The fact is that your conventional doctor is not exactly the best suited to spread lifestyle awareness; he/she will do a great job of treating the disease once it sets in. Community health issues have to be dealt with by another group of professionals and volunteers.
EXAMPLE OF REVERSAL
Depressing as it might be, being diagnosed as pre-diabetic still gives you a head start over those who were diagnosed late. It takes a small — but very determined — effort to move from pre-diabetes back to normalcy.
In Chennai, leading diabetologist Dr V Mohan has been actively campaigning for an overhaul of the lifestyle of potential patients under the Chennai Urban Population Study [CUPS]. The uplifting story of Asiad Colony under this project has now gone into the Journal of Association of Physicians of India.
Around 500 residents of this suburban colony, with flab around the middle and bad urban lifestyle habits, decided to get into shape. They built a park with a track for walkers and joggers. Their health parameters were monitored over a period. Each of them showed great improvement in their blood sugar and cholesterol levels.
“If you are pre-diabetic and can knock off 7 per cent of your weight, the chance of turning into a diabetic reduces by 58 per cent. Not just that, for another five years, your body will continue to reap the benefits of your effort,” says Dr Mohan.
But it needs determined effort to turn the clock back. Dieticians who counsel and monitor diabetics point out that they tend to be in denial most of the time. Till not long ago, 110 was the cut-off level for fasting sugar levels for pre-diabetes. This was then pared down to 100, but not many are aware of this or willing to accept it.
Delhi-based nutritionist Ishi Khosla says the toughest part is getting a pre-diabetic to admit that they are in a perilous situation.
“I have people who say, yeh kaise ho sakta hai? Mere ko to low sugar hota hai. Mujhe to chakkar aate hain. (How can it be? My sugar levels are in fact low. I feel dizzy sometimes.) But I am ruthless with the cut-off point. I don’t budge from 100,” says Khosla.
COMMON SENSE
Khosla is also stern with the diet she recommends (see box). She says she normally prescribes similar regimens for both full diabetics and those on the verge of the disease and makes no allowance for the latter.
Not every doctor will prescribe you the same do’s and don’ts as far as food goes. Dr Mohan, for instance, says that he varies the diet chart depending on which end of the pre-diabetes spectrum the patient is. “I would definitely allow someone with mild glucose intolerance more latitude with food, allowing, say, more fruits which have a low glycemic index,” he says.
Though most diabetologists in India are cautious with advising fruits, Dr Sujeet Jha is convinced that five servings of fruit (a serving is the size of your fist) a day is good for those with impaired glucose tolerance.
The plethora of food advice, a lot of it contradictory, coming at you may be confusing, but a pre-diabetic discipline is mostly a matter of common sense. The idea basically is to keep your weight at ideal levels by eating healthy, keeping the calorie count low, and also exercising to burn it.
As for the large spoon of gajar halwa you sneaked in after months of behaving yourself, instead of wallowing in guilt and misery, why not halve the carbohydrate count from the next meal and double your resolve to stay fit?
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