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Diabetes management plan: Understanding medications, diet and exercise | Health

Type 2 diabetes still remains undoubtedly a lifestyle malady, the result of abundance, poor food choices, lack of awareness, little need for self control, obesity, reducing need for physical toil for daily living, a curse of human advancement and industrialisation. However, this very scientific advancement is now also paving the way for diabetes cure and urging humankind to unlearn and relearn a lifestyle that can fight this diabetes pandemic.

The discovery of diabetes remission in 2017 is one such scientific marvel that will be looked back upon by humankind as one of the life changing discoveries of the century. This has now led us to rethink the predominant drug-based approach to diabetes and instead bring in strong life-style based interventions as the first step in diabetes management.

Diabetes is one of the major global concerns, which is now turning into an epidemic with more than 463 million adults affected by diabetes and it has nearly quadrupled in the past two decades, growing from 4.7% to 8.5%. This challenging illness is affecting an increasing number of adults and is now more prevalent in young people where according to experts, it is sharply rising in rural and urban India so, there is an immediate need to pay attention to the growing concerns about the health threats posed by this and prioritise preventive care.

In an interview with HT Lifestyle, Dr Hema Venkataraman, Consultant Endocrinologist at NHS UK and Medical Advisor, shared, “With the advent of new wonder drugs for diabetes and obesity (eg Munjaro, Semaglutide), the pharma industry in diabetes care is also entering a new era. These new drugs bring unparalleled weight loss and induce a drug induced diabetes remission of sorts. It is well known that the average Indian with diabetes does not meet the required physical activity levels necessary for optimal health (150 min of aerobic activity / week), with over 50% deemed to be inactive as per the ICMR-Indiab-5 report.”

She insisted, “Just like the idea of “diet” should pave the way for “healthy food choices”, so must “exercise” pave the way for “active living”. Our society will have to come full circle from ditching the bicycle for the car and now ditching the car for the bicycle (only this one will have some gears!).”

According to Vilasini Bhaskaran, Specialist Registered Dietitian at NHS UK and Head of Nutrition and Dietetics at Practo in India, there is no one single prescriptive dietary approach to diabetes management as “one-size” doesn’t fit all and nutrition therapy should be aimed at catering to the individual needs of patients. She recomended, “It is high-time we ditch the diet mentality and re-tune our overall approach and behavior towards eating. The ideal way to control blood sugars long term is through intuitive, healthy eating, focusing on food choices, balance, moderation, textures and consistency. A healthy meal plate should consist of vegetables or salad (1/2 plate), proteins (1/4 plate) and carbohydrates (1/4 plate) in recommended portions. Restrict eating out/ takeaways to once a fortnight as they contain a lot of calories and saturated fat even in smaller portions and this could make you put on extra pounds.”

The health expert added, “It is ‘OK’ to include sweets occasionally in smaller portions and choose ‘sugar-free’ alternatives where possible. Non-nutritive artificial sweeteners such as aspartame, stevia, acesulfame and saccharin don’t increase blood glucose and can be safely used as part of a healthy diet. Avoid foods labeled as ‘suitable for diabetics’ as these products have no special health benefits and they are often high in calories, may contain hidden ingredients that can still increase your blood glucose levels and may have a laxative effect!”

Vilasini Bhaskaran advised, “People with diabetes need to be extra careful with alcohol as it significantly increases the risk of hypoglycemia (low blood sugar levels) and adds to calories. Recommended allowance is <14 units (around 6 medium {175ml} glasses of wine) per week spread throughout the week with 2-3 alcohol-free days/ week. Remember, diabetes management is a life-long intervention and positive health outcomes hugely depend on your commitment, engagement and participation in your own healthcare management.”

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