By: Dr. Paras Agarwal, Senior Consultant Diabetologist
One of the frequently asked questions in our day is, ‘how one can prevent diabetes and keep fit’. With our lifestyles becoming sedentary, the sugar levels have been rising, creating a much induced panic about prevention.
Much is heard, read and discussed in our daily lives about diabetes. The disease, which is popularly called ‘high sugars’ in the community, unfortunately denotes the uncontrolled status of diabetes in most people. Modern medicine has the power to safely control the disease, if compliance is ensured. The fear of not keeping it in control is there among those who know the life-threatening complications it can cause. Thus, the anxiety of preventing its onset in oneself is obvious.
India, with the world’s second largest population, has a prevalence of people living with diabetes in the urban area estimated around 11%. These numbers are huge, and ever rising. With a skewed sex ratio towards male, one can easily fathom the proportionate men affected.
Those who have seen what an untamed wolf can do, tame it. Those who know that a wolf can be dangerous, simply don’t keep one.
Understandably, for the urban male who is perhaps at risk for future diabetes, be it his lifestyle issue or having a strong family history (parents, grandparents, first degree relatives), working towards preventing diabetes, would be the best advice. This means you are at a stage where your blood tests do not indicate onset of diabetes already.
Your blood report of a test called glycosylated hemoglobin (also known as HbA1c in a numerical value with % tag) can indicate your status either as not having diabetes (HbA1c < 5.7 %), pre-diabetes or borderline stage (HbA1c 5.7 to 6.4 %) or diabetes (HbA1c > 6.4 %). Prevention strategies are more intensely directed towards the former two categories where diabetes has not yet set in.
I am providing some doable suggestions, which should be incorporated in your daily lives. They would keep you in your path of health and reduce risk of metabolic diseases like diabetes, obesity, dyslipidemia (high cholesterol) and hypertension.
These simple measures can be applied to day to day living (if not already):
Eat less carbs and optimise fat intake to not more than 10% of your daily calorie intake (avoiding trans fats totally). Oil/fat should not be more than 4 teaspoons in a day. It is best to rotate (you can pick 3-4 different types of oils, including Ghee or clarified butter) usage of oils in your kitchen. Do not reuse oil after frying once. Increase the proportion of proteins and fiber in your diet. Increase green leafy vegetables and seasonal fruits in adequate quantities. Two portions (150-200gms) of seasonal fruits in mid-morning and mid-afternoon snacks are advisable. Consuming whole fruits are better than fruit juices.
Dairy products are good for health, ensure you take 2 glasses of pure milk daily (toned or skimmed milk is better) and/or other dairy products like cottage cheese, eggs, etc.
Avoid processed food, sweetened beverages, reheating of refined oils, smoked or deep-fried foods totally. Avoid skipping meals, timely eating habits are always physiological.
Getting adequate sleep:
6-7 hours of sound sleep is recommended daily for an adult male. A healthy sleep cycle ensures optimum functioning of both body and mind.
Practice Yoga and Meditation:
Spending a few minutes every day discovering your inner self through meditation improves spiritual health and general well-being.
Daily exercise schedule:
Do aerobic forms of exercises, for at least 30-45 minutes a day. Moderate intensity exercises that keep you fit are the best. These can be easily done even at home in case access to the gym is a barrier, especially in the pandemic lockdown situations. The crux is to initiate and sustain the exercise schedule implemented.
Avoid smoking and alcohol:
Smoking and drinking alcohol are both injurious to health. Smoking should never be started. If already a smoker: must take steps to quit ASAP. If you don’t drink alcohol there is no need to start as it increases risk of diabetes. Alcohol in moderation may be fine for some patients, however discuss it with your doctor.
Maintain ideal body weight:
If you are overweight or obese, weight loss is the most dependable solution to prevent diabetes, especially if the disease runs in the family genes. Abstain from overeating especially in wedding seasons, festive times and travel. Smaller frequent meals with regular physical activity is recommended to maintain a healthy body weight.
A diet high in fibre is always helpful as it raises blood glucose levels less post meals. I suggest discussing the concept of Body Mass Index (BMI) and Body Composition Analysis (BCA) with your doctor on your next visit.
Screening for diseases:
Always go for a basic health checkup as recommended by your doctor or minimum once in a year. I tell my patients to do so (even when they may not feel any symptoms) as a precautionary routine ritual once on their birthday. Some of my patients who are couples prefer to do so on their anniversary days, which is also perfect. These annual milestones act as simple reference memory action points in which you present yourself the gift of health. I have seen this to be quite an effective protocol, and many times it has picked up borderline diabetes levels and alerted the patients on time. Simple diet planning and reinforcement of lifestyle changes advised during consults have shown fantastic results in preventing onset of diabetes (dropping down of HbA1c to less than 5.7 % after 3-4 months) in follow up visits.
Whether you are an active male, perhaps all geared up with a smart wrist watch tracking your daily progress, or a busy executive who doesn’t get time for fitness, or even a retired healthy man at home: apart from diet and healthy lifestyle measures, screening strategy for diabetes is strongly recommended for all. This is because prevention of a disease has its limitations: it works better when we catch hold of a disease in its earlier stage.
After all, “The greatest medicine of all is to teach people how not to need it.” (Hippocrates)
About the Author:
Dr. Paras Agarwal, MD, FRCP (Edin), MRCPS (Glasgow) Diabetologist, is a graduate of the prestigious Maulana Azad Medical College, New Delhi. Currently practices as a Diabetologist at the Diabetes & Wellness Clinic in Sector 15 Gurgaon. He has special interest in Diabetes, Thyroid and Obesity. He has wide experience in the field of inpatient and outpatient management of patients with Diabetes, Thyroid and Hypertension. He is fellow in Advanced Diabetology & Endocrinology from Medanta, the Medicity (Gurgaon), has is MRCPS (Glasgow), PG Diploma in Clinical Endocrinology & Diabetes from Royal College of Physicians (RCP), UK and is also Fellow of Diabetology (Apollo and Royal Liverpool Academy UK). He has and been Attending Consultant in Endocrinology & Diabetes at Medanta the Medicity, Gurgaon. Currently he is attached as Consultant Diabetology with Max Super Specialty Clinic (Panchsheel Park, New Delhi) and Max Super Specialty Hospital, Gurugram.