The keys to combating diabetes
Diabetes is fast gaining the status of a potential epidemic in India, with about 67 million in India currently diagnosed with the disease. The aetiology of diabetes in India includes genetic factors coupled with environmental influences like obesity associated with rising living standards and lifestyle changes.
More than 90 per cent patients belong to Type 2 diabetes (adult-onset diabetes) category. “Other types are Type 1 diabetes (juvenile onset), gestational diabetes and other rare types of diabetes,” says Deepti Dua, dietitian, Mutation Diet Clinic Gurugram.
Dr Sanjay Kalra, consultant endocrinologist, Bharti Hospital Karnal, and vice president, South Asian Federation of Endocrine Societies, says, “The prevalence of Type 1 diabetes is also increasing at the rate of 3-5 per cent per year. There is a higher prevalence of this condition in urban India, almost double that of rural India.” “There is a clear increase in diabetes in people of low socio-economic stratum and in semi-urban and rural areas as well. Urbanised lifestyle, low physical activity and unbalanced food are responsible for the disease in urban areas,” says Dr Anoop Misra, Chairman, Fortis C-DOC.
But young children are increasingly becoming prone to developing diabetes due to factors like smoking, high blood pressure, abnormal lipid levels, and being overweight or obese. Says Dr Sanjay, “The youngest diabetic patient I’ve diagnosed is as young was one week old! The most common age group of diabetic patients falls in the range of 25 to 50 years, but we see three generations suffering from diabetes.”
Dr Vineet Surana, senior consultant, endocrinology, Aakash Healthcare Super Speciality Hospital, adds, “We have seen children developing genetic and Type 1 diabetes even in neonatal period, whereas Type 2 diabetes has been seen in children as young as 12 years of age.”
There are essentially two main types of diabetes: Type 1 and Type 2. Type 1 diabetes is an autoimmune disease wherein the body is unable to produce any insulin. It develops most often in children and young adults, but the disorder can appear at any age. Symptoms usually develop over a short period, although beta cell destruction can begin years earlier.
Type 2 diabetes is the more common and is often a part of metabolic syndrome that includes obesity, elevated blood pressure, and high levels of blood lipids.
Symptoms include hunger, fatigue, frequent urination, feeling thirsty all the time and dry mouth, itchy skin, blurred vision and unplanned weight loss. While some symptoms are typical of diabetes, the ones in Type 2 diabetes are so mild that they can even go unnoticed. Slow healing of cuts/bruises is another sign of Type 1, while tingling, pain, or numbness in the hands/feet and yeast infections construe symptoms of Type 2, which are often ignored. There’s no cure for Type1 diabetes. As people with Type 1 don’t produce insulin, regular insulin injections are required along with special diet and workout. Regular monitoring can help manage diabetes as it keeps your sugar level on track. Deepti adds, “Type 2 usually lasts a lifetime. But, some people have managed to get rid of their symptoms without medication, through a combination of exercise, diet (as it plays a major role) and body weight control. Sometimes insulin injections are also required.”
Dr Sanjay adds, “Controlling blood sugar (glucose) levels is the major goal of diabetes treatment which will help prevent complications of the disease. Type 1 diabetes is managed with insulin as well as dietary changes and exercise. Type 2 diabetes may be managed with non-insulin medications, insulin, weight reduction or dietary changes.”
Dr Anoop suggests, “Bariatric surgery can also induce weight loss and can cure diabetes in some selected individuals.” Some lifestyle changes you can make to control your symptoms and live a relatively normal life with diabetes include:
1. Staying fit. Young people generally become overweight or obese because of the imbalance of physical activity and eating habits. Genetics and lifestyle might also contribute to weight issues. Aim to sweat and exercise for at least 30 minutes or more (moderate-intense physical activity) for at least five days a week. Examples include walking for 15 minutes, going up and down a few flights of stairs or even gardening. Physical activity also boosts good cholesterol and improves blood circulation.
2. Children should have an hour of moderate physical activity daily. Encourage children to eat only when hungry, and to eat slowly. Regular exercise is a must for a healthy body and mind as well as to combat insulin imbalance disorders.
3. Avoid junk food as processed foods contain refined sugar which is a major risk factor for diabetes. Consumption of junk food increases the chances of getting diabetes and should be avoided.
4. Every woman should undergo a blood sugar after the age of 30. Knowing your vitals will help you in managing your lifestyle better.
5. Stress is another catalyst for diabetes, so keep it at bay by practicing yoga and meditation.
6. Smoking can exacerbate symptoms in those living with diabetes.
7. Watch your alcohol. It may be easier to control your blood sugar if you don’t get too much beer, wine, and liquor. So if you choose to drink, don’t overdo it.
The American Diabetes Association says that women who drink alcohol should have no more than one drink a day and men should have no more than two. Alcohol can make your blood sugar go too high or low.
Check your blood sugar before you drink, and take steps to avoid low blood sugars. If you use insulin or take drugs for your diabetes, eat when you’re drinking. Some drinks – like wine coolers – may be higher in carbs, so take this into account while counting carbs.
Transform your diet
1. Increase intake of high fibre food as they help regulate blood sugar level and reduce weight. Eat five to six servings of fruits and vegetables, along with some dried fruit. Choose whole grain foods such as brown rice and whole wheat bread. Avoid highly processed foods made with refined white sugar, flour and saturated fat. People with diabetes should look at the ingredients list on foods and avoid anything made from white flour, or enriched flour.
2. Weigh and measure food to gain an understanding of portion sizes. Avoid super-sized menu items particularly at fast-food restaurants. You can achieve a lot just with proper choices in serving sizes.
3. Add fermented food to the diet. In the fermentation process much of the carbohydrates are converted to alcohol or lactic acid. Fermented foods like yogurt maintains blood sugar level, because it leads to increase of antibodies, improves immune system.
Also, it regulates the appetite and reduces sugar and carbohydrate cravings. Fermentation also adds nutrients to the diet. Not all the fermented food is diabetic friendly, as the sugar level of the food before fermentation may vary.
4. Some fruits which are low in sugar like pomegranate, peaches and watermelons should be consumed. Meat and fish should be had in small servings per day.
5. Avoid sugar rich products like jam, jiggery, ice cream, chocolate, pastries, cakes.Some vegetables like potatoes, sweet potato and fruits like banana, mango, grapes and litchi should be also avoided. Also dry fruits like cashew, fried foods, butter, red meat, thick gravies should be cut out from the diet.
These asanas help balance the functioning of the endocrine system. They massage and tone abdominal organs like the pancreas and liver, stimulate the nervous and circulatory systems, which in turn help in controlling diabetes.
Asanas help in harmonising the body, breath and mind, thereby contributing to the overall health of the individual. These also assist in optimal secretions of the endocranial glands which help insulin in the body to be used more effectively.
Vrikshasana helps in stimulating hormonal secretion from the pancreas.
1. Stand straight and keep your feet close to each other. Your knees, legs and hand should be held straight.
2. Bring your right foot and keep it on your left thigh. Try to make a right angle. If you are unable to keep your foot on the thigh, try to keep your foot on the left leg wherever you feel comfortable and maintain your balance. Your right toe should point down wards. Your body balance should depend on the left leg.
3. Join your palms and bring them to the middle of your chest and keep the figure pointing upwards. Slowly move your hands overhead and raise your arms. Your arms should be slightly bent.
4. Stand straight, look in front and relax.
5. Stay in this position for about 10 seconds. Breathe normally.
6. Slowly lower your hands in the same position as before, bring your right leg to the ground and come back in the starting position. Repeat the same procedure with the other leg.
7. Try to repeat the whole procedure two to three times.
Dhanurasana improves the functioning of pancreas and intestines.
1. Lie on your stomach with your feet as wide apart and your arms by the side of your body.
2. Fold your knees and hold your ankles.
3. Breathing in, lift your chest off the ground and pull your legs up and back.
4. Keep the pose stable while paying attention to your breathing. Your body should now be taut as a bow.
5. Continue to take long deep breaths as you relax in this pose. But don’t get carried away. Do not overdo the stretch.
6. After 15-20 seconds, as you exhale, gently bring your legs and chest back to the ground.
7. Release the ankles and relax.
Halasana stimulates the pancreas, spleen and activates immune system.
1. Lie on your back with your arms beside you and palms facing downward.
2. As you inhale, use your abdominal muscles to lift your feet off the floor, raising your legs vertically at a 90-degree angle. Continue to breathe normally and supporting your hips and back with your hands, lift them off the ground.
3. Allow your legs to sweep in a 180-degree angle over your head till your toes touch the floor.
4. Your back should be perpendicular to the floor. Hold this pose and let your body relax more and more with each breath.
5. Gently bring your legs down as you exhale.