Diabetes is now reaching epidemic proportions in India, and it’s a health crisis that can no longer be ignored. With obesity on the rise and the nation’s love for fried carbs, the incidence of diabetes continues to climb at an alarming rate. It’s no surprise that India has earned the unfortunate title of the “diabetes capital of the world.” In fact, experts predict that this trend will only worsen unless decisive action is taken.

To shed light on this growing concern, Delhi is currently playing host to a major international event: the 52nd Annual Conference of the Research Society for the Study of Diabetes in India (RSSDI) and the International Diabetes Federation’s South East Asian Region Diabetes Congress. Being held at the Yashoboomi Convention Center, this conference brought together doctors, experts, and global leaders in the field of diabetes research and treatment. One of the key highlights of the event was an insightful and engaging conversation between Drug Today Medical Times correspondent, Rohit Shishodia, and none other than Prof. Peter Schwarz, the President of the International Diabetes Federation.

The discussion covered a wide range of crucial topics, from the subtle warning signs of diabetes that many overlook, to how diet and lifestyle play a critical role in either triggering or preventing the disease. Let’s dive into this fascinating and eye-opening conversation.

DTMT: Prof. Schwarz, there’s so much talk about fatigue being a symptom of diabetes. Can you tell us more about that?

Prof. Schwarz: Yes, fatigue is often one of the first signs. Interestingly, one of the strongest predictors of diabetes is actually fat in the liver. You may not see it, but if there’s fat accumulating in your liver, your body becomes less responsive to physical activity. This can significantly increase your risk of developing diabetes. And the worst part? Diabetes progresses faster in people with fatty livers compared to those who don’t have this issue.

DTMT: That’s fascinating. So, where does this liver fat come from?

Prof. Schwarz: Most of the liver fat comes from refined carbs, and this is especially a concern in India, where people often consume large amounts of fried carbs. To prevent this, it’s essential to cut back on carbs—especially fried ones—and make physical activity a regular part of your routine. If that feels difficult, there’s also the option of intermittent fasting or even longer periods of fasting, but that’s more of a last resort.

DTMT: It seems that many people are unaware of the early warning signs of diabetes. Why do you think that is?

Prof. Schwarz: It’s unfortunate, but many people miss the early signs of diabetes because they don’t recognise them. Common symptoms like nerve issues or even subtle changes in vision can go unnoticed. But the damage is happening quietly. High blood sugar can slowly destroy the fine nerves, blood vessels, and organs like the eyes and kidneys, which ultimately leads to more severe complications. That’s why regular testing for glucose and glycated hemoglobin (HbA1c) is so important. If you have any symptoms or risk factors, get tested right away.

DTMT: There’s been some discussion about diabetes impacting people’s mood. Is there really a hidden link between blood sugar levels and mental health?

Prof. Schwarz: Absolutely. Diabetes doesn’t just affect the body; it deeply impacts a person’s emotional well-being. Many patients report feelings of burnout and depression. Unfortunately, these mental health issues often go unaddressed. Diabetes care needs to evolve to focus not just on managing blood sugar, but also on improving the overall quality of life for patients. We need to put the patient at the center of care, addressing both their physical and mental health needs."

DTMT: It sounds like there’s a lot more to managing diabetes than just monitoring blood sugar. Moving on, we often hear people with diabetes complain of numbness or tingling in their feet. Can you explain why that happens?

Prof. Schwarz: That’s actually a very common symptom. High blood sugar doesn’t just damage major organs; it also affects the fine nerves in the body. For people who have undiagnosed diabetes, these nerves can be silently damaged over the course of two years before the condition is even recognized. This damage to nerves in the feet is what causes the tingling sensation. So, if you experience this symptom, it’s a good idea to get your blood sugar tested to catch the issue early.

DTMT: How does diabetes affect the skin? Are there any strange skin symptoms that people should be aware of?

Prof. Schwarz: Yes, diabetes can significantly affect the skin. It’s often one of the first organs to show signs of trouble. High blood sugar levels cause damage to blood vessels in the skin, leading to conditions like dry skin, infections, and even a burning sensation. If you notice any unusual changes in your skin, it’s important to get your blood sugar tested immediately.

DTMT: Many people are unaware of the connection between diabetes and kidney failure. Can you elaborate on why people with diabetes are at such high risk for kidney damage?

Prof. Schwarz: Diabetes causes hidden damage to the kidneys long before it’s detectable. The blood vessels in the kidneys become damaged due to high glucose levels, which eventually leads to kidney failure. If the kidneys stop working, dialysis becomes necessary. Unfortunately, many people with undiagnosed or poorly managed diabetes end up in this situation. That’s why early diagnosis and regular blood sugar testing are so critical."

DTMT: Is there any connection between diabetes and thyroid disorders?

Prof. Schwarz: Yes, there is a direct link, especially in type 1 diabetes, which is an autoimmune disease. People with type 1 diabetes are at a higher risk for thyroid disorders, especially when there’s a presence of thyroid antibodies. If you have either thyroid disease or type 1 diabetes, it’s important to get tested for both.

DTMT: Finally, is there a cure for diabetes?

Prof. Schwarz: That’s the million-dollar question. While we don’t have a definitive cure yet, there is a lot of promising research underway. Cell-based therapies that focus on replacing the function of insulin-producing beta cells are showing potential. New lipid-based drugs are also helping to improve insulin sensitivity. And then there’s fasting—intermittent fasting or total fasting—which has shown significant benefits in managing diabetes. It’s still being studied, but the early results are encouraging.

DTMT: Does food intake play a role in diabetes? Especially when it comes to high-refined and genetically modified foods?

Prof. Schwarz: Food is definitely a major factor. In India, the excessive consumption of refined carbs, particularly fried carbs, is a leading contributor to diabetes. These carbs damage the liver, pancreas, and insulin production. The idea is not to demonize food, but rather to focus on reducing high-carb, fried foods that are common in the Indian diet. As for genetically modified foods, they are not the primary cause of diabetes; it’s the excessive intake of carbs—especially fried carbs—that leads to this issue.