Prevention Of Diabetes

By in Diabetes & Endocrinology

Aug 14, 2019

Pollution is one of the negative effects of unplanned industrialization and urbanization. Both industrialization and urbanization, along with a sedentary lifestyle, are also contributing to the epidemic of diabetes mellitus in India. India is regarded as the diabetes capital of the world, as it has the highest number of diabetic patients. By 2025, India is projected to have about 8 crore diabetic patients.

The high number of diabetic patients is not solely due to India’s large population, but also because Indians are more prone to developing diabetes. Additionally, the rapid transition from rural to semi-urban to urban areas has led to significant changes in eating habits and the adoption of a sedentary lifestyle, both of which contribute to the increasing number of diabetic patients. Another important fact is that the incidence of diabetes in urban populations is 2 to 4 times higher than in rural populations in different parts of the country. However, the incidence of pre-diabetes is almost the same in both urban and rural populations. Therefore, there is an urgent need to target pre-diabetics or those at risk of developing diabetes to contain the epidemic.

Obesity, especially central obesity, high intake of refined carbohydrates, aerated drinks, fast and deep-fried foods, increased total fat and saturated fat intake, low fiber intake, and lack of physical activity or a sedentary lifestyle are risk factors for the rapid conversion of pre-diabetes to diabetes. This conversion rate is very high among Indians, reaching around 20% per year in some parts of India.

People with a family history of diabetes, pre-diabetes, obesity or overweight (more than 20% above ideal body weight), central obesity, increased body mass index (BMI) and waist-hip ratio (WHR), heart disease, high blood pressure, early-onset cataract, diabetes during pregnancy, or repeated infections are at risk of developing diabetes.

Those at risk should be tested for diabetes. Ideally, they should undergo a 75 g oral glucose tolerance test. If that is not possible, a fasting plasma glucose test should be done after 10 hours of overnight fasting. Fasting blood sugar should be less than 100 mg%, and 2 hours after 75 g glucose should be less than 140 mg%. If fasting is more than 126 mg% or 2 hours postprandial is more than 200 mg%, it is labeled as diabetes mellitus. If fasting is more than 100 mg% but less than 126 mg%, and/ or 2 hours plasma sugar is more than 140 mg% but less than 200 mg%, it is labeled as pre-diabetes.

As the rate of conversion from pre-diabetes to diabetes is very high in India, there is an urgent need to target this high-risk population. Indian and international studies have shown that the conversion from pre-diabetes to diabetes can be prevented or delayed by adopting a healthy lifestyle. This can be achieved by reducing body weight by 5-10%, decreasing total calorie intake by 500 calories per day, avoiding sugar and refined carbohydrates, avoiding fast and deep-fried foods and aerated drinks, reducing total and saturated fat intake, and increasing fiber intake through leafy vegetables and fruits.

Physical activity should include at least 150 minutes of brisk walking or similar activity per week, or 30-45 minutes of brisk walking at least 5 days a week. There should not be a gap of more than 48 hours in the exercise schedule.

It has been observed that adopting a healthy diet and lifestyle as described above provides long-term benefits in preventing the development of diabetes in pre-diabetic individuals.

Frequently Asked Questions (FAQs)

Q1: What are the main causes of diabetes in India?

A: Unplanned industrialization, urbanization, sedentary lifestyle, high intake of refined carbohydrates, aerated drinks, fast and deep-fried foods, obesity, and genetic predisposition are major contributing factors.

Q2: Who is at risk of developing diabetes?

A: People with a family history of diabetes, pre-diabetes, overweight or obesity, central obesity, high BMI or waist-hip ratio, high blood pressure, heart disease, early cataract, diabetes during pregnancy, or repeated infections.

Q3: How can pre-diabetes be diagnosed?

A: Pre-diabetes can be detected with a 75 g oral glucose tolerance test or a fasting plasma glucose test. Fasting blood sugar of 100–125 mg% or 2-hour post-glucose of 140–199 mg% indicates pre-diabetes.

Q4: How effective is physical activity in preventing diabetes?

A: Consistent physical activity, such as 30–45 minutes of brisk walking 5 days a week, significantly reduces the risk of progression from pre-diabetes to diabetes. No gap of more than 48 hours should occur between sessions.

Q5: Can a healthy diet alone prevent diabetes?

A: While diet is critical, combining a balanced, low-sugar, high-fiber diet with regular physical activity provides the most effective prevention for high-risk individuals.