Diabetes is metabolic disorder, which bears a great burden of disease, and is the leading cause of morbidity and mortality in India and worldwide, mainly fueled by the increasing prevalence of overweight/obesity, unhealthy eating & sedentary lifestyle. In fact, India is the diabetes capital of the world. According to the recent data, around 80 million individuals have diabetes in India. Approximately 60% of these individuals remain undiagnosed.
The theme for World Diabetes Day (2021-23) is Access to diabetes care. 100 years after the discovery of insulin, millions of people with diabetes around the world cannot access the care they need. This theme highlights the importance of ensuring that all people with diabetes have access to the care and support that they need to manage their condition and live healthy lives. In the year 2022, the slogan given was Education to protect tomorrow, to raise the awareness of diabetic education.
World Diabetes Day 2023 focuses on delaying or preventing type 2 diabetes and diabetes-related complications, with the slogan “Know your risk, Know your response.” One can easily calculate the risk of developing diabetes, by clicking on the following link:
This score takes into account your age, gender, Body Mass Index (BMI), waist circumference, regular intake of fruits & veggies, physical activity, and family history of diabetes.
* For people at risk of type 2 diabetes, knowing your risk and what to do is important to support prevention, early diagnosis and timely treatment.
The symptoms can be mild or absent, so people with type 2 diabetes can live several years with the condition before being diagnosed. Some common symptoms of diabetes include:
Frequent urination
Excessive thirst and dry mouth
Blurred vision or frequent change of glasses
Lack of energy, tiredness
Slow healing wounds
Recurrent infections in the skin
Tingling or numbness in hands and feet.
* For people living with diabetes, awareness and access to the correct information and best available medicines and tools to support self-care is vital to delay or prevent complications. The risk factors of developing diabetes related complications:
· Longer duration of diabetes mellitus
· Higher glycated hemoglobin levels
· Hypertension
· Obesity
· Dyslipidemia
· Tobacco use
· Chronic alcohol use
Lifestyle changes are the pillars of the diabetes treatment and encompass a range of modifications to daily habits and routines that can significantly impact our overall health and well-being.
Key areas of lifestyle changes include:
Healthy Diet: Opt for a balanced and nutritious diet rich in fruits, vegetables, whole grains, and lean proteins. Limit consumption of processed foods, sugary drinks, and unhealthy fats.
Physical Activity: Engage in regular physical activity, aiming for at least 150 minutes of moderate-intensity exercise per week. Exercise helps control blood sugar levels, improve cardiovascular health, and promote weight management.
Weight management: Maintain a healthy weight or aim for gradual weight loss if necessary. Excess weight can exacerbate diabetes and increase the risk of other health problems.
Stress management: Find healthy ways to cope with stress, by following a hobby or using relaxation techniques such as yoga, meditation, or spending time in nature. Chronic stress can worsen blood sugar control and overall health.
Smoking cessation: Quitting smoking significantly reduces the risk of developing diabetes and other health complications.
Adequate sleep: Prioritize getting enough sleep, typically around 7-8 hours per night. Sleep deprivation can disrupt hormones that regulate blood sugar levels.
Regular health check-ups: Schedule regular check-ups with your doctor to monitor your diabetes management and overall health.
Remember, lifestyle changes are a journey, not a destination. Start with small, sustainable steps and gradually incorporate more changes into your routine.
A healthy diet includes:
· Meal pattern/distribution: regular timing
· Meal quantity: small portion size
· Meal sequencing: soups & salads followed by protein rich foods followed by carbohydrates
· Meal composition: mega & micro nutrients include one third each of:
1. cereals/millets/starchy vegetables
2. colourful or green veg./salads/fruits
3. dairy products/meat/egg/lentils
Some tips for a healthy diet:
reducing calories if you are overweight
replacing saturated fats (eg. cream, cheese, butter) with unsaturated fats (eg avocado, nuts, olive and vegetable oils)
eating dietary fibre (eg. fruit, vegetables, whole grains)
controlling portion sizes to avoid overeating
avoiding tobacco use, excessive alcohol and added sugar
choosing healthier cooking methods like baking, grilling, steaming or sautéing, instead of frying
Exercises includes cardio, strength training & flexibility exercises.
1. Cardio which includes walking, jogging, swimming or cycling.
2. Strength training increase muscle mass and improve insulin sensitivity by using weights or resistance bands to strengthen muscles & prevent muscle loss, which is common in people with diabetes.
3. Flexibility exercises like yoga, Pilates focus on stretching and improving balance & joint mobility reducing the risk of falls & injury.
ABCDE approach to manage diabetes related complications:
Assess A1c: HbA1c measures our average blood sugar levels over the past 3 months. HbA1c of 6.5% and above is suggestive of diabetes. The American Diabetes Association (ADA) recommends that adults with diabetes should aim for an A1C of 7% or less.
Blood Pressure control: High blood pressure is a major risk factor for heart disease and stroke. People with diabetes have a higher risk of developing high blood pressure. It is important to control your blood pressure to reduce your risk of complications. The ADA recommends that adults with diabetes aim should for a blood pressure of less than 130/80 mmHg.
Cholesterol: High cholesterol is another major risk factor for heart disease and stroke. It is important to manage your cholesterol levels to reduce your risk of complications. The ADA recommends that adults with diabetes should aim for an LDL cholesterol level of less than 70 mg/dL.
Drugs to manage Diabetes: Diabetes is a progressive disease. Early in the course of disease, it might be controlled with just healthy eating and regular exercise. In addition to lifestyle changes, some people with diabetes may need to take medications to manage their diabetes and reduce the risk of heart disease. Modern medicine, is a system of an evidence-based medicine. All our medicines are a result of decades of research, where billions of dollars are spent to find a safe molecule, its exact dose and side effects. Unlike the other alternative branches of medicine, one can easily google the known effects and side effects of each of our substance, but the same can’t be done with ayurvedic or homeopathic medicines. You’ll be surprised to know that the Metformin, the back bone of diabetes treatment, was first extracted from a plant known as Professor’s weed in the late 17th century
Educate yourself and others about Diabetes and Insulin. Learn about the signs and symptoms of diabetes, as well as the risks and complications of the disease. There are many misconceptions about Insulin like it is habit forming, injections are painful & it’s harmful for the body or the last resort in treatment. Insulin is not a drug you can get addicted to! We already have insulin in our blood right from birth. In diabetes, insulin production is not sufficient to meet body’s demands. So outside insulin, only helps to make up for that lack of insulin. Insulin is a hormone which acts as a key to unlock the cell to use glucose. When the key is not available, glucose is not able to get inside the cell, and so there’s excess glucose which gets deposited in the retina, blood vessels, nerves and kidneys leading to various complications. Injecting insulin multiple times per day is not a pleasant thought to anyone. However, the needles are so thin that the pain is minimal. Various studies have proved that, early insulin initiation can even lead to remission of diabetes and delay many diabetes-related complications. Insulin is absolutely indicated in type 1 DM, gestational diabetes, during infections, surgeries or acute stressors like heart attack or stroke. So, one should always say yes to insulin when advised by their doctor. We come across many patients reluctant to start Insulin when prescribed by their doctor. This is our duty as doctors to clear doubts, spread awareness and mitigate fear of Insulin, improving its acceptance in the general public. Share what you learn with your family and friends
By raising awareness about diabetes and promoting access to diabetes care, we can help to improve the lives of millions of people with diabetes around the world.