How uncontrolled blood sugar is pumping up chronic illness numbers

Diabetes, if not addressed properly, will worsen and cause complications in the form of damage to the heart, blood vessels, eyes, kidneys and nerves, health experts have warned, adding that the blood sugar disease is worsening chronic illnesses.

About 400 million people worldwide have diabetes with more than 100 million in India alone.

According to healthcare providers, individuals with diabetes mellitus (DM), an inadequate control of blood levels of glucose, are at three times the risk of developing TB and there are now more individuals with TB-DM co-morbidity than TB-HIV co-infection.

Pulmonary TB accounts for 70-80 per cent of the cases, and it is generally accepted that immune compromise facilitates hematogenous dissemination of Mtb, predisposing to extrapulmonary TB.

Mtb induces a strong cell-mediated immunity leading to the formation of pulmonary granulomas (tubercles) that are thought to be a double-edged sword for the host treatment failure.

“TB-DM versus TB-no DM patients are more likely to remain sputum smear-positive after completion of the intensive phase of treatment, and this outcome is an early predictor of treatment failure (sputum smear or culture positivity at five months or later during treatment), which is also more likely in TB-DM versus TB-no DM,” explained Dr Kuldeep Kumar Grover, Head-Critical Care and Pulmonology, CK Birla Hospital.

In the last 30 years, the prevalence of Type 2 diabetes has risen to a pandemic level, involving all countries and all income levels.

For people living with diabetes, access to affordable treatment, including insulin, is critical for their survival. It is now a global target to halt the rise in diabetes and obesity by 2025.

Dr Archana Juneja, Consultant, Endocrinologist at Kokilaben Dhirubhai Ambani Hospital in Mumbai said that diabetes significantly exacerbates chronic illnesses by directly affecting multiple systems in the body.

“Uncontrolled diabetes induces cellular-level changes that can adversely impact vital organs such as the kidneys, heart, eyes, nerves, and circulation. The presence of additional factors like high blood pressure, high cholesterol, and smoking further compounds the detrimental effects of long-standing and uncontrolled diabetes, worsening the overall burden of chronic diseases,” Juneja told IANS.

Elevated blood sugar levels can be toxic to cellular functions, affecting cells throughout the body.

Diabetes is commonly associated with chronic illnesses like cardiovascular diseases, kidney diseases, and eye diseases.

“In terms of communicable diseases, diabetes affects the body's immune system. This is a result of chronic, long-standing diabetes rather than an immediate effect. Long standing uncontrolled diabetes suppresses the immune system and impairs the body's defense mechanisms, making individuals with diabetes more susceptible to infections such as tuberculosis, as well as fungal, viral, and bacterial infections,” said Juneja.

According to Dr Rakesh Kumar Prasad, Consultant, Endocrinology, Fortis Hospital in Noida, heart disease is more common among people with diabetes.

“Individuals with diabetes have a higher risk of developing heart disease compared to those without diabetes. This increased risk is attributed to various factors, including obesity, age, high blood pressure, high cholesterol levels, and insulin resistance,” he told IANS.

Heart disease in the context of diabetes often manifests as atherosclerosis, a condition characterized by the accumulation of plaque inside the arteries, leading to their narrowing and decreased blood flow to the heart.

This can result in symptoms such as chest pain (angina), heart attacks, or even sudden cardiac death.

To prevent heart disease, individuals with diabetes can adopt several lifestyle changes like quitting smoking, losing weight, eating a healthy and balanced diet, regular exercise and maintaining ideal blood pressure/cholesterol levels, along with managing healthy blood sugar levels which is vital for individuals with diabetes to reduce the risk of complications.

To minimise the impact of diabetes on chronic illnesses, the key solution lies in maintaining optimal glucose levels. This involves adhering to specific targets, such as fasting blood sugar levels between 90-120 (depending on the patient's age) and post-meal levels between 140-180.

“Additionally, the glycosylated hemoglobin (HbA1c), a marker of long-term diabetes control over three months, should ideally be kept below 7 per cent,” Dr Juneja informed.