The burden on health that diabetes carries has undergone an exponential rise over the last decade. According to a survey conducted in 2019, an estimated 1.5 million deaths were reported annually directly due to diabetes across the world. Apart from the health impact, there is significant economic and psychological stress on the community hence, it becomes important to address this at a grassroots level.
This is where we ask the question about the reversal of diabetes.
Since type 1 diabetes or insulin-dependent diabetes relies on an external source of the hormone due to a fundamental deficiency of the same in the body, it is not possible to cure the type 1 disease.
Type 2 diabetes, on the other hand, has many factors which collectively contribute towards its development. Therefore, remission has been achieved in cases with strict glycemic control and diets.
How to reverse diabetes?
Since obesity has been tightly linked to the development of type 2 diabetes, so much so that a new term ‘Diabesity’ was introduced in the medical dictionary recently; controlling body weight could be the starting point to remission. Adipose tissue secretes proinflammatory cytokines, Non-esterified fatty acids (NEFA) and leptins that lead to the development of insulin resistance and pancreatic beta-cell dysfunction. On top of that, abdominal fat being more lipolytic than subcutaneous fat is more resistant to the anti-lipolytic action of insulin which explains why abdominal obesity is more hazardous. Additionally, fat accumulation in the liver, where a majority of glucose storage occurs essentially means that there is no more space in the liver to accommodate the glucose. This results in elevated glucose levels in the bloodstream. Therefore, a BMI of >30 has been associated with type 2 diabetes.
How lifestyle changes can contribute to disease remission?
Type 2 diabetes has been on the rise in middle and low-income countries. Many factors contribute to this. Adoption of a western diet with more processed carbohydrates and preservatives coupled with a sedentary lifestyle and psychological stressors make the situation grave. Therefore, conscious efforts have to be put in to reduce weight. Cycling, brisk walking and regular treadmill exercises are recommended to these patients who are reported to have a postprandial blood sugar at >140mg/dL and an HbA1c level of >6.5.
An analysis recommended 10,000 steps a day and cutting calorie intake by 500 calories a day to reach a near-normal blood glucose level.
Moreover, as the levels of anxiety and stress rise in urban dwellers, regular meditation and yoga have managed to marginally lower the afflictions of type 2 diabetes in the city population.
Food items that can lower blood sugar
Glycemic index (GI) is a number that informs about the effect of a particular food item on the glucose levels of the body. A food is said to have a high GI if it is above 70 or so and a low to medium GI if it is 55 or less. People suffering from diabetes should pick out items that have a low GI. Here is a list of food products that can be safe to consume for patients with high blood sugar
- Fresh fruits, excluding pineapples and melons. Blueberries, grapes and apricots, in particular, have a low glycemic index and are safe to consume. Consumption of fruit juices, however, should be avoided because juices are stripped of their outer skins which reduces their fibre content and increases their glycemic index.
- Oatmeal is rich in the beta-glucan component that has been linked to increased insulin sensitivity and reducing spikes in blood glucose.
- Garlic is a superfood in diabetes as it helps by increasing insulin sensitivity and secretion.
- Plain yoghurt has been found to be the only dairy product that is not detrimental to diabetes patients. Sweetened or flavoured yoghurt should be avoided.
In other words, an effective diet plan is vital. Carbohydrates should be balanced with proteins and fibres. To make this easy, include green vegetables like celery and broccoli along with lean meat like chicken breast or chickpeas for vegetarians as sources of protein. Avoiding the consumption of saturated fats like butter and processed cheese also lowers blood glucose.
This is recommended for diabetic patients with a BMI>35 or higher. Bariatric surgery helps to lose weight by cutting a portion of the stomach to limit the amount of food intake that directly results in weight loss.
Therefore, it can be concluded that reversal of type 2 diabetes has been achieved with regular exercises, efficient diet plans and a regular check on the spike in blood glucose level. However, it is important to bear in mind that intervention needs to be started as soon as diabetes is diagnosed to prevent and minimise the adverse effects of elevated blood sugar which in the long run can affect a multitude of organ systems and lead to significant morbidity and mortality.