Type 2 Diabetes is generally seen in people above the age of 40. However, Type 2 Diabetes is becoming more and more common in younger patients due to change in lifestyle. Eating fast-food/junk-food, high body weight, lack of physical activity are all contributing to make them obese. This lifestyle induced obesity is leading to Diabetes. People who have a family history of Diabetes are at a much higher risk.
Type 2 Diabetes generally occurs due to
Insulin Deficiency – When beta cells (explained in next section) are not producing as much amount of insulin that is required to maintain the normal glucose level of the body.
Insulin Resistance – Even though sufficient insulin is produced it is not able to act to its optimum level in maintaining the glucose level in the body
“Insulin is a hormone made by the pancreas that allows your body to use sugar (glucose) from carbohydrates in the food that you eat for energy or to store glucose for future use. Insulin helps keeps your blood sugar level from getting too high or too low (hypoglycemia).” https://www.endocrineweb.com/conditions/type-1-diabetes/what-insulin
At times Diabetes can be a combination of these two types. Unlike type 1 deficiency where there is total deficiency of insulin here there is partial deficiency. Hence type 2 Diabetes patients can be treated with tablets. The tablets would either push the beta cells to produce more insulin or it increases the insulin efficacy (for insulin resistance). They might not need insulin injections
So how does so called bad lifestyle lead to Diabetes…
well! Each and every food that we eat,is full of carbs, proteins, fats etc. which upon consumption,is converted into calories by the body. These calories then get used up for maintaining body functions and other physical activity. However, when a person’s food intake increases as compared to his daily physical activity, the excess calories which should have been used for some physical activity now gets stored in the body as fat and the person starts to become obese. The obesity starts with visceral obesity (fat around the belly!). This excess fat stored in the body releases hormones which causes insulin resistance in the body… Triggering Diabetes.
Internationally a person with BMI above25 is considered obese However in India a BMI above 23.5 is considered obese. Indians are genetically more prone to diabetes.
With this logic one might conclude that hey! Let me just reduce my weight and my Diabetes will go away. In rare cases, it might work. However, in most cases the results are not so favourable. Once Diabetes is triggered a person needs a systematic Diabetes reversal/management protocol which if charted out by a qualified Diabetes Specialist can have the desired effect or at-least have a better controlled diabetes.
So how do we go about controlling and managing Diabetes:
If a person has reached a stage where he has become Diabetic; it is important to consult a good Diabetologist who can chart out the right way to reverse and then control diabetes.
The process, that is generally employed, involves controlling diet, increasing physical activity. Subsequently, managing & monitoring blood sugar levels to keep the Diabetes in check. Of course, at Sweet clinics our nutritionist who specialises in Diabetes & our Diabetologist work with you to do all of the above in a controlled manner.
Stage1: Shedding Excess Calories:
The idea here is to reduce the persons weight gradually. Trying to lose15-20 Kgs in a 2-3 months is not practical often not advisable. Even by losing 4-5 Kgs over a period of 2-3 months can give good results in reigning in type – 2 Diabetes.
- 1st Up Diet: Controlling Calories: Often people think that to lose weight they have to give-up on certain foods completely.Well if it is junk food then yes that has to completely stop. Nonetheless, patients are allowed to have their regular foods with some changes. For example, ifa person who is used to eating rice in every meal, we cannot totally stop rice for him. Instead we recommend then to just reduce the rice to, say half and replace it with 1 chapati or opt for brown rice. This becomes more acceptable to the patient and helps us in controlling his overall calorie intake. If a person is addicted to junk food and finds it hard to avoid we first provide counselling and assist him in changing his dietary habit.
- Next up: Burning Calories: Just controlling calories is not enough. Burning or using stored calories is equally important. The best way to burn calories is by exercising. Not only does these help burn calories but also helps in reducing blood sugar levels, blood pressure & cholesterol level; apart from improving overall mental and physical state of the body. At Sweet clinics we offer a more patient centric exercise protocol. For example, a younger patient can go to a gym or play the sport he prefers which can achieve the calories to be burned. While for an elder patient we look at all his medical history, and then prescribe appropriate exercise. If the patient has heart condition just walking for 15-20 mins might be recommended after consulting our in-house cardiologist.
For Diabetic it is important to do this under the supervision of a Diabetologist. At times Type – 2 Diabetics suffer from peripheral neuropathy, in which the feet become totally numb. Such people need to wear proper footwear, else they might suffer from ulcers without even realising it.
Also, most people prefer to go for a walk early morning. For them we recommend that they should not go for a walk on an empty stomach. They should go for a complex carb like a fruit or a cup of milk with biscuit. They need to do this as they had their last meal at night (8-10hrs before the walk) and when they walk their sugars might crash and they may become hypoglycaemic.
Stage2: Monitoring & Managing Diabetes:
Diet and exercise is just a small part of the treatment. Along with the calorie check some supplementary medication is required to effectively manage Diabetes. The Diabetologist often encourage monitoring blood sugar level and other markers regularly, accordingly advice a change in regime, if required.
Controlling calories and bringing blood sugar in check is only part of complete Diabetes treatment. Often patients who had a first encounter with Diabetes and managed to control it with professional help feel they are completely cured of it. However, that is not the case; these patients are now more prone to suffering from Diabetes and its complications. They still need to monitor their critical parameters regularly as advised by their Diabetologist. Patients need to understand that Diabetes is a chronic & progressive illness. Progressive means that as the duration of Diabetes increases or as the body ages, the functioning of beta cells reduces. Hence, the treatment protocol also changes from time to time.
Finally, even though curing Diabetes may be difficult, managing it is not; As long as patients follow certain precautions. In-fact many Diabetes patients live an active life by keeping their calories in check and having regular Diabetic checks.