Prevalence of Type II diabetes with reference to ageing and gender differences

Article Citation:
K. Kanagalakshmi Vivekanandan
Prevalence of Type II diabetes with reference to ageing and gender differences
Journal of Research in Biology (2016) 6(1): 1944-1951
JournalofResearchinBiology
Prevalence of Type II diabetes with reference to ageing and
gender differences
Keywords:
Diabetes, Metabolic disease, Epidemiology
ABSTRACT:
Diabetes, commonly referred as diabetes mellitus, in general describes a
group of metabolic diseases that are caused by insulin deficiency. In which the person
has high blood glucose level (blood sugar), either due to the insufficient production of
insulin, or due to the body’s cells does not respond to insulin, or both. As long as the
cells cannot take up the available glucose molecules from the blood of patients due
to the lack of insulin hormone, it develops the sense of hunger (polyphagia). Kidneys
act as a filter and normally reabsorb the blood glucose before it gets excreted in the
urine, but when glucose level is high, kidnies cannot reabsorb all of the sugar, hence
the excess sugar is dumped into the urine (polyurea). The increased urine production
and consequential dehydration leads to the extreme thirst (polydipsia). India being the
capital for diabetic world, visible increase of Type 2 diabetes is coupled with increasing
age and that imposes a significant burden on the health care system. Hence, this work
was therefore designed to assess the gender and age prevalence of type 2 diabetes
mellitus (T2DM) patients attending Government Stanley Hospital, Chennai.
1944-1951 | JRB | 2016 | Vol 6 | No 1
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Journal of Research in Biology
An International
Scientific Research Journal
Authors:
K. Kanagalakshmi
Vivekanandan
Institution:
Assistant professor,
Department of Zoology,
Stella Maris College
(Autonomous) Chennai -86.
Corresponding author:
K. Kanagalakshmi
Vivekanandan
Email Id:
Web Address:
http://jresearchbiology.com/
documents/RA0580.pdf
Dates:
Received: 28 Nov 2015 Accepted: 04 Jan 2016 Published: 04 Feb 2016
Journal of Research in Biology
An International Scientific Research Journal
Original Research
ISSN No: Print: 2231 –6280; Online: 2231- 6299

INTRODUCTION
Diabetes is the fastest growing long term disease
that affects millions of people worldwide. Due to the
inadequate production of insulin, or the body's cells do
not respond properly to insulin, or both. Patients with
high blood sugar will typically experience polyuria
(frequent urination); they will become increasingly
thirsty (polydipsia) and hungry (polyphagia).
Diabetes (diabetes mellitus) is grouped under
metabolic disorder due to insulin deficiency. Metabolism
refers to a set of anabolism and catabolism by which it
yields energy and this energy is utilized for our body
growth. During the process of digestion the complex
carbohydrates found in our food is broken down into
glucose. Glucose is a form of sugar in the blood and it is
the principal source of fuel for our body. When the food
gets digested, all the carbohydrates present in the food is
finally converted into glucose and this glucose is
absorbed by the villi and enters into the bloodstream.
Insulin is a hormone that is produced by
the Islets of Langerhans of Pancreas. After eating,
adequate quantity of insulin released from the pancreas
make the cells to take-up the glucose present in our
blood, as soon as glucose enters the cells blood-
glucose levels drop. If the quantity of glucose in the
blood is too elevated (hyperglycaemia), this condition is
due to either not producing insulin or producing insulin
only a in little quantity or the cells do not respond to the
insulin produced. This condition leads to the building up
of excess glucose in the blood stream, this excess blood
glucose eventually passes out of the body in urine. So,
even though the blood has plenty of glucose, the cells are
not getting it for their essential energy and growth
requirements.
Diabetes is one of the well known metabolic
disease that affects millions of people worldwide
However, the defense mechanism of our body (immune
system) protects us from various infectious agents, rarely
attacks our own insulin producing cells in the pancreas
and causes Type 1 diabetes. Type 1 diabetes is thought to
be caused by a combination of genetic reasons and
environmental factors. The development of Type 2
diabetes is believed strongly due to lifestyle factors, but
not everyone with type 2 is overweight. Hence, other
than body weight, BMI, there are various factors like
alcohol, smoking, stress, genes etc., are linked to it to
cause the metabolic disorder namely Diabetes World
Health Organization (WHO, 1999).
The ‘World ‘Epidemiology’ surveyed by
International Diabetes Federation (IDF) said that 381
millions of people were affected with diabetes in the year
2013. Its prevalence is increasing rapidly, and by 2030,
this number is estimated to almost getting double
(Wild et al., 2004). Diabetes mellitus occurs throughout
the world, but is more common (especially type 2) in the
more developed countries. The greatest increase in
prevalence is, however, expected to occur in Asia and
Africa, where most patients will probably be found by
2030. According to the Indian Heart Association (2015),
highest number of diabetic population surveyed in India
having 109 millions of people affected with diabetes,
which is more than 7.1% of India's adult Population.
Ramachandran (2003) reported that the
prevalence of diabetes was less in India compared to
western countries in 1970’s. The terrific increase in the
prevalence of diabetes is now estimated in India by
International Diabetes Federation (IDF), to be as the
number of diabetic patients in India more than
doubled from 19 million in 1995 to 40.9 million in 2007.
It is projected to increase to 69.9 million by 2025. A
recent report made by International Diabetes Federation
(IDF) said that, up to 11% of India’s urban population
and 3% percent of rural population above the age of 15
has diabetes.
According to WHO (2003) the prevalence of
diabetes varies from country to country, state to state,
races and ethnic groups. Hence, it is important to
quantify the prevalence of diabetes and the number of
Vivekanandan, 2016
1945 Journal of Research in Biology (2016) 6(1): 1944-1951

people affected by diabetes for national planning and
allocation of resources in future. Utmost diabetic
population is now found to be in India is mainly due to
rapid cultural and social changes, ageing populations,
increasing urbanization, dietary changes, reduced
physical activity and other unhealthy lifestyle and
behavioral patterns. Beckles and Thompson-Reid (2001)
reported that the more prevalence of diabetes in female
is justified, because of the impact of gestational diabetes
on both the mother and baby regarding the increased risk
of developing type 2 diabetes in later life.
This work was therefore designed to assess the
gender and age prevalence of type 2 diabetes mellitus
(T2DM) on the patient attending Government Stanley
Hospital, Chennai. This is mostly catering to the needy
people who are socially backward with low income and
uneducated from the rural and urban areas of Chennai
city.
MATERIALS AND METHODS
The participants the diabetic patients
attending Government Stanley Hospital, Chennai, India.
Service catering to the deprived and needy people are
extended even to the far distance patients who visits this
hospital. Permission to examine the patients and record
their personal data was obtained from the concerned
authorities of the Hospital.
Selection of the study area was primarily due to
more number of patients from all category of life to visit
the Government Stanley Hospital - this initiated the
study; moreover, it is was one of the oldest and well
known medical centres in India. The hospital has an out-
patient attendance of around 5000 patients per day in
which more than 150 are visiting the diabetes department
with the proportion of 10 to 15% new patients with 1 to
2% of Type 1 diabetic patients. Thus, it is anticipated
that the study population would yield an adequate blend
of individuals who falls on various age and socio-
economic criteria, so that the impact of Type 2 diabetes
and their prevalence with reference to ageing and gender
could be scrutinized. The study conducted with a sum of
485 individuals attending Diabetes department,
Government Stanley Hospital, who were randomly
selected and the study was conducted for two years.
Study design
A survey was conducted based on the
questionnaire provided among the participants. Persons
who reached hospital at 7 am were met personally
and the questionnaire was presented to them to collect
information regarding their socio-economic condition
such as age, height, weight, waist circumference, hip
circumference, waist and hip ratio annual
income, duration of diabetes, family history of
diabetes, veg/non-veg eater active worker, moderate
worker, sedentary worker, ex-
alcoholic, current alcoholic nonalcoholic, ex-
smoker, current smoker, never, exercise, cardiac
problem, eye problem, hypertension.
The second part of the present research work
consists of the clinical data collection
after the examination of patient’s samples.
RESULTS
Percentage distribution of type 2 diabetes male and
female with different age group
Observations showed that the diabetic patients
were visiting in massive number throughout the year
with the blend of Type 1 diabetes, Type 2 diabetes,
Gestational diabetes and a set of new patients. Among
these patients, female population was found to be more
in occurrence throughout the year in the present study.
Patients were reaching the hospital at 7.30 a.m.
from faraway places in and around Chennai, they
were wait for the Doctor’s arrival, a questionnaire was
given to them personally to gather information.
Observations made from continuous two years of study
showed that percentage population of female Type 2
diabetes (61%) was higher than that of male (39%) (Fig
Journal of Research in Biology (2016) 6(1): 1944-1951 1946
Vivekanandan, 2016

1).
Type 2 diabetes mellitus showed an increasing
trend with reference to ageing. It was also observed
among the patients that the incidence of this disease was
started with the age group of 25. Among the age group
intervals, the patients showed their highest incidence of
this disease belongs to 40 - 50 and 50 - 60 in both the
gender and the prevalence of diabetes at this age group
(40 - 50, 50 - 60) was found to be 10%,13% for male and
20%, 20% for female respectively. The results also
revealed the decline in the percentage occurrence of
diabetes in male (7%, 3%) and female (12%, 1%) in the
age group of 60 - 70 and 70 - 80. It is further recorded
from the present study that there is no trace of patients
attending at the age group above 80 (Fig - 1).
DISCUSSION
The oldest and one of the well known Medical
health care centers in India is Stanley Medical College
and Hospitals, Chennai. This institution was sown as
early as 1740 by the East India Company. The well
known departments of the Stanley Medical Hospitals are
Surgical Gastroenterology, Urology and the Institute of
Hand Rehabilitation and Plastic Surgery.
The Department of Diabetology in Government Stanley
Medical Hospital started before 50 years. It stood as a
pillar in Diabetes care among all Government Hospitals
in Tamil Nadu by servicing the people particularly those
from the lower socio economic class of society
belonging to various places such as Madhavaram,
Cholavaram, Minjur, Ponneri, Kavarapettai and
Gummidipoondi because of the care and commitment by
professionals trained in Diabetes working in this
Hospital. This hospital records a registry of more than
70,000 patients. The hospital receives at least 700
patients every day at the outpatient department, of these,
150 suffer from insulin-dependent Type 1 diabetes.
The metabolic disease that increases an alarming
rate all over the globe is Type 2 diabetes (Huizinga and
Rothman, 2006). According to WHO (2008), Type 2
diabetes is an incurable, chronic endocrine disorder
characterized by insulin resistance, decreased pancreatic
beta cell function and elevated hepatic glucose output.
Further, hyperglycaemia is the hallmark
Vivekanandan, 2016
Figure 1. Percentage occurrences of type 2 diabetic male and female of different age group

of diabetes mellitus and common effect of uncontrolled
diabetes leads to serious damage to many of the body’s
systems such as the nerves and blood vessels. In the
recent decades the status of diabetes has changed from
being considered as a mild disorder of the elderly to one
of the major causes of morbidity and mortality affecting
the youth and middle aged people (Wild et al., 2004).
World Health Organization (WHO) reports showed that
32 million people had diabetes in the year 2000 (Wild et
al., 2004). The International Diabetes Federation (IDF)
estimated the total number of diabetic subjects to be
around 40.9 million in India and this is further set to rise
to 69.9 million by the year 2025 (Sicree et al.,2006).
The present observation showed that the higher
risk of developing Type 2 diabetes at the age group of 25
invariably, from both the gender due to their food habits,
life style, unawareness, stress in the study population.
Whereas in developed countries, the diabetes affects the
people between the age of 45 and 64 years with
predominantly Caucasian populations; most people with
diabetes are older than 65 years (Cockram and Chan,
1999).
Females have shown to have over representation
in their visit to the hospital regularly when compared to
men and this might be due to their abnormal BMI,
obesity, unawareness, lack of exercise etc., and mostly
men who are attending this hospital for their treatment
are fall in the category of heavy manual job for daily
wages and these men are either currently alcoholic and
smoking or ex- alcoholic and smoking attitude and
because of this behavioral attitude they became an easy
victims for this incurable disease at their early age.
Ramachandran et al., (1988) studies are in
consistent with the present results which revealed that in
south India there is a female predominance in Indian
diabetic subjects due to increased frequency of obesity in
females as compared with males. However, few studies
have also reported that men are more prone to develop
Type 2 diabetes after certain stages of life span (Pan et
al., 1997; Kanaya et al.,2002; Williams et al., 2003 and
Amini and Janghorbani, 2007) as compared to women.
Likewise a population of biased study conducted in
Chennai showed that the prevalence was higher in
women 83.3% when compared to men 65.3% (Rajiv et
al., 2010). Reports of Cameron et al., (2004) and Ford et
al.,(2002) showed that in Turkey, India, Iran, African
Americans, Mexican Americans etc. women were much
more frequently affected, whereas the metabolic
syndrome in France and Australia was found to be more
common among men (Cameron et al., 2004).
The present study showed that the occurrence of
this disease starts at the age group of 25, but the
prevalence of this disease was more for the people of age
group of above 40, which is due to their ageing, food
habits, life style, stress and also the beta cells of pancreas
starts their apoptosis. There were more female patients of
diabetes of age group above 40 attending hospital; it
showed the delayed onset of diabetes in the elder
generation but in the current generation the onset is ideal
with very early part of their life. (Abdul-Ghani et
al., 2006) also reported that the most common form of
diabetes is Type 2 diabetes. About 90 to 95 percent of
people with diabetes have Type 2 diabetes and the
alarming increase in Type 2 diabetes is mainly due to
increase in life expectancy, genetic reasons, food habits,
sedentary life style, hypertension, stress, cholesterol
consumption of certain pills and lack of exercise (Abdul-
Ghani et al.,2006).
The present data’s also showed that the patients
who were suffering with the consequence of diabetes due
to prolonged duration of their disease belong to the
elderly age group 60 - 70 and 70 - 80 respectively.
During the present research period, on the other hand
there was not even a single female patient found
attending to the hospital at the age group above 80, it
might be due to no attendees to take them to hospital for
treatment or checkup.
A similar study conducted on Sweden reports
Vivekanandan, 2016

that the early onset of this disease such as at 15 years
affects their both length of life and health status due to
debilitating and life-threatening long-term
complications (Vibeke et al., 2013). The study conducted
in USA, showed the prevalence of diabetes increased
across among all age-groups,but adults ≥65 years of age
experienced the largest increase in absolute change
mainly due to Obesity, as measured by
BMI, waist circumference was strongly associated with
the increase in diabetes prevalence, especially in adults
<65 (Cheung et al., 2008).
Among Asians, Indians showed their highest
prevalence of diabetes and their peak prevalence of
diabetes was approximately 10 years younger when
compared with Chinese and Japanese subjects (Qiao et
al., 2003).
The mortality rate was comparatively higher for
diabetic individual in all age, sex, race groups. Median
life expectancy was eight years lower for diabetic adults
aged between 55 - 64 years and 4 years lower for those
aged between 65 - 74 years (Ken Gu et al., 1998).
However it becomes a challenging task for the elderly
people in controlling their glycemic level of Type 2
diabetes and their consequences such as retinopathy
(Morisaki et al., 1994), coronary artery disease events
and mortality morbidity, uncontrolled glycemic level
also affects the quality of life (Laakso, 1996).
CONCLUSION
 The present investigation clearly showed that the
diabetes is a metabolic disorder that can affect
anybody, despite the fact that diabetes affects the
higher income group.
 Females have shown to have over representation in
their visit to the hospital regularly when compared to
men to check their glycemic level. A female
predominance in diabetic subjects is due to increased
frequency of obesity in females when compared with
males.
 The present study evidence indicates that metabolic
disease could be observed right from the age group of
25 in both the gender and may play a critical role in
the development and progression of metabolic
syndrome in the study group. However the prevalence
shows an increasing trend with increasing age group.
ACKNOWLEDGEMENT
I am immensely grateful to the Principal - Dr.
(Sr) Jasintha Quadras, Secretary - Dr. (Sr) Susan and
staff members of the Department of Zoology, Stella
Maris College (Autonomous), for their valid support. I
express my heartfelt gratitude to my mother Mrs.
Vasantha and my husband Mr. Vivekanandan for their
constant motivation and moral support. I extend my
gratitude to my daughter V. Nandika and my sister Mrs.
Mohanasundari for their love and support.
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