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With more than 235 million people living with diabetes or prediabetes, India’s healthcare burden could see a steep rise in the near future. Experts, however, say all is not lost and some easy-to-follow steps could help bring the condition under control in most cases.
Chronic diabetes could severely affect the functioning of multiple organs and reduce the overall quality of life, especially in older adults.
Dr Muthu Kumaran Jayapaul, consultant, endocrinology & diabetes, Fortis Malar Hospital, Chennai, says poor sleep patterns, physical inactivity (resulting from sedentary work hours) and prolonged sitting (for eight to 10 hours a day) also add to the risk of diabetes.
Measures for managing diabetes
Experts recommend implementing the following lifestyle measures to manage high blood sugar levels:
1. Curb your carb enthusiasm
The foremost rule of diabetes management is to reduce your carbohydrate intake, mainly simple carbs. Dr Anjali Bhatt, endocrinologist and founder of Endo-clinic, Pune, recommends limiting carbohydrates to 50 percent of your total calorie intake and incorporating more complex carbs (like whole grains) into your diet. To put it simply, go easy on your rotis and extra servings of white rice.
2. Cut down your sugar intake
You should cut down on refined sugar (mainly white sugar) to maintain stable blood glucose levels. Replacing sugar with jaggery and honey could also prove ineffective, as they are not available in the market in their natural forms. Elevated blood glucose levels could lead to obesity. Dr Manjunath Malige, director, diabetes & endocrinology, Sakra World Hospital, Bangalore, explains that the pancreas secretes insulin to transport excess blood sugar to the cells. However, obesity makes the pancreatic cells less responsive to insulin over time, which in turn leads to high blood sugar levels.
3. Watch your weight
Keeping diabetes at bay should be your best excuse to lose those extra kilos, preferably around your waist. Excess abdominal fat gets deposited in the organs of the abdominal cavity, including the liver and pancreas. Fat accumulation in the pancreas adversely affects insulin secretion, while that in the liver causes severe inflammation, triggering insulin resistance. This creates difficulty for the existing insulin to effectively break down glucose, which in turn increases the risk of type 2 diabetes.
4. Ensure a balanced diet
Cutting down on simple carbohydrates might cause a sudden dip in energy levels, which is why experts instruct to compensate for this by including adequate protein and healthy fats in your daily diet.
Dr Jayapaul says protein should comprise 20 to 25 percent of your diet. The American Diabetes Association (ADA) suggests following the Diabetes Plate Method to ensure the perfect diet for people suffering from the condition. As per this method, one should take a nine-inch plate and fill half of it with non-starchy vegetables (like cabbage, carrot, cauliflower, radish and cucumber). The remaining half should be divided into two quarters containing protein-rich foods (like lentils, pulses, beans, paneer, lean meat, fish and eggs) and carbohydrates, respectively. It can be accompanied by a glass of water or a zero-calorie drink.
5. Set daily alarms for exercising
Exercising for about an hour, four to five days a week helps maintain an ideal bodyweight and improve insulin sensitivity. While aerobic exercises like cycling, walking and jogging help with weight management, strength training improves muscle mass, which in turn enhances the body’s efficiency to utilize glucose and increases insulin sensitivity. Dr Jayapaul says office workers having an eight-hour shift should ideally work out five days a week, while those with a 12-hour shift should work out for an hour every day to compensate for the physical inactivity.
6. Maintain an active lifestyle
Working on the ninth floor of your office building? If so, make it a point to use the stairs instead of the elevator at least twice a day. If your city has dedicated cycle lanes, try pedalling to work, as it would further help you keep your weight in check. Try walking to places that fall within a three-kilometre radius instead of using your car or scooter.
7. Ensure adequate sleep
Dr Malige says inadequate or interrupted sleep could cause blood glucose fluctuations in both directions. Complications like sleep apnea and excessive urination at night are also common among people with obesity, especially those already diagnosed with diabetes.
8. Avoid stress and anxiety
Addressing mental health concerns, general anxiety and stress is crucial for managing diabetes. The American Diabetes Association (ADA) points out that stress triggers the release of stress hormones, potentially affecting your blood glucose levels. Yoga, deep breathing exercises, reading books before going to bed or any activity that promotes general well-being and reduces stress could reduce the risk of diabetes, says Dr Malige.
9. Stay hydrated
The kidneys play a major role in blood sugar regulation by flushing out excess glucose through urine. Hence, adequate hydration is essential for facilitating this process. In addition, water, a zero-calorie beverage, also plays a role in weight management. Dr Malige says besides aiding kidney health, drinking optimal amounts of water also helps manage diabetes.
10. Stub that cigarette butt
Quitting smoking should be an indispensable part of your diabetes management plan. Dr Malige says smoking damages your blood vessels and affects blood circulation. Reduced blood flow to your pancreas will directly affect insulin secretion and, in turn, your blood glucose levels.
11. Say cheers but with caution
Doctors say people with diabetes can have a drink or two per week, but with extreme caution. Appropriate precautions should be taken before drinking, as alcohol can trigger a sudden spike or dip in blood sugar levels. In addition, it can also reduce the efficacy of some diabetes medications, say experts.
12. Follow-up regularly
According to Dr Bhatt, those with normal blood glucose levels should monitor the same annually, while those having borderline or prediabetic blood sugar levels need to follow up every six months. The HbA1c (glycated hemoglobin) level must be checked during these visits, as it reveals your three-month blood sugar average.
