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diabetes in india

Diabetes in India: A Holistic Approach to Tackling the Epidemic

by Dr. Shruthi R February 25, 2025

written by Dr. Shruthi R

Diabetes has emerged as a major health challenge in India, with an alarming 101 million diagnosed cases and an additional 136 million individuals estimated to be pre-diabetic. This troubling statistic reflects a growing epidemic that has deeply affected the country, especially considering the unique confluence of genetic, ethnic, and lifestyle factors that predispose Indian populations to diabetes. Urbanization, dietary changes, and sedentary living are major contributors to the rise of this condition. Alarmingly, even rural areas, once considered less affected, are now seeing similar trends due to the impacts of globalization. States like Goa and Kerala have reported diabetes rates exceeding 25%, underscoring the gravity of the situation.

Understanding Diabetes as a Complex Metabolic Puzzle

Diabetes is not merely a single disease but a complex metabolic puzzle that is intertwined with other non-communicable diseases (NCDs) and metabolic risk factors. This clustering of diseases can be best understood through the ‘Common Soil of Origin’ hypothesis, which explains how various NCDs, including Type 2 diabetes, share common root causes. The hypothesis suggests that a strong genetic background and ethnic predisposition lay the groundwork for these diseases, like bullets in a loaded gun. However, environmental and lifestyle factors like poor nutrition, lack of physical activity, inadequate sleep, mental stress, and exposure to environmental pollutants act as triggers, causing these diseases to manifest.

This theory demonstrates that Type 2 diabetes and other NCDs are not merely genetic or inevitable but are influenced by modifiable lifestyle factors. Effective management of Type 2 diabetes, therefore, requires a multi-dimensional approach that goes beyond controlling blood glucose levels. To reduce complications such as cardiovascular diseases, kidney damage, and liver issues, the management of other metabolic risk factors like obesity, high cholesterol, and high blood pressure is equally crucial.

The Bi-Directional Relationship between Obesity and Type 2 Diabetes

Obesity, especially abdominal obesity, is a significant risk factor for developing Type 2 diabetes, particularly in individuals with a family history of the disease. The relationship between obesity and diabetes is bi-directional, meaning that not only does obesity increase the likelihood of developing diabetes, but Type 2 diabetes itself contributes to the worsening of obesity. The presence of both conditions multiplies the risk of developing severe complications, such as heart disease, kidney damage, and stroke.

For this reason, healthy weight management is critical in the management of diabetes. Research has shown that even modest weight loss can significantly improve blood sugar regulation and reduce the risk of complications associated with diabetes. In some cases, losing more than 15% of body weight can lead to remission of Type 2 diabetes, demonstrating the profound impact of weight loss on long-term health outcomes.

A Holistic Approach to Managing Type 2 Diabetes

Given the complex nature of diabetes and its interconnectedness with other metabolic disorders, a holistic approach to its management is essential. This approach involves not only medical intervention but also lifestyle modifications that encompass nutrition, physical activity, mental health, sleep hygiene, and stress management.

Finger 1 & 2: Nutrition and Fitness

The foundation of diabetes management lies in proper nutrition and regular physical activity. It’s important to focus on the words “nutrition” and “fitness” instead of the negative connotations of “dieting” and “exercise.” A positive mindset towards these interventions helps patients embrace a sustainable lifestyle change rather than viewing them as temporary measures.

Nutrition for individuals with Type 2 diabetes should focus on three main pillars: quantity, quality, and timing. Portion control, balanced meals rich in fiber, healthy fats, and low in refined sugars are key components. Timing of meals also plays an important role, with many experts recommending smaller, frequent meals throughout the day to keep blood sugar levels stable.

Fitness advice for diabetes patients should include a well-rounded approach incorporating aerobic exercises, muscle training, flexibility, yoga, and even mindfulness practices like meditation. This comprehensive fitness regimen helps in controlling weight, improving insulin sensitivity, and reducing stress. Regular physical activity is a cornerstone of diabetes management and should be personalized to suit the patient’s unique needs and capabilities.

Finger 3: Medications

The treatment of Type 2 diabetes has evolved significantly over the years, with newer medications offering benefits that go beyond blood sugar control. Modern diabetes medications not only help lower blood sugar but also aid in weight loss, reduce blood pressure, improve lipid profiles, and protect vital organs like the heart, liver, kidneys, and even the brain.

The choice of medication should be individualized based on the patient’s health condition, age, and risk factors. When chosen appropriately, these medications can provide long-term benefits, offering comprehensive protection against the complications of diabetes. It is important to note that medications should be used in conjunction with lifestyle interventions for optimal results.

Finger 4 & 5: Sleep and Stress Management

Two often overlooked contributors to the worsening of diabetes are poor sleep hygiene and chronic stress. Mental health issues like stress, anxiety, and depression can interfere with blood sugar regulation, exacerbate symptoms of diabetes, and lead to long-term health complications.

Stress management techniques, such as mindfulness, meditation, and relaxation exercises, can be effective in controlling blood sugar levels. Additionally, promoting good sleep hygiene—such as maintaining a regular sleep schedule, creating a conducive sleep environment, and limiting screen time before bed—can significantly improve diabetes management. Addressing these aspects holistically is essential, as untreated mental health issues can derail the efforts to manage diabetes effectively.

The Urgent Need for a Holistic Diabetes Treatment Strategy

The growing diabetes epidemic in India calls for a shift towards a more comprehensive, holistic approach to care. This shift would address not only the medical aspects of diabetes but also the underlying causes and contributing factors such as lifestyle, mental health, and stress. By embracing this holistic perspective, healthcare providers can help individuals with diabetes achieve better health outcomes and quality of life.

Importantly, healthcare providers should be equipped with the knowledge and tools to offer personalized, patient-centered care. This would involve working closely with patients to understand their unique challenges, preferences, and goals. Through education, motivation, and support, patients can be empowered to take control of their health and manage their diabetes more effectively.

The Path Forward

India’s rising diabetes epidemic is a wake-up call for both individuals and healthcare systems. A holistic approach to diabetes care, encompassing not just medications but also lifestyle changes, nutrition, physical fitness, sleep hygiene, and mental health, is essential for managing the disease and preventing its complications. By addressing these interconnected factors, it is possible to reduce the burden of diabetes on individuals, families, and society at large.

As India continues to face the challenge of diabetes, embracing a holistic perspective can lead to significant health improvements. Healthcare providers, policymakers, and individuals must work together to create a supportive environment that encourages sustainable, long-term health behaviors. With the right strategies and a shift in mindset, India can make meaningful strides in combating this growing epidemic and improving the quality of life for millions of people living with diabetes.

February 25, 2025 0 comment

ICMR STUDY REVEALS THE HIDDEN ROLE OF PROCESSED FOOD IN FUELING INDIA’S DIABETES CRISIS

by Anshika Mishra October 7, 2024

written by Anshika Mishra

India’s soaring rates of diabetes have long been a cause for concern, and a new clinical trial sheds light on how the food choices of millions of people may be contributing to the problem. This groundbreaking research has found that certain foods rich in advanced glycation end products (AGEs) are playing a significant role in the country’s diabetes crisis.

The study, the first of its kind in India, brings attention to how common dietary habits, especially the consumption of processed and fried foods, are influencing the nation’s growing health burden. The findings have significant implications for India’s ongoing battle with diabetes, and they provide new avenues for dietary interventions.

What Are AGEs and How Do They Affect Health?

AGEs are harmful compounds that form when proteins or fats combine with sugars through a non-enzymatic process known as glycation. This chemical reaction often occurs during cooking, particularly when food is subjected to high heat through frying, roasting, or grilling. Once consumed, AGEs trigger inflammation in the body, which is a major contributor to the development of chronic diseases such as type 2 diabetes.

Inflammation is a natural immune response, but chronic inflammation caused by continuous exposure to AGEs can lead to a host of metabolic issues, including insulin resistance. Insulin resistance occurs when cells in the body stop responding effectively to insulin, the hormone responsible for controlling blood sugar levels. This sets the stage for the development of type 2 diabetes, a condition where the body can no longer manage blood glucose effectively, leading to elevated sugar levels in the bloodstream.

The Clinical Trial: Exploring the Impact of AGEs on Metabolic Health

This study, funded by the Indian government and led by researchers from the Indian Council of Medical Research (ICMR) and the Madras Diabetes Research Foundation (MDRF) in Chennai, focused on the dietary habits of 38 overweight and obese participants. While none of the participants had been diagnosed with diabetes, they were at a higher risk due to their body mass index (BMI), which was 25 or above. The researchers divided the participants into two groups: one group consumed a low-AGE diet, while the other followed a high-AGE diet for 12 weeks.

Foods rich in AGEs were prepared using methods like frying, roasting, and grilling, while the low-AGE foods were boiled or steamed. Importantly, both diets were carefully matched for calories and macronutrients to ensure that the only variable was the AGE content. This allowed researchers to isolate the effects of AGEs on the participants’ metabolic health.

At the end of the 12-week trial, the results were striking. Participants who consumed the low-AGE diet showed significant improvements in insulin sensitivity compared to those in the high-AGE group. Insulin sensitivity refers to how effectively the body’s cells respond to insulin, and improved insulin sensitivity is a key marker of metabolic health. Additionally, the low-AGE group had lower 30-minute post-load plasma glucose (PG) levels, which is an important indicator of future diabetes risk. These findings suggest that reducing dietary AGEs can have a direct and positive impact on diabetes prevention.

The Growing Diabetes Crisis in India

India’s battle with diabetes is becoming more urgent every year. A previous study conducted by the ICMR and MDRF, and published in The Lancet Diabetes and Endocrinology in 2023, revealed alarming statistics. As of 2021, 11.4% of Indians—equating to more than 10 crore people—were living with diabetes. The rapid rise in diabetes cases is largely driven by lifestyle changes, particularly the increased consumption of processed, high-calorie, and high-AGE foods.

Western research has long demonstrated the health risks associated with ultra-processed foods rich in fat, sugar, and salt. These foods are often packed with AGEs, further increasing the risk of chronic diseases. In India, as traditional diets give way to more processed and convenience foods, the shift is contributing to a sharp increase in obesity, diabetes, and cardiovascular diseases. The clinical trial’s findings provide crucial data that link the consumption of AGEs to the rise in diabetes cases in India, an area that had been largely unexplored until now.

How to Reduce AGEs in the Diet

The results of this study suggest that one effective way to reduce the risk of diabetes is by making smarter food choices and adjusting cooking methods to minimize the formation of AGEs. According to Dr. V. Mohan, Chairman of the MDRF and one of the study’s authors, understanding which foods are high in AGEs and how cooking techniques influence their formation is key to better managing diabetes.

Foods that are high in AGEs include fried, grilled, and roasted items, such as chips, cookies, crackers, fried meats, and processed snacks. Even foods that are considered relatively healthy, like roasted nuts or grilled vegetables, can become high in AGEs due to the cooking method used. In contrast, low-AGE foods include those that are minimally processed and prepared using gentler methods like steaming, boiling, or poaching.

By making a few simple changes, such as opting to steam or boil vegetables instead of frying them, or by choosing fresh fruits, vegetables, and whole grains over processed snacks, individuals can significantly reduce their intake of AGEs. For example, steamed rice and boiled lentils are low-AGE alternatives to fried rice or lentil fritters. Likewise, fruits and raw vegetables are naturally low in AGEs and provide vital nutrients without the inflammatory risks associated with processed foods.

The Importance of Low-AGE Diets for Managing Diabetes

The study’s findings suggest that adopting a low-AGE diet could help prevent and manage type 2 diabetes, particularly in a country like India, where the disease is becoming increasingly prevalent. By reducing the intake of foods that trigger inflammation and oxidative stress, individuals can lower their risk of developing obesity-related type 2 diabetes. Oxidative stress occurs when there’s an imbalance between free radicals and antioxidants in the body, leading to cell damage. Minimizing AGEs in the diet can help restore this balance and prevent long-term metabolic damage.

Dr. Mohan emphasizes the need for a shift towards cooking methods that preserve the nutritional integrity of foods while keeping AGE levels low. “Boiling and steaming are far better options than frying or grilling,” he explains. “These methods not only help maintain the nutritional value of food but also prevent the formation of harmful AGEs.” He also recommends incorporating more fruits, vegetables, and whole grains into the diet, as these foods are naturally low in AGEs and provide a wealth of essential vitamins, minerals, and antioxidants.

Implications for India’s Fight Against Diabetes

As India faces the challenge of managing its diabetes epidemic, the findings of this clinical trial provide a crucial new perspective on the role of diet in disease prevention. By understanding the impact of AGEs on metabolic health, policymakers and health professionals can better tailor public health initiatives to address the dietary habits contributing to the rise in diabetes cases.

The study underscores the need for widespread dietary interventions and public awareness campaigns aimed at reducing the consumption of high-AGE foods. Such interventions could play a vital role in alleviating the growing burden of diabetes in India. As research continues to explore the connection between AGEs, diet, and chronic diseases, the evidence suggests that making simple changes to the way food is prepared and consumed could have a profound impact on the health of millions.

By taking steps to reduce the intake of AGEs and embrace healthier cooking methods, India can make significant strides in curbing the diabetes epidemic and improving the overall health of its population.

October 7, 2024 0 comment

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TYPE 2 DIABETES IN INDIAN YOUTH: HERE’S HOW SCHOOLS CAN HELP REDUCE THE RISK

by Anshika Mishra August 5, 2024

written by Anshika Mishra

Diabetes has become a pressing health issue in India, with alarming trends indicating a rising incidence among both adults and children.

According to the World Health Organization (WHO), over 77 million Indians aged 18 and above have type 2 diabetes, and an additional 25 million are prediabetic, placing them at high risk of developing the disease soon. This growing prevalence is concerning, particularly as type 2 diabetes, once rare among younger populations, is now increasingly affecting adolescents aged 12 to 18.

The Indian Journal of Endocrinology and Metabolism highlighted that type 2 diabetes impacts between 0.5% and 1.5% of children and adolescents, a figure that, despite seeming modest, represents a significant increase over previous decades. Approximately 10.4% of Indian adolescents between the ages of 10 and 19 are estimated to be prediabetic, underscoring a troubling trend.

Lifestyle Changes and Rising Diabetes Rates

Urbanization and shifts in lifestyle have contributed significantly to the rise in type 2 diabetes cases among youngsters. Reduced physical activity and increased consumption of processed, high-calorie foods are central factors driving this trend.

The modern sedentary lifestyle, marked by long hours spent in front of screens and a lack of outdoor play, has exacerbated the problem. Stress and rising obesity rates further compound the risk, with a third of Indian teenagers now estimated to have high blood pressure.

This combination of factors is creating an environment where diabetes is increasingly becoming a concern for younger generations. Intervening early to address these lifestyle habits is crucial to prevent the development of diabetes and associated health issues in adulthood.

The Impact of Sedentary Behaviour

The correlation between obesity and type 2 diabetes is well-documented, and rising rates of childhood obesity in India are a major contributor to the increasing incidence of diabetes.

Sedentary behaviour, including insufficient physical activity and prolonged screen time, is prevalent among Indian adolescents, with three out of four being insufficiently active. This lack of exercise, coupled with unhealthy dietary choices, creates a high-risk environment for developing diabetes.

The rise in obesity rates among school-age children further exacerbates the issue, highlighting the urgent need for preventive measures and lifestyle changes.

The Importance of Early Intervention

Addressing the rising burden of diabetes requires a proactive approach, focusing on early intervention and education. Schools represent a pivotal platform for developing healthier lifestyle choices among children and adolescents.

By incorporating health education programs into the curriculum, schools can promote the importance of a balanced diet, regular physical activity, and positive lifestyle habits.

Providing nutritious meals in school cafeterias and limiting the availability of sugary snacks and drinks are practical steps that can help reinforce healthy eating habits.

Promoting Physical Activity and Healthy Eating in Schools

Schools play a critical role in encouraging physical activity and healthy eating among students. Implementing programs that offer opportunities for regular exercise, such as sports and active play, can help counteract the effects of sedentary behaviour.

Routine health screenings within schools can aid in the early detection of diabetes risk factors and enable timely intervention. By fostering a supportive environment that prioritizes health, schools can significantly reduce the risk of diabetes and other related conditions in children.

Creating awareness about diabetes prevention and the importance of early diagnosis is essential for combating the growing prevalence of the disease. Educational initiatives should target not only children but also their families and communities.

According to the World Health Organization, up to 80% of heart disease, 80% of type 2 diabetes, and 40% of cancers can be prevented through three key lifestyle changes: eating a balanced diet, engaging in regular physical activity, and avoiding tobacco.

The Role of Schools in Combating NCDs

Schools are a valuable resource for addressing the non-communicable disease (NCD) crisis, particularly through their ability to influence the behaviours of young individuals.

Research shows that adolescents are highly adaptable, making them an ideal target for health interventions. By prioritizing school-based programs that integrate good dietary practices and regular exercise, the National NCD Monitoring Framework aims to tackle the growing burden of NCDs.

Schools can act as a cornerstone for improving health behaviours and reducing the future prevalence of diseases such as diabetes and heart disease.

By addressing lifestyle factors such as poor diet and lack of physical activity, and by leveraging schools as platforms for health education and intervention, it is possible to limit the cases of diabetes. Early intervention, coupled with community-wide awareness and education, can play a crucial role in preventing diabetes and other related health issues.

August 5, 2024 0 comment