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Diabetes: Introduction to the Biggest Epidemic in Pakistan

Dr. Mehreen Zaman Niazi

3 min read

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The causative agents for the non-communicable disease diabetes are so vast that it is not possible to pack them in a single article. This article is an attempt to provide you with an introduction to diabetes, or ‘Diabetes mellitus’, is a group of metabolic diseases usually caused by an imbalance in the blood glucose-insulin production relationship. It is a chronic ailment which, once diagnosed by doctors, can be controlled or reversed, but never entirely cured.

With rapidly rising diagnostic rates, this gender inclusive ‘epidemic’ claims more lives than AIDS and breast cancer combined, mostly due to the vast number of resultant complications such as heart issues, nervous system disorders, kidney failure and vision impairments, among others.

Since every fourth person in Pakistan is suffering from this condition or is on the verge of acquiring it, many home remedies have originated which claim to cure the condition for ever and people jump at these remedies due to their desperation.

Such cases of treatment through half-doctors especially with a condition as dangerous as diabetes can be life threatening. Awareness about one’s own condition is the first step towards managing it. In this article, we will be giving an introduction to diabetes and also explain it in detail so that you can manage it sensibly.

How It Happens

Insulin hormone, produced in the pancreas, is responsible for the conversion and storage of excess blood glucose into fat cells after use by the muscles and liver. Insufficient or ineffective insulin production, or high insulin resistance by the muscles, liver and fat cells results in blood glucose accumulation, causing diabetes. The destruction of pancreatic beta-cells (which make insulin) by the immune system is also a key reason for diabetes development.

The Leptin Connection

According to studies by M. Friedman and Douglas Coleman in 1994, leptin, a fat-cell produced hormone that regulates appetite and body weight along with effective guidance of energy use, also signals and directs insulin production and use. Since leptin resistance is linked with obesity, a major cause of diabetes, it also causes irregular insulin production and eventual insulin resistance, leading to diabetes.

The Bottom Line: Both leptin and insulin malfunction are contributors to diabetes.

Diabetes in Numbers

You may be at risk of diabetes when, in addition to other symptoms, blood glucose levels are greater than or equivalent to:

126 mg/dL (decilitre) after and 8-hour fast


200mg/dL without fasting


200 mg/dL in a 2-hour glucose tolerance test.

Types of Diabetes

Diabetes is categorized into 4 categories – 2 main and 2 sub-types:

Type 1

Of those diagnosed, approximately 10% have type 1 diabetes. Previously known as ‘Insulin Dependent Diabetes Mellitus (IDDM)’ or ‘Juvenile-Onset Diabetes’, it is irreversible and most common in children and individuals under the age of 30. Although older adults might also be at risk of Latent Autoimmune Diabetes in Adults or LADA; a slow, progressive form of type 1 diabetes.

Type 1 diabetes is an autoimmune disorder, in which the immune system directs antibodies, which destroy potential foreign ‘threats’, towards the beta-cells in the pancreas, rendering it unable to produce insulin and forcing diagnosed patients to survive on injected insulin to regain regular function and avoid piling up of blood glucose and other health problems. The injected insulin is of four types:

  • Rapid-acting: Takes effect after 15 minutes and continues to work for 2-4 hours.
  • Regular-acting: Takes effect after 30 minutes and continues functioning for 3-6 hours.
  • Intermediate-acting: Enters the bloodstream 2-4 hours post-injection and works for 12-18 hours.
  • Long-acting: Starts working several hours after injection and works for nearly 24 hours.

Type 2

In this version, the pancreas can still produce insulin. Muscle and fat cells, however, become Insulin Resistant, causing overproduction and underutilisation of insulin, resulting in large amounts of unuseable insulin and blood glucose. Earlier known as ‘Adult-Onset’ or ‘Non-Insulin Dependent Diabetes Mellitus (NIDDM)’, affected individuals may require injected insulin later on due to the gradual beta-cell production decline.

Gestational Diabetes

Glucose intolerance, high blood sugar, obesity and underproduction of insulin prior to or during pregnancy are the main causes of gestational diabetes. It occurs in 2-10% of all pregnancies and is temporary; usually resolved after giving birth. However, gestational diabetes may evolve into Type 2 diabetes in 35-60% of all cases, particularly if extra weight is retained post-pregnancy or if insulin is required during it. Babies born to mothers with this condition have a high blood sugar, which can lead to future developmental problems. Diabetes retention can be checked 6 weeks after delivery via an Oral Glucose Tolerance test. If you want to change your diet or how you eat in order to avoid this disease then it is best if you contact a gastroenterologist in Karachi.

Secondary Diabetes

Surgical removal of the pancreas, trauma and other diseases such as Graves’ disease and Chronic Pancreatitis (which destroy beta-cells), results in increased blood sugar levels, causing ‘Secondary Diabetes’.

If you suspect yourself or anyone you know of diabetes, contact an Endocrinologist as soon as possible. You can also book an Appointment with a top Endocrinologist in Islamabad, Lahore and Multan through oladoc.com. Or call our helpline at 042-3890-0939 for assistance to find the RIGHT Doctor for your diabetic needs.

Disclaimer: The contents of this article are intended to raise awareness about common health issues and should not be viewed as sound medical advice for your specific condition. You should always consult with a licensed medical practitioner prior to following any suggestions outlined in this article or adopting any treatment protocol based on the contents of this article.

Dr. Mehreen Zaman Niazi - Author Dr. Mehreen Zaman Niazi is a Hepatologist practicing in Lahore. With MBBS, FCPS (Gastroenterology) and 10 years of experience in the field, she offers sound medical advice and services to patients for a range of medical conditions.

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