‘Make informed and intelligent life choices to keep diabetes at bay’

One needs individualised dietary counselling for balanced diets and must maintain normal body weight from early age, says doctor

Updated - January 22, 2018 09:05 am IST

Published - January 22, 2018 01:43 am IST

 Dr. Anoop Misra

Dr. Anoop Misra

Diabetes with Delight , a comprehensive manual on the metabolic disorder written by Dr. Anoop Misra, chairman of Fortis C-Doc, was launched at the World Book Fair 2018 at Pragati Maidan. Speaking to The Hindu about diabetes and its management, Dr. Misra says his new book is an “educative guide that teaches readers about how diabetes can affect mental, emotional and physical well being but can be prevented or managed through some simple, methodical steps”

What is the magnitude of diabetes problem in India, more specifically in Delhi?

Currently, 82 million people in India are affected due to diabetes and the number is expected to rise to 151 million by 2045. In a 2015 study, it was estimated that around a quarter of Delhi’s population suffers from some form of diabetes and around 48% from pre-diabetes (impaired glucose tolerance).

What does your book talk about?

Before this book, patients obtained knowledge and education about diabetes from physicians and the Internet. Physicians do not have enough time to educate patients and the Internet often provides confusing and wrong information.

Further, most of this information is derived from sources in the United States and the United Kingdom, which is often not applicable to Indian patients. An India-specific information source for management of diabetes was needed and is provided by this book. Diet, exercise and management techniques in the book are tailored towards Indian patients, based on research done by our and other groups in India.

How is it helpful for the common man?

Besides giving comprehensive information about diabetes, the book also informs readers about solutions to common problems that patients face. For example, what to do in case a patient develops nausea, vomiting or fever? What drugs to take when travelling to the hills? What if a diabetic person plays competitive sports? This book answers scores of questions on diabetes and has a list of frequently asked questions for quick reference. The book has photographs and diagrams to better explain exercises or insulin-injection techniques. This book also gives healthy food recipes and a sustainable diet plan. Knowledge about these issues can empower patients and their relatives to manage diabetes. The book is also apt for nutritionists, lifestyle coaches and physicians.

Are there ways to prevent diabetes?

With modest weight loss (around 7-10% of ideal body weight), physical activity (at least 60 minutes a day) and proper diet, onset of diabetes can be prevented or delayed.

For those who are morbidly obese, massive weight loss can reverse diabetes, as has been shown with application of bariatric surgery. Type-2 diabetes is often preventable by simple lifestyle changes. Keep your weight in its ideal range, exercising regularly and eat a balanced diet in small meals with intermittent snacks, which should include whole grains. Avoid sugary drinks and over refined grains.

Choose good fats instead of bad fats. Polyunsaturated fats and monounsaturated fats in olive, canola and mustard oils can help ward off Type-2 diabetes.

Limit intake of red meat and avoid processed meat. Nuts, seeds, beans, masoor dal,lobia, sprouts, tofu, or poultry are much more healthy sources of protein. Also add two servings each of green leafy vegetables and fruits.

What are the rules to help prevent diabetes in children?

Prevention of obesity and Type-2 diabetes in children requires systematic and focused approach involving not only the child, but also the parents and peers. You need individualised dietary counselling for balanced diets and must maintain normal body weight from early age. It is important that children/adolescents be encouraged to include at least 60 minutes of moderate intensity outdoor physical activity/sports daily. Discourage time spent watching TV or playing computer games. Parents should try to set an example by themselves exercising regularly. They should share at least one meal with the children and should accompany them to parks and play with them. Group/community must encourage participation in physical activity. Fitness centres, courts for basketball and badminton, playgrounds for hockey and skating, and parks for jogging and walking should be made more accessible. Regular health check-ups should also be done at least once a year. During this visit, the doctor should calculate the child’s Body Mass Index and counsel parents if it is above the normal range.

What is the proportion of women affected by diabetes?

The prevalence of diabetes for women 20-79 years is estimated to be 8.4%, which is slightly lower than among men (9.1%). There are about 17.1 million more men than women with diabetes (221.0 million men against 203.9 million women). Going by the current trend, they will outnumber men in diabetes soon. There are a number of factors responsible for this. Many studies show that girls in India are getting obese and show more metabolic syndrome — clustering of risk factors such as high sugar, blood pressure, deranged lipids — as compared to males. Other factors include weight gain after pregnancy, post-menopausal hormonal changes, as well as social and security issues that prevent them from engaging in outdoor activities and exercises.

What are the essential tips to manage diabetes?

Making patients understand the importance of correct diet and exercise throughout their life. Enhancing awareness about the importance of scientific treatment and its compliance, which can prevent complications, disability and death. Providing good education to prevent long-term diabetes complications. Regular physical examination and check ups to detect early damage. Maintain positive outlook even if disease is complicated. Maintain disciplined lifestyle.

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