing Multiple Auto-antibodies

According to WHO, about 422 million people worldwide have diabetes and 1.5 million deaths are directly attributed to diabetes each year. As per Indian Council of Medical Research – India Diabetes (ICMR INDIAB) study published in 2023, the prevalence of diabetes is 10.1 crores in Indian Population.

In an interaction with the editorial team of OnlyMyHealth, Dr Priyanka Pagare, (MBBS, MD Pathology), Consultant Pathologist, Metropolis Healthcare Laboratory talks about the measures and preparation before diabetes strike. She shares, "Symptoms of diabetes aren’t restricted to increased frequency of micturition or feeling thirsty. You may experience blurring of vision, neuronal pain, recurrent urinary tract infection, fatigue, etc. "

The factors contributing to the risk of developing diabetes can be genetics, family history, environmental factors as well as lifestyle. Our body is like a magic box. Many of its secrets are revealed by scientists and many still remain hidden. One of the magic glands is our pancreas whose beta cells secrete a magical hormone called Insulin that carries the glucose from our blood stream to various cells of our body which acts as a source of energy to carry out their function. When our pancreas is able to secrete the Insulin hormone but our body is not able to utilise it for cellular glucose uptake effectively it is called Diabetes mellitus or type 2 Insulin resistance Diabetes mellitus which is more common. 

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"Our lifestyle plays a vital role in its progression. However, when our pancreas is unable secrete the Insulin hormone due to antibodies against its cells producing Insulin, indirectly accumulating glucose in the bloodstream is called Diabetes mellitus type 1 or Insulin dependent. The exact cause to develop type I diabetes is difficult to determine however, genetic factors and faulty immune regulatory mechanisms can be a few to blame. The presence of autoantibodies is the first sign of beta cell of pancreas autoimmunity. The era of scientific evolution have proven antibodies like GAD-65 Antibody, IA2-Insulin, Islet Cell Antibody and Zinc Transporter 8 (ZnT8) Antibody to be indicative for developing type 1 diabetes. Their appearance in the blood serves as an early marker to diagnose type 1 diabetes and its severity depends on the age of detection of antibodies, how many antibodies are positive at a time and their titres. A three and a half year study in the Global Reference Laboratory of Metropolis have found around 53% of the Indian population tested positive for one or more auto-antibodies indicating risk of  developing type 1 diabetes. However, this is just the tip of an iceberg as many Indians aren’t even aware of the availability for such test parameters," Dr Pagare added.

Early intervention during the pre-diabetic phase can help manage the disease and prevent serious long-term complications like Diabetic Nephropathy, Neuropathy, Stroke, Diabetic Retinopathy, Dermopathy and the list is never ending.

Today diagnosis and management of diabetes is not restricted to fasting and postprandial glucose and HbA1C evaluation only. Indices like HOMA index, C-peptide and Insulin levels can guide us to differentiate between Type 1and Type 2 Diabetes. But finding the root cause of blood glucose elevation; whether resistance or autoimmunity, and act accordingly at the earliest should be our aim to avoid such complications.