NUTRITION: There has been a tremendous change in our food pattern within the last 2-3 decades. These are, consumption of too much fat in diet with decrease in fibre contents, consumption of fast food, soft drinks, alcohol, smoking and sugar etc. These diet contribute to the development of diabetes in two ways. First quantitatively- those who eat more become obese and cause insulin resistance and impiared glucose tolerance and second qualitatively by effects of specific food (lack of fibre in diet. i.e. refined diet).

Efforts should be made to take a balanced diet and to prevent obesity.

STRESS :The role of stress and constitution as causative factor in diabetes in India has been discussed more in older literature than at present. It is very difficult to assess the stress. It is all the more difficult to assess the contribution of stress in precipitating diabetes in people with genetic susceptibility of the disease.

PARITY & GDM : (Gestational Diabetes Mellitus) : Several studies have suggested repeated pregnancies is related to the risk of developing diabetes. Blood Sugar becomes normal after delivery in women with GDM but they are associated with increased risk of developing diabetes (Type-2) in the subsequent years.

AGE & DIABETES: The prevalence of diabetes increases with age in India as in elsewhere. The maximum incidence of diabetes is in the 4th & 5th decades. Most studies show that prevalence of diabetes doubles if the results of population below 30 years are excluded.

Conclusion : The role of genetic and environmental factors (life-style changes, dietary habits, physical inactivity, obesity etc.) contribute powerfully to the explosion of Type-2 DM or NIDDM. As diabetes is increasing like an epidemic in India, effort should be made for primary prevention and provision of proper health services to reduce diabetic complications.

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