How diabetes is being controlled using the ‘lifestyle medicine’

Sandeep Singh was only 36 when he was diagnosed with type 2 diabetes. His fasting blood glucose level was 500-plus mg/dL, which is five times higher than normal. Sweets were banned and medicines started. But the sugar level did not budge. A year later, the dosage was doubled but the reports were still disappointing. “I feared my organs and eyesight would start failing due to the uncontrolled sugar level. The result of a routine liver function test also shook me up,” says Singh, who works in the administration department of a company in Gurgaon.Singh is 41 now and way more upbeat. His sugar levels are perfectly normal and he is not even taking medicines. He attributes the improvement to a combination of a stringent diet, daily exercise and intermittent fasting.Singh is among a section of individuals who are controlling type 2 diabetes, which is linked to obesity and inactivity, by using ‘lifestyle medicine’.medium87206054While type 2 diabetes is considered an incurable, lifelong disease, studies have shown that right eating and weight loss can often eliminate the need for medication and even send it into remission. Of course, it takes serious discipline and willpower but some clinics like the Aasaan Health Clinic in Mumbai, Freedom from Diabetes Foundation in Pune and digital startups like Breathe Well-being and Sugar.fit are helping people move towards drugs-free diabetes treatment. “Eighty percent of our users have gone off medicines; others have managed to reduce dosage,” says Rohan Verma, co-founder of Gurgaon-based Breathe Well. medium87204125Endocrinologist Dr Roshani Sanghani, who practised in Chicago before moving to Mumbai and founding Aasaan Health Solutions in 2016, admits she used to be like any other diabetes doctor, relying heavily on medication. But one patient made her rethink her approach. This old man was already on five pills a day and refused to take insulin shots due to a fear of needles. Based on her knowledge of the role of diet in diabetes, she asked the patient to halve his consumption of chapattis. Much to her surprise, his sugar levels dropped considerably. After cutting out carbohydrates altogether, he was able to reduce his medicines, too. “Sometimes we busy allopathic doctors forget that we can play such a powerful role in guiding a patient towards a healing journey, and still be true to our profession,” she says. Sanghani now works in collaboration with a naturopath and fitness expert to provide a holistic prescription that comprises the right diet, adequate sleep, exercise and, if required, intermittent fasting. medium87204080Delhi-based journalist Rita Glancey (name changed), who was diagnosed with diabetes after a bout of Covid in April, says that within three months of following the protocol, her HBA1C level, which measures average amount of glucose in the haemoglobin, went from 11 to 5.4, which is considered normal. “I also knocked off quite a bit of weight, my skin started glowing, the aches and pains vanished. Plus, I feel so energetic now,” says the 41-year-old, who did not want to end up dependent on insulin.Patients who enroll in these diabetes reversal programmes attend webinars or watch videos to understand why and how the body fails to produce insulin or resists it. They are then given step-by-step guidance to change their lifestyle. Their diet is altered to reduce carbohydrates (rotis, rice and bread) and increase proteins (dal, eggs and meat). Glancey kicked her habit of munching on biscuits and bakery items and increased water intake. Singh, too, curbed his cravings. “Like most north Indians, I used to eat poha, paranthas or, even chhole bhature, for breakfast,” admits Singh. Now, he has switched to spinach smoothies and dal chillas. The cups of chai and canteen snacks were also struck out from his ‘food diary’. medium87204092Only after patients control their blood sugar levels to some extent are they advised to follow intermittent fasting, which involves going hungry for 16 hours and eating within an eight hour window. Several studies have found this method beneficial in managing type 2 diabetes. The American Diabetes Association noted the same in a 2018 report.Exercising is also an integral part of the programmes. Most doctors advise at least an hour’s workout four-five times a week. Singh recalls the first day he tried to follow a video by a fitness trainer at Breathe Well. “We started with a simple exercise where we had to just dab ourselves with a towel top to toe. Surprisingly, it left me exhausted,” says Singh, who has now lost 15 kilos. medium87204111Doctors point out that diabetes cannot be ‘cured’ but it can be ‘reversed’, which means blood sugar levels can be brought down to pre-diabetic or non-diabetic levels if we correct our lifestyle and reduce excess fat, especially around the waist. “It is possible to reverse diabetes if we drastically change our lifestyle within 10 years of the diagnosis. Unfortunately, in our country diabetes is usually detected late and by this time one or two complications have occurred,” says Dr Anil Bhoraskar, secretary of Diabetic Association of India and director of Mumbai’s Raheja Hospital. He calls for a change in mindset. “I know doctors who see 100 patients per day. They don’t have time to counsel patients. Moreover, the patients expect tablets. They don’t want to be told they need to stop eating junk.” medium87204136Considering India is home to 77 million people with diabetes, the emergence of the minimum-medicine approach holds great promise. Doctors, however, warn that weight gain and lack of proper sugar monitoring could make diabetes come back. Also, not every patient is advised to skip drugs or try fasting without proper supervision and monitoring. Individuals who enrol in diabetes reversal programmes are expected to update the app or the concerned doctor daily with their fasting glucose levels. Medicine dosage is gradually reduced based on progress.Untitled Carousel 82597508