Understanding Diabetes: A Silent Global Epidemic

Our article aims to raise awareness among both the general public and healthcare professionals about the critical role of lifestyle management in controlling high blood sugar levels. By emphasizing practical strategies such as regular physical activity, targeted muscle stretching, balanced nutrition, and stress management, we highlight evidence-based approaches that can significantly improve blood sugar control. The goal is to empower individuals with actionable knowledge to prevent and manage diabetes effectively while providing professionals with insights to guide their patients toward healthier, sustainable habits.

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VNR Bem - Estar
A Healthy Lifestyle

Understanding Diabetes: A
Silent Global Epidemic

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Author:
Prof.Dr.Y.Shanthoshraja., MPT (Orthopaedics).,
MSc (Microbiology),
Swamy Vivekanandha Physiotherapy College,
Namakkal District - 637205.
Tamil Nadu,
India.


Editor-in-Chief (EIC):
Mr.SRY
VNR Bem-Estar,
A unit of VNR Foundation,
Vennandur - 637505,
Namakkal District,
Tamil Nadu,
India.
Ph: [phone]
Email: [email protected]

Published in VNR Bem-Estar Magazine by VNR
Foundation.

Published on : 03-10-2025

Volume: 01
Issue: 01

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Acknowledgments:

This is my first article written for a public
magazine, and I sincerely hope that both the
general public and professionals can connect with
and understand my thoughts. I believe that through
my Physiotherapy profession I can teach and guide
everyone towards achieving a healthy lifestyle. I
am deeply grateful to my Parents and Friends for
their constant encouragement, and to the VNR
Foundation and Jagan's Charitable Trust for their
invaluable support. My sincere thanks also go to
Swamy Vivekanandha Physiotherapy College and
its Management for providing me with
opportunities to grow. I extend special gratitude to
Prof.Dr.S.K.Rajkumar.PhD Sir for his guidance
and motivation. Finally, I acknowledge my Faculty,
Students, and Clients, whose trust and cooperation
have inspired me to complete this article. The
references and insights for this work were drawn
from globally recognized portals and scientific
articles, ensuring that the content is both evidence-
based and accessible.
Thank You All……

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Understanding Diabetes: A Silent
Global Epidemic

Diabetes Mellitus has emerged as one of the
most challenging health problems of the 21st
century. It is not only a metabolic disorder but also
a lifestyle-linked condition that affects millions
across the globe. As the prevalence rises sharply in
both developed and developing nations,
understanding diabetes is crucial for prevention,
timely diagnosis, and effective management.

Global Epidemiology of Diabetes:
Diabetes is a major public health concern
worldwide. According to the International Diabetes
Federation (IDF), more than 540 million adults
globally are living with diabetes as of 2025, and
this number is projected to rise to 783 million by
2045. The prevalence is increasing in both high-
income and low-to-middle-income countries due to
urbanization, sedentary lifestyles, and unhealthy
diets.

Key statistics:
Asia-Pacific region: Accounts for nearly 60%
of global diabetes cases.

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United States: Approximately 37 million adults
have diabetes, with another 96 million at risk
(prediabetes).

Europe: Over 60 million adults are affected, with
increasing trends in Eastern Europe.

Africa: Prevalence is rising rapidly, projected to
double by 2045 due to lifestyle changes and
urbanization.


The global burden highlights the urgent need for
prevention strategies, early diagnosis, and
comprehensive management to reduce
complications and healthcare costs.

Diabetes in India:
India is often called the “diabetes capital of the
world”. Currently, over 74 million adults in India
are estimated to have diabetes, with numbers rising
steadily due to urbanization, changing diets,
obesity, and sedentary lifestyles. Worryingly,
almost half of Indian diabetics remain undiagnosed,
increasing the risk of complications like heart
disease, kidney failure, and blindness. Rural
populations are now also at risk, as lifestyle
patterns shift toward higher-calorie diets and
reduced physical activity. Public health initiatives

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emphasizing awareness, screening, and early
intervention are therefore critical.



Types of Diabetes:
Diabetes is not a single disease but a group of
disorders characterized by chronic high blood
glucose levels (hyperglycemia). The main types
include:

Type 1 Diabetes:
An autoimmune condition, usually diagnosed
in childhood or adolescence. The body’s immune
system attacks insulin-producing beta cells in the
pancreas, leading to absolute insulin deficiency.
Patients require lifelong insulin therapy.

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Type 2 Diabetes:
The most common form, accounting for nearly
90–95% of all diabetes cases, Type 2 diabetes is
strongly linked with obesity, sedentary living, and
genetic predisposition. The body develops insulin
resistance, and over time, insulin production
declines.

Other Types of Diabetes:

*Gestational Diabetes Mellitus (GDM): Appears
during pregnancy, increasing risks for both mother
and child.
*Monogenic Diabetes: Caused by mutations in a
single gene.
*Secondary Diabetes: Develops due to pancreatic
disease, hormonal disorders, or long-term use of
steroids.

Prediabetes – The Warning Stage:
Prediabetes is a gray zone between normal
blood sugar levels and diabetes. Blood glucose
levels are higher than normal but not yet in the
diabetic range. It often goes unnoticed, yet it
significantly raises the risk of developing Type 2
diabetes and cardiovascular diseases. Lifestyle
changes such as regular exercise, balanced diet, and
weight management can reverse prediabetes and
prevent progression.

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Pathophysiology of Diabetes:
Diabetes results from disruption in normal
glucose regulation, primarily involving insulin
secretion and action.



Normal Glucose Regulation: After a meal,
carbohydrates break down into glucose, raising
blood sugar. The pancreas secretes insulin, which
allows glucose to enter cells for energy. Excess
glucose is stored as glycogen.

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Type 1 Diabetes: Autoimmune destruction of beta
cells leads to absolute insulin deficiency, causing
glucose to accumulate in the blood and triggering
fat and protein breakdown for energy.

Type 2 Diabetes: Insulin resistance initially
develops, with the pancreas overcompensating by
producing more insulin. Eventually, beta-cell
function declines, leading to chronic
hyperglycemia.

Complications: Persistent hyperglycemia damages
blood vessels and nerves, leading to microvascular
complications (retinopathy, nephropathy,
neuropathy) and macrovascular complications
(heart disease, stroke, peripheral artery disease).

Glucose Metabolism in Diabetes:
In healthy individuals, insulin acts as a “key,”
allowing glucose from food to enter body cells for
energy. In diabetes:

Type 1: Little or no insulin is produced.

Type 2: Cells do not respond properly to insulin,
and eventually insulin production decreases.


The result is persistent hyperglycemia, which
damages multiple organs over time.

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Clinical Features of Diabetes:
The classic symptoms, remembered as the “3
Ps,” are:

*Polyuria: Excessive urination

*Polydipsia: Excessive thirst

*Polyphagia: Excessive hunger

Other signs include unexplained weight loss,
fatigue, blurred vision, slow wound healing,
recurrent infections, and tingling sensations in
hands and feet. Many patients, especially with
Type 2 diabetes, remain asymptomatic for years,
highlighting the importance of regular screening.

Medical Management of Diabetes:
Management of diabetes focuses on blood
sugar control, prevention of complications, and
lifestyle modification.

1. Lifestyle Interventions:
*Regular physical activity (at least 150
minutes/week)
*Balanced diet low in refined sugars and saturated
fats
*Weight management and stress reduction

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2. Oral Hypoglycemic Agents:
*Metformin: First-line drug for Type 2 diabetes,
reduces glucose production in the liver.
*Sulfonylureas: Stimulate insulin secretion.
*DPP-4 inhibitors, SGLT2 inhibitors, and GLP-1
receptor agonists: Modern options for better
glucose control and weight management.

3. Insulin Therapy:
Required in Type 1 diabetes and advanced Type 2
diabetes. Various regimens include basal, bolus,
and premixed insulin to mimic natural insulin
patterns.

4. Monitoring:
*Regular self-monitoring of blood glucose
*Periodic HbA1c tests to assess long-term control
*Screening for complications such as kidney, eye,
and nerve problems

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Physiotherapy Management and Lifestyle
Interventions:
Physiotherapy plays a critical role in blood
sugar control, improving circulation, and reducing
diabetes-related complications. The following SRY
Physio Protocols are designed for different patient
groups:

1. SRY Physio Protocol I:
45 minutes walking + 15 minutes ankle-toe
movement
For Type 2 diabetes adults

2. SRY Physio Protocol II:
15 minutes walking + 15 minutes ankle-toe
movement twice a day
For Type 2 diabetes adults with associated
problems

3. SRY Physio Protocol III:
15 minutes ankle-toe movement four times a day
For seniors with Type 2 diabetes

4. SRY Physio Protocol IV:
30 minutes Low Volume High Intensity Interval
Training (LVHIIT) twice a day
For adults with Prediabetes

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5. SRY Physio Protocol V:
30 minutes High Volume High Intensity Interval
Training (HVHIIT) twice a day
For young adults with Prediabetes

Dietary Recommendation:
Daily intake of 2000 kcal with balanced nutrients



Food group Quantity
Fat Limit to 25% to 30% of
daily caloric intake.
Carbohydrate Not more than 55% of
your daily caloric intake
Fibre 30-40 gm/day
Protein 15% to 20% of daily
caloric intake

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Lifestyle Recommendations:
*Sleep: 8 hours/day
*Avoid alcohol, smoking, and drug abuse
*Minimize stress

These physiotherapy protocols, combined with
diet and lifestyle modifications, have shown
significant improvement in glycemic control,
cardiovascular fitness, and overall quality of life
for diabetic and prediabetic individuals.

Investigations:
Diagnosing diabetes requires a combination of
clinical assessment and laboratory tests:
*Fasting Blood Sugar (FBS)
*Postprandial Blood Sugar (PPBS)
*Oral Glucose Tolerance Test (OGTT)
*Glycated Hemoglobin (HbA1c)
*Random Blood Sugar (RBS)

These tests guide diagnosis, treatment, and
monitoring.

Conclusion:
Diabetes is no longer a disease of the elderly;
it affects all age groups and demographics.
Recognizing early signs, understanding risk factors,
and undergoing timely screening can prevent or
delay disease and its complications. While modern

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medicine provides effective management,
physiotherapy, diet, and lifestyle interventions
remain equally crucial, especially in countries like
India, where the prevalence of diabetes is
alarmingly high. Early action can prevent
progression, improve quality of life, and reduce the
burden of long-term complications.

References:

1. SRY Physio Protocol I:
https://www.ijsdr.org/viewpaperforall.php?paper=IJSDR2408022

2. SRY Physio Protocol II:
https://www.ijsdr.org/viewpaperforall.php?paper=IJSDR2408051

3. SRY Physio Protocol III :
https://www.ijsdr.org/viewpaperforall.php?paper=IJSDR2508155

4.https://en.wikipedia.org/wiki/Diabetes

5. https://en.wikipedia.org/wiki/Prediabetes

6. https://www.who.int/news-room/fact-sheets/detail/diabetes

7. https://www.who.int/india/health-topics/diabetes

8. https://diabetesatlas.org/data-by-location/region/europe/

9. https://www.cdc.gov/diabetes/php/data-research/index.html

10. https://diabetesatlas.org/data-by-location/region/africa/

11. https://worldpopulationreview.com/country-rankings/diabetes-
rates-by-country

12. https://www.who.int/news/item/05-09-2025-who-updates-list-of-
essential-medicines-to-include-key-cancer--diabetes-treatments

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13. https://www.thelancet.com/journals/lancet/article/PIIS0140-
6736(23)01301-6/fulltext

14. https://www.mohfw.gov.in/press-info/7883

15. https://pmc.ncbi.nlm.nih.gov/articles/PMC9223048/

16. https://pmc.ncbi.nlm.nih.gov/articles/PMC10693913/

17. https://www.webmd.com/diabetes/managing-stress-with-diabetes

18. https://nutriphy.in/blog/2000-kcal-diabetic-diet-8263/

19. https://www.mayoclinic.org/diseases-conditions/type-2-
diabetes/in-depth/diabetes-prevention/art-20047639

20. https://pharmeasy.in/conditions/prediabetes-symptoms-in-indian-
patients/

21. https://www.istockphoto.com/illustrations/glucose-metabolism

22. https://www.fitterfly.com/blog/best-exercises-for-diabetes-at-
home/

23. https://www.sugarfit.com/blog/how-to-control-diabetes-with-
indian-food/