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Three years ago, life took a completely unexpected turn for 45-year-old Sukhwinder Kaur, when a COVID-19 test came back negative, but her blood sugar test did not. In fact, her levels were an alarming 250 mg/dL and the lab asked her to consult a doctor at the time. She was nervous when she was diagnosed with type 2 diabetes. For a long time, the Jalandhar-based entrepreneur was comforted by the fact that she had no family history of the condition. Her busy work day convinced her that she was active enough. And only after answering the doctor’s inquiries about her lifestyle and diet did she realize that she could not blame her for her cruel fate. Her diabetes was not accidental. She brought it upon herself over many years of indulgence.
“At 5ft 4in, I weighed over 85kg, had tummy fat or belly fat, and apart from housework, I had no exercise regimen. Taking care of my work and family meant there was no time to go for a walk On foot or doing yoga or any indoor exercises.But the biggest problem was my diet.Like many Punjabi families our diet is mainly carbohydrates – aloo parathas, chapattis made with ghee and rice for all 3 main meals.We cooked all vegetables and curries in ghee or butter, with a generous use of spices. While we didn’t eat out, we were on a high-calorie diet at home. Desserts were a must after every meal, whether it was halva with san or suji or our local khoya sweets,” recalls Sukhwinder, who was She had already developed prediabetes with her increased calories.
They represent the increasing burden of diabetes in India caused by poor lifestyle management, diet and lack of exercise. Dr. Ashu Rastogi, Assistant Professor in the Diabetes Clinic in the Department of Endocrinology and Metabolism, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, was not at all surprised by Sukhwinder’s case. He had led a study in 2019 where he tested a group of people for their blood sugar levels, many of which had a normal range. “We tracked them through the years and found that many in the normal group only developed diabetes because of poor lifestyle choices,” he says.
Due to her high sugar levels, Sukhwinder began experiencing anxiety, heavy sweating, unexplained pain in her legs, loss of appetite, extreme thirst, fatigue, shortness of breath, swollen and itchy feet, and poor eyesight. Aside from the physical changes and discomfort, Sukhwinder felt nervous and out of control. “I stopped keeping track of how many times I had to rush to the bathroom, sometimes in the middle of work and chores, and the situation was so restrictive and embarrassing. I was constantly worried if this was the beginning of the end for me,” she says.
After experiencing treatment at a local hospital, consulting private practitioners and taking alternative medicines, Sukhwinder is now a regular at PGIMER. Aside from medication, the doctors here instituted a strict calorie-restricted diet and exercise schedule. Her sugar levels and weight have decreased over the past few months. This meant changing everything she had known until now, and although it wasn’t easy, her efforts finally paid off. “I have been instructed to restrict my caloric intake, cut back on carbs and sweets, measure each meal to my daily carb quota and not sit for long hours. Instead of chapatis and rice, I now have a side of roti. I have reduced the portion size, and have two chapatis instead. From four, and I completely cut back on fats, fried foods, and sweets.The bulk of my meal consists of vegetables, sprouts, protein, and low-calorie, high-fiber fruits like papaya and guava.Instead of samosas and pakoras, I snack on toasted chanas.I go for a regular brisk walk for 40 minutes on “The least, I do breathing work to take care of stress and follow all the doctors’ suggestions, especially taking my medication on time and not missing a dose. I feel more positive now and I make sure my whole family eats better, participates in physical activities and we don’t neglect our health.” There was a time when Sukhwinder couldn’t resist a mango. Now she only allows herself a small piece when she feels like snacking between meals.
Meanwhile, Dr. Rastogi works with time to clear the pile of outpatient cards piling up on his desk as he struggles to convince a patient to take insulin injections as her glucose levels hit 350.” In 2010, we used to have 150 to 200 new outpatients. We have. Now we see 500 to 600. The latest study by the International Center for Psychiatry says that India has about 101 million people living with diabetes and another 136 million people are in pre-diabetic stages. Apart from diabetes, there is also a high prevalence of disorders Metabolic disorders such as obesity, high blood pressure, and elevated cholesterol levels, and this condition must be addressed immediately through policy changes, such as screening for diabetes after the age of 40, even if there is no family history or symptoms,” he says. Obesity is seen in all age groups, and it is one of the leading causes of metabolic disorders. The circumference of the abdomen should not exceed 90 cm for men and 80 cm for women. A random blood glucose over 140 mg/dL indicates prediabetes and if the random reading is over 200, the person likely has diabetes. An HbA1c test of 5.7 to 6.4 is the case for prediabetes, Dr. Rastogi adds.
Lifestyle modifications, such as losing five percent of your body weight, can reduce your risk of developing diabetes by 60 percent, your doctor assures. Type 2 may be reversible if a person has had diabetes for less than five years. Do not stop taking the medication until tests show normal blood sugar levels for a year. Fasting glucose should be less than 100 mg/dL and less than 140 mg/dL after eating. Women are 1.5 times more likely to develop diabetes and obesity, because they view housework as exercise, and women who experience high blood glucose during pregnancy need to be extra careful. It is very important to do some kind of aerobic exercise, 150 minutes per week. A good walking speed is more than 5 kilometers per hour and add some resistance training to it. Dr. Rastogi says simple lifestyle changes, regular check-ups, and adhering to your doctor’s advice are the best ways to prevent and manage diabetes. That is why Sukhwinder travels 150 km to reach PGI at 4 am for an early consultation. She doesn’t want to slip up again.
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