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The 60-plus diabetic fight club

The 60-plus diabetic fight club

Senior citizens are taming diabetes through sheer grit and healthy lifestyle choices


Sixty-two-year-old Anuradha Kar has only one regret when she looks back. Had she switched to a proper diabetes diet plan in her thirties, not only would it have saved her countless visits to doctors, but maybe also nipped other health complications in the bud.

Having completely altered her eating habits over the years, Kar is today a fitter version of herself and has been able to keep ailments at bay. “I feel much healthier than I have felt in over three decades,” she says.

Kar was diagnosed with gestational diabetes when she was 33; it was her second pregnancy. Then she fell prey to several other ailments.

Autoimmune disorders ran in her family, and Kar was affected with idiopathic thrombocytopenic purpura (ITP, a disorder which leads to abnormally low levels of platelets). Simultaneously, she had third-grade kidney damage, fatty liver and arthritis.

She blames these health issues partly on her erratic and mindless eating pattern, and also on heavy medication. “Apart from aggravating diabetes, careless and unmonitored eating took a toll on my liver and kidneys as well,” says Kar.

At one point, Kar’s health deteriorated so much that she was unable to walk much and feared she might have to undergo dialysis.

The diabetes diet plan

When her health deteriorated further, she consulted Delhi-based clinical nutritionist Ishi Khosla in 2014. The modified diabetes diet plan that Kar was then given proved to be her saviour; within a year she lost all extra weight (she reached 96 kilos from 120 kilos), stopped insulin and reversed her creatinine levels. Kar has been following Khosla’s diet plans for eight years and weighs 92 kilos now.

“It was unbelievable for my diabetologist,” says Kar. “I was on a heavy dose of medication and insulin, he had to stop my insulin and significantly change my dosages (of medicines) from high to low, looking at the progress in my reports.”

Her medication was reduced from six to two tablets each day. “When my sugar levels came down to 128, I was asked to stop insulin by my doctor,” she says. She has been off insulin for about eight years now.

Though she was not suffering from type 1 diabetes, Kar was put on insulin because of high levels of blood glucose, age and comorbidities. According to Dr Vineeta Singh Tandon, consultant, internal medicine, and diabetologist at Pushpawati Singhania Hospital and Research Institute, New Delhi, people with type 2 are given insulin when their blood glucose levels are to be brought down much faster than through regular oral medication. Dr Farah Ingale, director, internal medicine, Fortis Hiranandani Hospital, Vashi, Thane, adds that insulin is prescribed for those found to be suffering from beta cell complications that affect insulin production.

“It is estimated that every year there will be a five per cent decline in beta cells, and at one point, insulin production will be severely affected so that we will have to prescribe insulin shots for them,” Dr Ingale says.

Develop healthy gut instincts

While planning the diet for Kar, Khosla had to keep several things in mind.

“Because Kar had many health issues, I planned her diet keeping her liver, kidney and arthritis in mind,” Khosla says. “She also needed a balanced diet that targeted her low-grade inflammation, dysbiosis, nutrition restoration and to rebuild the gut flora and immune system.”

Khosla emphasises that there was a great need to target Kar’s gut health because her weight gain was mainly triggered by the inflammation of the gut and poor dietary supervision. “Once issues like systemic low-grade inflammation and leaky gut are addressed, losing weight and feeling energetic become simpler,” says Khosla.

Kar is also particular about taking care of her gut health. She makes it a point to have homemade fermented rice water or beetroot kanji (fermented beetroot drink) at home as natural probiotics early in the morning. Sometimes when she can’t prepare these, she has ready-made ones.

According to an article published in the journal Nutrients in November 2018, gluten in diet could lead to more stress on insulin-producing beta cells, adversely affecting blood glucose levels. Hence avoiding gluten would help control blood glucose levels. The article points out that though this research is still in its early stages, a diet free of gluten could help control obesity and type 2 diabetes since it could decrease insulin and leptin resistance, and also increase beta cell volume in our body.

Eating right with diabetes

To begin with, Khosla excluded grains like wheat, barley, corn and oats from Kar’s diet but added a variety of rice (brown, black, red, poha [beaten rice], rice upma) and millets (pearl millet, sorghum, finger millet, kodo millet, foxtail millet, etc).

Kar’s mornings would start with saunf (fennel), jeera (cumin) and ajwain (carom) water. Sometimes she would switch to ginger juice mixed with water, black pepper and turmeric. Alternatively, she could have aloe vera and amla juice with water.

Since Kar could not tolerate excessive proteins because of her kidney issues, Khosla went easy on them. As per the weekly diet plan, her lunch comprised of dal cheela (lentils pancake) or almond or besan (gram flour) roti teamed with salads and vegetable-based preparations twice a week.

For the next two days, she could have chicken (up to 150 gm) with salad and vegetables for lunch. For the remaining days, she was put on cauliflower rice (grated and steamed cauliflower) with a combination of salad and vegetables; one day of the week would be dedicated to quinoa roti along with salad and vegetables.

The diet was regularly altered with other similar meal plans so that it didn’t become monotonous. She could have some nuts in the evening with coffee or fruit, while dinner was almond milk or fruit. Apart from the diet, Khosla also suggested a few supplements rich in vitamins and minerals to be taken.

“Once the doctor saw her improved reports, all the medicines were titrated, and the doctor asked her to continue doing whatever she was doing,” says Khosla.

Before the pandemic, Kar also used to exercise daily; she used to walk for 30 minutes a day and also did stretches.

Eating right to fight blood sugar

Seventy-two-year-old Neera Obhan, from Solan, Himachal Pradesh, discovered that she had diabetes in 2020.

Her blood reports showed her sugar after fasting was 140.  She wanted to avoid going to the hospital and make dietary changes first. That’s when she decided to try a gluten- and dairy-free diet. Result: her sugar level dropped to 100mg/dl, and she lost 12 kilos in a year.

“Sugar, gluten and dairy were the culprits for me and once I stopped these, my sugar was under control,” she says. “I lost weight which, in turn, helped me significantly in reducing the joint pains caused by arthritis.”

Obhan was also asked to avoid nightshade vegetables such as tomatoes, brinjal and capsicum, which are known to have alkaloids (a class of naturally occurring nitrogen) that can cause discomfort and pain in the body.

Obhan says limiting carbohydrate intake was crucial. “For instance, I have rice twice a week and then if I want to have idli that week, I replace the carbohydrate with protein – dal idli and not the one made with rice,” she says. “Similarly, instead of flattened rice or poha for breakfast, I have dal poha.”

Deepak Hiramath, the 60-year-old owner of an NCR-based advertising agency, also had a life-altering experience after switching to a tailor-made, diet-plan.

In his case, the symptoms of diabetes surfaced about ten years ago when he would always feel low on energy, frequently experience an upset stomach and couldn’t walk for more than 20 minutes. That’s when Hiramath was asked to test his glucose; also his mother had been a diabetic. The results reflected high sugar levels and he was put on insulin.

Six years after the diagnosis, Hiramath decided to opt for a supervised healthy diet in an attempt to bring his blood glucose under control. The first thing his dietician asked him to do was to eliminate gluten and dairy products from his diet. The new diet plan made him switch from refined wheat flour chapatis to ones made with ragi, jowar and isabgol (psyllium husk). As per his modified diet for diabetes, he had to stay away from sweets and carbohydrate-rich food. Jackfruit flour was another addition to his diet, replacing refined flour.

“Once you abstain from sweets for about 45 days, then you get used to it and don’t miss them anymore,” he says. A diabetic who needed insulin initially, Hiramath managed to bring down his sugar to normal levels with diet control and restrictions.

However, Dr Anoop Misra, endocrinologist and chairman of Fortis-C-DOC Centre of Excellence for Diabetes; director of National Diabetes, Obesity and Cholesterol Foundation (N-DOC) and president of the Diabetes Foundation India, does not believe in banning carbohydrates. Instead, he suggests alterations such as mixing wheat with besan. “White rice should be replaced with brown,” Dr Misra says. “Small portions of potatoes could be eaten.”

Gluten-lean diet to lower blood sugar levels

Delhi-based Priti Shahare, a 64-year-old former banker with a family history of diabetes, was diagnosed with gestational diabetes at the age of 37. Soon after, she was asked to take medication for blood sugar and also hypertension and cholesterol (statins). This was when she decided to take dietary control of her life to keep diabetes at bay. She was diagnosed as gluten intolerant by her dietician and was prescribed a gluten-lean diet that was also rich in proteins (egg, fish or chicken).

“Apart from gluten, I could eat most of the things in moderation,” she says. “So, if we used to make most of our veggies with potatoes, now we don’t add those. Similarly, I used to have fruit juices, but I now have a whole fruit instead, which is rich in fibre.”

Shahare isn’t too rigid when it comes to diet but always stays away from anything made using atta, maida or suji and prefers to switch it with ragi or jowar. For breakfast, she prefers eggs or moong or besan cheela (gram flour pancake)“Sometimes I even have red meat but that is very rare, and the portion is too little,” she says. While most Indian sweets have maida (refined wheat flour) or some form of gluten, sweets automatically get eliminated from her diet. “My dairy consumption is limited to tea and coffee in moderation,” she says.

Shahare practises yoga thrice a week and walks for half an hour each day, but she feels it was the diet that made a huge difference to her HbA1c readings. She also lost weight — and now weighs 59 kilos compared to 64 kilos before the diet plan.

Her exercise routine comprises walking, yoga and pranayama thrice a week. “If I don’t walk for at least 30 minutes every day, I feel my day is incomplete,” she says. “Sometimes, on days I can’t step out, I make sure to walk inside the house.”

Making a U-turn on the diabetes highway

Reversing type 2 diabetes need not be the same for everyone who has it, says Dr Tandon. Some experts disagree about using the term reversal in the context of controlling it.

“Reversal can be interchanged with the term ‘remission’, which implies bringing the insulin and medication dosage down from the high dosages,” says Dr Tandon.

But Dr Misra is comfortable with the term reversal. “Diabetes reversal is certainly possible, and has been shown in experimental and community studies,” he says. “Those who require insulin have low insulin secretion from the pancreas; some will recover insulin secretion to near normal and they may not require insulin. For others, it is a lifelong treatment.”

Shikha Mahajan, a Delhi-based holistic nutritionist and dietician, believes that only gluten and dairy need to be cut down when there is an allergy or intolerance present in the body because in such cases, various health issues — like gut problems, diabetes, hair fall and nausea — can occur from ingesting such food.

“Not all diabetics need to cut down on gluten because most of the time when you go on a whole-grain diet (most of which is gluten-free) you are naturally reducing your gluten intake,” Mahajan says. “This is a very healthy switch and will naturally bring down sugar levels, but it should not cause one to believe that the gluten was at fault.”

Mahajan has observed when it comes to lactose, most people tend to develop some sort of mild sensitivity or intolerance to milk in their 20s or 30s. “So, eliminating it for a few days and recording the changes and results work best in case of milk or lactose,” she says.

According to the advocacy group Diabetes UK, weight loss is the primary factor responsible for achieving remission of type 2 diabetes and stopping the medication. The group says type-2 diabetes remission might not occur in everyone who reduces their body weight substantially (say, around 15 kilos), but it leads to the general improvement in health condition. This could ensure better insulin secretion and effective breaking down of blood glucose, which in turn would have a positive effect on blood glucose levels.

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