India has the largest diabetic population in the world. Faulty eating habits and a sedentary lifestyle are major factors leading to obesity which is the most important modifiable risk factor for type 2 diabetes. Long-standing diabetes can also lead to several complications affecting several systems of the body like heart attack, stroke, blindness, kidney failure, and lower limb amputation.
Thus, managing the condition by the earliest is crucial.
The prevention of Type 2 Diabetes Mellitus includes lifestyle modification such as weight loss, increasing physical activity, and dietary changes. Dietary management should not only aim to achieve glycemic control but also to normalize the body mass index.
Weight Loss And Diabetes
The United States Diabetes Prevention Program (DPP), one of the largest and most comprehensive lifestyle modification studies involving diabetes mellitus, demonstrated that patients diagnosed with diabetes who were either overweight or obese could effectively reduce diabetes risk with weight loss.
Analysis of various studies demonstrated that improvement in fasting glucose and haemoglobin A1c is observed beginning at only ≥ 2- 5% weight loss. Greater weight loss was associated with greater benefits of glycaemic outcomes directly and linearly.
Dietary Management
The dietary management of diabetes should be aimed at reducing the energy intake to lose 5-10% of body weight. The main strategy is to balance carbohydrate intake based on the sugar levels and medications avoiding any episode of hypoglycemia.
Including whole foods, rich in fiber and having a low glycemic index, will help prevent insulin spike. Also, complex carbohydrates being slow-digesting in nature, will provide a slow and sustained release of glucose in the bloodstream.
Meals need to be placed evenly throughout the day including a good amount of protein per meal which will maintain satiety levels. Cutting down simple sugars is also crucial as they have low satiety factors and also cause insulin spikes.
The Mediterranean diet incorporated in a diabetic meal plan will provide several nutritional benefits. It helps control diabetes as this diet comprises a lot of fiber-rich foods and low glycemic index foods.
It also prevents sudden blood sugar spikes and imparts multiple benefits for diabetic patients. This includes regulating glucose levels and preventing diabetic complications. This diet plan emphasizes on fruits and vegetables, whole grains, beans, legumes, seafood, nuts, seeds, and unsaturated fats. It also limits the consumption of sweets, refined grains, sugars, and red meat.
Moreover, this diet can prevent various cardiovascular diseases as it helps control diabetes, body weight, and high blood pressure.
Physical Activity In Diabetes
Physical activity will not just help the individual manage sugar levels but also bring down weight thus, helping in the long-term management of diabetes. A minimum of 120-300 minutes of exercise every week is required to bring glycemic control. Both aerobic (such as cardio) and anaerobic exercises (such as resistance training) are recommended.
One must consume a portion of carbohydrates before physical activity to prevent hypoglycemia. Also, the intensity of exercises can be kept low to moderate as high-intensity workouts can induce hypoglycemia.
Role Of Physician
Though lifestyle interventions can help manage blood sugar levels, it is very crucial to keep your physician in the loop concerning changes in diet and training. The physician can revise medications when required to avoid any episode of hypoglycemia.
References:
Evert, A. B. and Riddell, M. C. (2015) ‘Lifestyle intervention: Nutrition therapy and physical activity’, Medical Clinics of North America, 99(1), pp. 69–85. doi: 10.1016/j.mcna.2014.09.001.
Franz, M. J. (1997) ‘Lifestyle modifications for diabetes management’, Endocrinology and metabolism clinics of North America, 26(3), pp. 499–510. doi: 10.1016/S0889-8529(05)70263-2.
‘Nutrition recommendations and principles for people with diabetes mellitus’ (1994) Diabetes Care, 17(5), pp. 519–522. doi: 10.2337/diacare.17.5.519.
Patel, R. and Keyes, D. (2022) ‘Lifestyle Modification For Diabetes And Heart Disease Prevention’, StatPearls. Available at: https://www.ncbi.nlm.nih.gov/books/NBK585052/ (Accessed: 21 February 2023).
Author: Dr. Poonam Vichare (INFS Faculty)
