Gundu H R Rao, Pratiksha G Gandhi and Vineeta Sharma
According to recent projections of World Health Organization (WHO), India already leads the world, with the largest number of diabetic subjects. China is fast approaching to claim the number one spot. World Diabetes Federation estimates, that India has over 65 million diabetics and an equal number of pre-diabetics. Major contributors for the development of this chronic disorder are hyperglycemia, insulin resistance, dyslipidemia, hypertension, endothelial dysfunction, obesity, oxidative stress, and metabolic syndrome. Some of the early symptoms related to this altered glycemia include polydipsia, polyphagia, polyuria and changes in the vision. Later clinical complications include vasculopathy, peripheral neuropathy, nephropathy and pre-disposition to infections. Clinical trials have demonstrated the benefits of tight control of hyperglycemia as well as of multiple risk factors. Early detection of hyperglycemia, insulin resistance, altered lipid metabolism and better management of these observed risks, is the best choice we have, to reduce the Global Health Care burden. Excess glucose in the circulating blood seems to impair the endothelial dependent vasodilatation in both the microcirculation as well as macro-circulation. Prolonged exposure to hyperglycemic environment and altered endothelial function seems to accelerate the pathogenesis of atherosclerosis and type-2 diabetes and its clinical complications.