November 3, 2024
Diabetes, not a death sentence: These lifestyle modifications can help you live well
Did you know that diabetes has surged fourfold in the last 40 years, marking an alarming rise in mortality risk compared to major non-communicable diseases (NCDs) such as cancer or cardiovascular ailments? This concerning trend, according to data from the World Health Organization (WHO), calls for urgency in action. However, there’s hope. Type 2 diabetes—a condition that stems from the body’s glucose regulation issues—can be effectively managed through lifestyle shifts. Endocrinologists Dr. Pramila Kalra, Dr. Manoj Chadha, and Dr. P. K Jabbar convened to demystify diabetes. Dr. Pramila Kalra, Professor and Head of Endocrinology at Ramaiah Medical College and Hospital, Bengaluru, Dr. Manoj Chadha, a consulting endocrinologist at PD Hinduja Hospital and Medical Research Center, Mumbai, and Dr. P. K Jabbar, Professor and Head of the Department of Endocrinology, and Director-CEO of the Indian Institute of Diabetes Intervention, shared insightful, sustainable-yet-smart lifestyle strategies and solutions in a panel discussion moderated by Miloni Bhatt, Editor – Digital Broadcast, EconomicTimes.com as part of a webinar titled ‘Beat Diabetes With Lifestyle Modification’. This webinar is the second installment of the USV diabetes awareness multimedia series—Beat Diabetes Win Life—in collaboration with The Economic Times. Their goal was to empower patients and vulnerable populations at risk, offering feasible approaches to kickstart diabetes management through lifestyle modifications—simple, adaptable, and tailored for contemporary living.

Beat Diabetes With Lifestyle Modification

The dreaded ‘D’ word—diabetes—no longer carries the same weight as a life sentence. While traditional diabetes management relied solely on medications, there’s a growing emphasis on the pivotal role lifestyle changes can play in supporting and enhancing the well-being of individuals suffering from diabetes. In the second installment of the USV diabetes awareness multimedia series, titled ‘Beat Diabetes With Lifestyle Modification’, some of India’s leading endocrinologists convened to impart savvy and sustainable strategies for embracing transformative lifestyle shifts.

Combating the ‘hurry, worry, curry’ lifestyle
Enlightening the audience about this dreaded lifestyle disease, Dr. Chadha pinpointed the culprit as our ‘fast-paced ‘hurry, worry, and curry’ lifestyle,’ capturing the essence of our everyday life. ‘We need to reconsider our eating habits, manage stress levels, incorporate physical activities into our routines, and allocate time for various aspects, including sufficient sleep.’ Above all, the Mumbai-based endocrinologist emphasized that ‘when we speak about lifestyle, it’s not merely a temporary adjustment but something sustainable and fitting for each individual.’

Dr. Jabbar dived into this paradigm of sustainable shifts, rather than fleeting fixes, through the lens of a balanced diet. Since ‘we are what we eat,’ a balanced diet holds a significant spot in diabetes management. Apart from being well-informed about recommended dietary guidelines, individuals often encounter challenges in adopting and, more importantly, sustaining healthy eating habits.

Dr. Jabbar recalled that her mentor used to ’emphasise that there’s no specific diet solely for diabetic patients.’ Rather, it’s about modifying your diet. ‘Cutting back on heavy or fatty foods, excessive carbohydrates, or high-sugar content is crucial.’ According to Dr. Jabbar, a balanced diet by definition means regulating portions and including items like brown rice instead of white, limiting sugary items, and incorporating salads, which provide positive energy and aid bodily functions.

While implementing these recommendations entirely across the population might not be practical, making small, achievable changes is crucial for positive health. ‘As our textbooks emphasise, the most crucial step is dietary modification, coupled with exercise,’ said Dr. Jabbar.Dr. Kalra seconded Dr. Jabbar, adding that ‘When we discuss lifestyle modifications with our diabetic patients, adherence can be a challenge. It needs to be tailored to each individual.From brisk walks to heavy lifting, build your exercise regime
Since Dr. Jabbar already highlighted dietary changes, Dr. Kalra shared insights into another vital component of diabetes management: exercise. ‘Often, time constraints are cited as a barrier to exercise. We emphasise flexibility in timing—whether morning, afternoon, or evening—to encourage regularity,’ said Dr. Kalra.

Contrary to popular perceptions, even brief breaks, like walking every 30 minutes while working on a laptop, can make a difference, meaning lifestyle modifications can seamlessly integrate into daily routines. ‘For instance, opting to walk while commuting or adding a stationary cycle at home for cycling in the evenings or mornings can effectively maintain health parameters. These adaptable suggestions align with individuals’ lifestyles, as a dedicated exercise routine might not always be feasible for everyone,’ added Dr. Kalra.

Expanding on Dr. Kalra’s insights, Dr. Chadha provided a deeper understanding of how physical activity plays a role in regulating blood sugar levels for individuals with diabetes. ‘Expanding on Dr. Kalra’s point, it’s crucial to emphasise the detriment of prolonged sitting; it’s often termed the ‘new smoking.’ Continuous sitting is equally harmful, if not worse, than smoking.’

Dr. Chadha emphasised that following a few simple steps, such as getting up every 30 minutes, even for a few seconds, can be highly beneficial. Incorporating activities like walking, games, dancing, or even basic weight training can be easily integrated into daily routines, even within corporate settings during short breaks. Dr. Chadha shared another critical insight, an emerging concern in recent years: the significance of bone health in diabetes. Diabetics face an increased risk of fractures, surpassing that of non-diabetics. Therefore, the emphasis on lifestyle changes and weight-bearing exercises doesn’t just aid in diabetes management but also reduces the risk of fractures and addresses bone health concerns, shared Dr. Chadha.

Dr. Chadha also allayed fears for those who are possibly diabetic and possibly at a higher risk of fracture, as some might have reservations against physical exercises. Dispelling such fear, he further explained that the spectrum of physical exercise encompasses various activities like regular walking, dance exercises, or outdoor games, allowing a person to avoid contact sports if that’s a concern. Additionally, weight-bearing or stretching exercises don’t necessarily involve heavy lifting; tools like stretch bands are effective and safe. They work on energy levels without the need for specific weight loads. These exercises have remarkable effects on muscles and bones simultaneously. There’s no need to be apprehensive; these exercises are safe and immensely beneficial.”

Obesity and diabetes management
A 2021 study highlighted that there were 101 million people with diabetes and 136 million with pre-diabetes, while 254 million had generalised obesity. Abdominal obesity stands at 40% across the population, with female abdominal obesity at 50%. This makes it evident that obesity is a critical concern for diabetes and raises the risk for others. Therefore, obesity management is a significant part of supporting the overall health of individuals with diabetes.

Dr. Kalra explained that when addressing obesity, it’s not merely about BMI but also about visceral obesity—a harmful type of fat causing increased insulin resistance and inflammation. This predisposes individuals to diabetes, cardiovascular diseases, and elevated cholesterol levels. Additionally, obstructive sleep apnea is prevalent among those with obesity, disrupting sleep patterns and contributing to higher blood pressure and risks of cardiovascular issues and diabetes. Fatty liver, characterised by fat deposition in inappropriate areas, adds to these complications.

“So, when a patient adheres to an exercise regimen or undergoes treatment for these concerns, alongside lifestyle adjustments, we monitor and assess these factors comprehensively. Our focus isn’t solely on insulin resistance, diabetes, hypertension, or cholesterol; we also address fatty liver, a significant predisposing factor not just for cirrhosis or liver damage but also for heart disease. In managing obesity, we address a spectrum of issues such as obstructive sleep apnea, fatty liver, diabetes, prediabetes, blood pressure, and cholesterol,” explained Dr. Kalra.

Obesity management isn’t solely about shedding pounds; weight loss is quantified in percentages—3%, 4%, 5%, or more—because a 5% or higher weight loss has shown significant benefits across various parameters, including fatty liver and insulin resistance,” said Dr. Kalra.

The Professor and Head of Endocrinology at Ramaiah Medical College and Hospital, Bengaluru, also expanded on various methods, including medications, aiding in achieving significant weight loss, even surpassing 10 to 15%. This weight reduction contributes to alleviating insulin resistance and can even lead to “diabetes remission,” a concept gaining attention in contemporary discussions.”

Sleep and stress management
Dr. Jabbar, building on Dr. Kalra’s insights into sleep issues, emphasised the necessity for an average sleep duration of about six to seven hours to avoid accompanying medical conditions. He delved deeper into stress management and its impact on blood sugar control, while also elaborating on the significance of sleep in diabetes management.

Stress has a profound link with our well-being, especially in diabetes management. Uncontrolled diabetes often intertwines with stress-related factors, affecting blood sugar levels. Sleep disturbances, such as snoring, are equally critical. Visceral or abdominal obesity, coupled with snoring, can lead to obstructive sleep apnoea—a condition beyond mere snoring. It’s a serious medical issue impacting diabetes and hypertension control, affecting personal and professional spheres. Sleep disruptions hinder oxygenation, leading to fatigue and performance issues, not uncommon in workplace settings. Addressing snoring is crucial; lifestyle changes or minor surgeries can significantly alleviate these issues. Snoring isn’t just a sound; it carries significant health implications and warrants attention for better diabetes management and overall health.

Dr. Jabbar also highlighted some stress management strategies: Stress management can be approached through various methods, primarily through lifestyle adjustments. Adequate sleep plays a crucial role, and activities like exercise are beneficial in reducing stress. Sometimes, seeking guidance from counsellors or considering medications might be necessary for long-term management. Maintaining a work-life balance is vital. It’s essential to delineate work hours from personal time and avoid routinely bringing work home. Additionally, taking regular breaks from work, as practised in several countries, is essential for mental well-being. Accumulating excessive leave days without utilising them might not be advantageous in the long run.

Additionally, Dr. Chadha stressed the significance of regular monitoring in assessing the effectiveness of lifestyle modifications. He explained that monitoring is incredibly crucial. Often, discussions centre on medications or injections, but lifestyle modifications play an equally, if not more, significant role. Encouraging patients to monitor their sugar levels at home is vital. Even if it’s not as frequent as multiple times a day, doing it once or twice a week provides insight and a sense of progress. Visiting the lab occasionally, as advised by the doctor, is also important.

“I can assure you, as Dr. Pramila uses the word ‘remission’ in diabetes, it’s a reality, not fiction. However, it requires respecting your body, taking care of it, and monitoring regularly as advised by your physician, depending on the treatment you’re undergoing. I believe that the group of patients solely relying on lifestyle changes, without any medications, are the ones who can speak in terms of reversing or achieving remission,” summed up Dr. Chadha.”

Disclaimer: This content is part of a disease awareness initiative by USV. The opinions and views are that of the Health Care Personnel (HCP). The content on this site provides general information about health and wellbeing. It is not intended as medical advice, nor is it a substitute for professional medical expertise or treatment. If you need help getting your health under control, we recommend speaking to your doctor.

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