It’s all in the hands of Women and Moms! – World Diabetes Day Message

In the year 2015, International Diabetes Federation (IDF) reported that 415 million adults have diabetes worldwide; and India alone harbor 69.2 million adults with diabetes. As we expect the release of the eighth edition of IDF Atlas in a couple of days, soon we will know the alarming diabetes prevalence as of today. What can we do to stop this? On the occasion of World Diabetes Day (14th November) with a theme “Women and Diabetes: Our Right to a Healthy Future” - “Diabetes can be prevented and controlled… It’s all in the hands of Women and Moms” – says Dr. M. Balasubramanyam, Dean of Research Studies & Senior Scientist from the Madras Diabetes Research Foundation, Chennai, India.

World Diabetes Day: the Background: November 14th is globally observed as World Diabetes Day – aimed at raising diabetes awareness and calling for urgent action to tackle the diabetes epidemic. The date was chosen because it marks the birthday of Frederick Banting, who, along with Charles Best, is credited with the discovery of insulin. World Diabetes Day was created in 1991 by the International Diabetes Federation and the World Health Organization in response to growing concerns about the escalating health threat that diabetes now poses. World Diabetes Day became an official United Nations Day in 2007 with the passage of United Nation Resolution. This landmark resolution also recognized diabetes as “a chronic, debilitating and costly disease associated with major complications that pose severe risks for families, countries and the entire world.” Until 2006, there was no global symbol for diabetes. A ‘blue circle’ logo is now the universal symbol for diabetes which was adopted in 2007 passage of the United Nations World Diabetes Day Resolution. The blue circle signifies the unity of the global diabetes community in response to the diabetes pandemic.

World Diabetes Day Theme: Since 1991, each year World Diabetes Day is centered on a theme related to diabetes. The theme and slogan for this year’s (2017) activity is “Women and Diabetes: Our Right to a Healthy Future”. The campaign is aimed to promote the importance of affordable and equitable access for all women at risk for or living with diabetes to the essential diabetes medicines and technologies, self-management education and information they require to achieve optimal diabetes outcomes and strengthen their capacity to prevent type 2 diabetes.

Women under deadly diabetes threat:
There are currently over 199 million women living with diabetes. This total is projected to increase to 313 million by 2040. Two out of every five women with diabetes are of reproductive age, accounting for over 60 million women worldwide. Diabetes is the ninth leading cause of death in women globally, causing 2.1 million deaths per year. Women with type 2 diabetes are almost 10 times more likely to have coronary heart disease than women without the condition. Women with type 1 diabetes have an increased risk of early miscarriage or having a baby with malformations. Therefore, all women with diabetes require affordable and equitable access to care and education to better manage their diabetes and improve their health outcomes.

Gestational diabetes is an alarming health burden in pregnant women:
Hard to believe but it is true. 1 in 7 births is affected by gestational diabetes (transient diabetes that occurs in certain women during their pregnancy). IDF estimates that 20.9 million or 16.2% of live births to women in 2015 had some form of hyperglycaemia in pregnancy. Approximately half of women with a history of GDM go on to develop type 2 diabetes within five to ten years after delivery. Half of all cases of hyperglycaemia in pregnancy occur in women under the age of 30. The vast majority of cases of hyperglycaemia in pregnancy were in low- and middle-income countries, where access to maternal care is often limited. Therefore, pregnant women require improved access to screening, care and education to achieve positive health outcomes for both the mother as well as child.

Diabetes Prevention is in your Mom’s hands! While the focus worldwide is to prevent diabetes – one way to prevent diabetes is to take care of the women during their pregnancy with aim to prevent and treat GDM; this means Diabetes Prevention is in your Mom’s hands! – says Balasubramanyam. The prevalence of GDM is increasing worldwide especially in developing countries. In India the prevalence of GDM is as high as 20%. It is crucial to detect women with GDM as the condition is associated with diverse range of adverse maternal and neonatal outcomes, i.e., health burden not only to the mother but also to the offspring at a later stage of the life. Research studies clearly point out that the risk for diabetes is programmed in the mother’s womb itself. As the slogan for this year’s World Diabetes Day is “Women and Diabetes: Our Right to a Healthy Future” – we can protect the mother as well as offspring from the development of diabetes by taking care of the women during their pregnancy. Type 2 diabetes prevention strategies must focus on maternal health and nutrition and other health behaviours before and during pregnancy, as well as infant and early childhood nutrition. Antenatal care visits during pregnancy must be optimized for health promotion in young women and early detection of diabetes and GDM.

Early Biomarkers to Predict as well as to Treat GDM³: ‘Both GDM and its progression to Type 2 diabetes could be potentially prevented by appropriate lifestyle modifications and medical management, but we need to identify the high-risk individuals’ – says Balasubramanyam. First-trimester biomarker discovery platforms appear to be promising to predict risk for GDM and expected to offer extended ‘window of opportunity’ for lifestyle changes and medical management. As the literature becomes loaded with several of these biomarkers, the challenge is now to develop, validate and pick-up a robust and reliable single or panel of biomarker that could predict GDM, adds Balasubramanyam.

Women, as mothers, have a huge influence over the long-term health status of their children. Research has shown that when mothers are granted greater control over resources, they allocate more to food, children’s health and nutrition, and education. Women are the gatekeepers of household nutrition and lifestyle habits and therefore have the potential to drive prevention from the household and beyond. Thus, by choosing healthy food choices and parental care, a mother can prevent her daughter or son to become obese and thereby prevent diabetes. Therefore, once again the same mantra ‘Diabetes prevention is in your mom’s hands’, concludes Balasubramanyam.

Dr.M.Balasubramanyam, PhD., MNASc., FAPASc is Dean of Research Studies & Senior Scientist at the Madras Diabetes Research Foundation (MDRF) in Chennai, India. Dr. Balasubramanyam's specialization is in Disease Biology; Molecular pathogenesis of diabetes and its vascular complications including diabetic retinopathy; Vascular Biology and signaling studies on VSMC; Clinical significance and subclinical relevance of cellular and molecular alterations in metabolic diseases; Mechanisms of accelerated senescence (ageing) and telomere biology; Insulin signaling & Proteomics; Epigenetics; RNAi and miRNA, gut microbiome aspects of diabetes, Unraveling mechanisms of hyperglycemic memory, Calcium & Redox signaling, Proinflammation, Oxidative stress, ER stress, AGE pathway and biomarker(s) identification; Role of Endocrine Disruptors in diabetes; Bioprospecting herbal molecules; Non-invasive point-of-care (POC) clinical measures and medical devices.