Sweet news no bitter pill for diabetics to take
Pune doctors speak to HT about their individual approaches to dealing with diabetespune Updated: Oct 03, 2017 16:41 IST
India’s emergence as the diabetes capital of the world ought to be a matter of distress for one and all in the country. The World Health Organisation (WHO) has estimated that there are more than 10 crore diabetics in India. This debilitating disease is known as a silent killer as it progresses silently without overt signs and symptoms. The progression of diabetes can have serious health consequences with an impact on all major organs of the body such as the heart, eyes, kidneys, feet and overall physiology. A major lifestyle disease, the prevalence of diabetes is widespread among all age-groups, be it children, young adults, the middle-aged and the elderly.
While Asians and especially Indians are genetically pre-disposed to diabetes, those with family history have a strong predisposition to this disease. Hindustan Times spoke to some leading doctors and specialists about their approach to dealing with this disease. While all of them stressed the importance of physical fitness and a controlled diet to prevent diabetes and keep it in check, some emphasised that it is possible reverse the disease.
Following are excerpts from their interviews with Hindustan Times.
Dr Pramod Tripathi, (MBBS with professional diploma in diabetes management)
Dr Pramod Tripathi started the Freedom from Diabetes programme in 2011. In less than four years since then, says Dr Tripathi, 5,000 people have been freed of medication for diabetes and 1,000 have been freed of insulin.
About preventing and managing diabetes, he says, “It should be understood that diabetes is a disease related to lack of fitness and not just a hereditary disease. When we take efforts to make our mind and body physically fit this disease can be prevented and even reversed.”
While Type-1 diabetes is difficult to reverse, Type-2 can definitely be reversed with a balanced diet, daily exercise and meditation to relieve stress. His goal is to help the country bring down the number of diabetics to less than one crore by 2030.
Dr Tripathi believes in a holistic approach while treating patients with diabetes. He advises low carbohydrate, balanced diet to his patients. By balanced diet he means eating all food items in the same quantity.
“I prescribe patients to eat one chapati with one bowl of vegetable, one bowl of salad and one bowl of dal. If the quantity of chapati is increased to two then all the other food items mentioned must also be doubled,” he explains. He advises diabetics to avoid rice and eat very little or no chapati.
Diabetics are encouraged to consume smoothies made of leafy vegetable, lime juice and mint instead of tea or coffee in the morning, and a complete ban on dairy products. Patients are advised not to consume milk-based products, bread, eggs and refined oils.
According to him, only walking does not help diabetics and anti-gravity exercises like walking against gravity and climbing steps is important.
Dr Abhay Mutha, (MD), diabetes consultant and president, diabetes care and research foundation
Making lifestyle changes which include proper physical exercise, eating the correct foods at the right time and being stress-free can go a long way in preventing diabetes or managing it once it has been diagnosed.
The sedentary lifestyle of people, lack of exercise, eating at wrong hours combined with high consumption of junk food, the stress on the body of night shifts, and rising mental stress has been contributing to diabetes among Indians. People who are obese and have a strong family history for diabetes fall in the high risk group. “Women with Polycystic Ovarian Disease (PCOD) among others must make lifestyle changes to prevent occurrence of diabetes in the future,” Dr Mutha says.
Apart from prescribing medicines to those whose sugar levels are found to be high, he ensures that the patients change their lifestyle by eating a balanced diet which is the normal Indian thali with more vegetables and salads and less carbohydrates, which include rice and chapatis.
Aerobic exercises including walking, jogging, swimming and exercises which help in muscle building. Along with these exercises yoga and meditation is is prescribed by him for diabetic patients.
Dr Mutha is President of Diabetes Care and Research Foundation Pune which was started in February 2004 to increase awareness about diabetes across the state. Presently, the foundation is supporting the education and medication of 70 children across the state who have been diagnosed with Type-1 diabetes.
AG Unnikrishnan, chief endocrinologist, Chellaram Diabetes Hospital
Diabetes today is commonly seen in all age groups and in people from all strata of the society. People who are obese must make special efforts to prevent diabetes. At Chellaram Hospital, emphasis is laid on spreading awareness about ways to prevent diabetes especially among obese children.
Dr. Unnikrishnan says Type-2 diabetes can be reversed in the early stages. His approach to controlling diabetes is through diet and exercise, without recommending any medicines in the initial stages. The focus and emphasis is always on a balanced diet and restricting carbohydrate intake while ensuring that the patient does not starve. Patients are also recommended aerobic exercises five days a week and yoga, pranayam and meditation, at least twice a week.” Merely walking does not usually help and various forms of exercises along with yoga and meditation is important.
Dr Shyam Kagal , consulting physician
According to consulting physician Dr. Shyam Kagal the most reliable test to understand if a person is prone to diabetes is the glycated haemoglobin test which gives an average level of blood sugar over the past two to three months. This is the most reliable test and does not even need a person to fast as is normally required while testing blood sugar.
Instead of going for testing random sugar, patients suffering from diabetes must either opt for glycated hemoglobin test or test blood sugar during fasting and post meal.
People who have urinary infection, frozen shoulders, fungal infection on the skin must test for diabetes as these things are more common in diabetes patients.
With regards to generic medicines, it has been observed that not many chemists stock generic medicines which is very disappointing. At the same time, big pharmaceutical companies are known to do all quality checks on medicines and hence these medicines are prescribed. “There are many low cost medicines available, but there is no certainty if they have been tested for quality and hence, doctors tend to prescribe drugs of well known companies even if they are costly,” he claims.
‘D’ company no more: Once diabetic, now free
Various people affected with diabetes who sincerely tried to change their eating habitats and exercised regularly have benefitted immensely from it.
Madhuri Kulkarni, 55 who was diagnosed with diabetes 10 years ago said that changing her sedentary lifestyle helped her a lot, to not only manage diabetes, but to reverse it. “Earlier I didn’t know what I was supposed to do to manage diabetes. I just stopped eating sugar and fruits like mangoes, bananas, chikku, but there was not much change in my sugar levels,” she said.
Kulkarni added that two years ago she started exercising regularly which included walking, jogging , yoga and praynayam and the effect was good.
“I also changed my diet to more a balanced diet where I ate minimum carbohydrates and it helped me a lot. I mainly eat vegetables, salad and dal. With these changing habits I slowly got my sugar levels under control and presently I take no tablets for diabetes,” she says.
Vasudha Chavan, 62, wo was diagnosed with diabetes years ago, shares similar views.
“I was diagnosed with diabetes when I was 47. My sugar levels continued to increase. I was later on insulin and suffered a lot of side effects due to diabetes. My feet veins looked blue and there were blisters. My teeth were also affected. Later, I sought medical help and was advised to have a balanced diet, more uncooked food and exercising against gravity. I saw the effects in four weeks and after a year I had stopped taking insulin and tablets, even for blood pressure.”
Sanjeev Tanksali has seen tremendous positive changes since the time he changed his lifestyle and eating habits. “I am 62 now and am planning to participate in a half marathon. Changing my eating habits and exercising regularly not only helped me manage diabetes, but also increased my stamina like never before.