Can you beat diabetes? Yes you can! But you must understand the basic patho-physiology. In type 2 diabetes there is a combination of peripheral insulin resistance (improper action of insulin on fat, muscles and liver) and inadequate insulin secretion by the pancreatic beta cells. Insulin resistance causes elevation of free fatty acids and pro-inflammatory tissue poisons such as cytokines, which prevents glucose entering into muscle cells and causes increased production of glucose in the liver and breakdown of fat. This is compensated initially by over-production of insulin and a person starts putting on weight, but then comes a stage when this compensatory insulin production seizes due to pancreatic exhaustion and the patient develops typical diabetes symptoms such as excessive thirst, frequent urination, fatigue, weakness and weight loss.
The genomic factor
There is no doubt that we Indians are genetically and ethnically susceptible to diabetes and heart disease but like a tree to bloom you need 'nurturing' for diabetes to manifest into its full blown syndrome. These factors include inactivity, lack of physical exercise, faulty nutrition (starting from your mother's diet when you were in the womb!) and severe mental and physical stress.
There's nothing (yet) that you can do about genetic factors, but you can certainly do a lot to control the environmental conditions that make diabetes flourish.
Now the question is, can you beat these factors? Here's what: there's nothing (yet) that you can do about genetic factors, but you can certainly do a lot to control the environmental conditions that make diabetes flourish. A healthy and nutritious diet and an active lifestyle with adequate exercise are the broad basics. While both play a role in managing diabetes they are also key to preventing it, starting from childhood and even before that in the case of pregnant mothers and the nutrition they pass on to their unborn babies. This needs considerable education, training and counselling--not only of pre-diabetics or high-risk individuals but the entire community.
The sobering fact is that every fifth person in the large metros at least is either a diabetic or poised to develop the disease. Globally, diabetes affects 387 million people and by 2035 this will rise to 592 million. It has already caused 5 million deaths in 2014. As you can see, this is not a matter to be taken lightly.
How can you beat diabetes?
The Diabetes Association of India has a pretty clear approach: "Treatment of diabetes is in your own kitchen". Broadly it can be classified as :
• "Aahar" (diet and nutrition)
• "Vihaar" (exercise and lifestyle changes)
• "Vichaar" (education, correct information and counselling)
• "Upachaar" (treatment with pharmacotherapeutic agents)
The Diabetes Association of India has a pretty clear approach: "Treatment of diabetes is in your own kitchen".
Beating diabetes with diet, although considered cornerstone of treatment, is the most neglected and ill understood form of therapy. This is the reason for rising childhood obesity and type 2 diabetes of the very young in the age group of 12-18 years.
The right diet
It's best to aim for a high fibre lacto vegetarian diet, with 50% carbohydrates, 30% proteins and 20% fats. Most of the carbohydrates should be complex such as cereals, whole grains, legumes, fruits and milk. Simple carbohydrates like sugars and fine flours should be avoided. Proteins should be available from milk, yoghurt and sprouts for vegetarians and from eggs , fish and chicken for non-vegetarians; red meat is best avoided.
The next thing is that you need fats in your diet. There are tremendous misconceptions about fats. Because of cholesterol phobia, many people cut out saturated fats such as ghee, butter, full fat yoghurt and coconut from their diet. All of the above are recommended by leading nutritionists! What we recommend two teaspoons of ghee, two teaspoons of coconut and two teaspoons of oil which has low levels of omega 6 fatty acids. We do discourage deep fried foods (such as bhajiyas, sev and so on) as well as fat from land animals.
Because of cholesterol phobia, many people cut out saturated fats such as ghee, butter, full fat yoghurt and coconut from their diet. All of the above are recommended...
You have to move it!
In my opinion, this subject should be part of the curriculum in every syllabus. We have to encourage young children to participate in outdoor sports for at least one hour every day; screen time should be reduced to maximum two hours a day. Every person should make an effort to exercise for at least 40 minutes a day, at least five times a week. There is no exercise like brisk walking (about 4km/hr) for 45 minutes. A word of caution: people above the age of 35 should undergo stress test prior to beginning an exercise regimen and undergo a detailed examination by a physician to rule out disease of bones and joints.
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