When most of us hear about the prevalence of a world-wide epidemic we usually break into a cold sweat combined with a sense of paranoia as we consider the implications of a contagious, fatal agent floating around in the air just waiting for an opportunity to take siege of our body. But unfortunately, the concept of diabetes – which in actuality is a very serious global epidemic with a WHO prediction of being the 7^th leading cause of death by 2030 – for some reason does not elicit such an extreme response.

The topic of the diabetes epidemic was brought up in this week’s seminar by Dr. Harish Kumar, Professor and HOD of the Department of Endocrinology at the Amrita Institute of Medical Sciences in Kochi. As the president of the Research Society for the Study of Diabetes in India (RSSDI), the secretary of the Indian Thyroid Society, and the author of over 56 publications, Dr. Kumar is a walking encyclopedia on diabetes mellitus – a disorder characterized by hyperglycemia caused by either a lack of insulin secretion or a lack of response towards secreted insulin.

Diabetes has a genetic link but is also largely affected by the patient’s lifestyle. According to Dr. Kumar, in a previous era the prehistoric man’s lifestyle was based on survival and followed a repeated cycle of hunting, feasting, and fasting. In order to efficiently use the energy derived from the large meal, the prehistoric man’s body would secrete excess insulin to be stored as fat. Unfortunately, this evolutionary advantage is now a disadvantage in today’s society as human lifestyle has changed drastically in the recent past with the advent of technologies that make our lives “easier”. As Dr. Kumar put it, “We are in a diabetogenic environment, despite genetic disposition”. What is the point of walking from point A to B when you can drive there and expend much less energy in the process? The large decline in exercise along with the consumption of fatty, carb-filled meals three times a day and the increase in stress levels are not very kind to the modern man’s insulin secretion patterns which still follow the prehistoric man’s routine. At some point, β cells cannot keep up with the amount of insulin production causing the process to undergo certain dysfunctions and thus the signs of diabetes are seen in the patient.

Diabetes may sound like a simple matter of glucose levels in blood, but the disorder’s complications are much more detrimental as Dr. Kumar made very evident through a series of diabetic foot injury cases he worked on. Diabetes, if not kept under control, can lead to cases of retinopathies, nephropathies, and neuropathies. In the diabetic foot injuries Dr. Kumar spoke about, diabetic patients who suffered from neuropathies had lost feeling in their feet and unknowingly damaged their feet to such an extent where in some cases the only hope was amputation.

Dr. Kumar also expanded on the new horizons of biotechnology in diabetes, including research in the areas of insulin analogs, synthetic insulin, pancreas or islet cell transplantations, insulin pumps, and artificial pancreases. These alternative methods of controlling diabetes may very well be the future of biotechnology. As of now, ASBT has already patented the Amrita Insulin Pump, the first of its kind produced in India.

Diabetes is a complicated disorder and therefore controlling it is equally complicated. Perhaps with the information conveyed to us by Dr. Harish Kumar and the future research ventures in this realm, we as biotechnology students can put up a strong fight in this battle against the epidemic.

March 15, 2014
School of Biotechnology, Amritapuri.