In today’s time it’s like who doesn’t have diabetes. In hospital the first question the nurse will ask you before she does anything to you is, “You have diabetes?” Whether you have diabetes or not will determine the treatment to be given…how much do you know about a disease which is the beginning of the end for many in Goa and India and the statistics are booming in the US of A of course for that’s where junk food is a mindboggling industry!
By Pankajbala R Patel
HONESTLY, food is at the heart of every chronic disease we suffer from and yet we can’t get it right! This whole week looking at the nitty gritty of diabetic-stricken senior patients at the Goa Medical College & Hospitality, I kept wondering why when we have a Cancer Society of Goa, we don’t have a Diabetes Society of Goa or for that matter a Tuberculosis Society of Goa (TB being the biggest killer of them all in the world with maximum funds routed into its eradication) or a Heart Disease Society of Goa?
It is important we have these healthcare-oriented societies so that there is patient-to-patient and patient-to-doctor exchange between those who suffer from diabetes and those who treat them and treatments may or may not be working at healing patients, in fact, making them worse and hastening them on their way to premature doomsday!
Not joking. I’m a fan and not a fan of modern-day Allopathy which we have all learned recently is at the mercy of the pharmaceutical giants (most of them headquartered in USA or the West), we learn now how the Covid pandemic was diabolically, artificially inflicted on humankind courtesy the evil world of pharma companies (with Pfizer leading the race to de-populate the good earth of humans, as if the butchering wars of Russia-Ukraine and Israel-Palestine are not devastating enough in impacting the rest of the world).
But most of us continue to live like lambs to the slaughter practicing a philosophy we don’t know and if we do we don’t care (as long as individually we remain untouched and supreme)! I am a fan of modern predominant medical system Allopathy but only up to a point. With overwhelming dependence on drugs artificial or not and never ending mod con technology, we know that most drugs work on the principle of diminishing returns; before that happens you have to get your lifestyle on the right track…easy to say, hard to do of course given the kind of indifferent or miserable circumstances we may be trapped in.
SENIOR CITIZENS
NOBODY promised nobody a rose garden but it is a fact that there is more poison of hate circulating than medicine of love! Don’t ask me why but a certain Prof Dr Edwin Gomes, Head of Department of Geriatics at the GMC assures me that we all have anxieties and stress but this does not play a role in aggravating the chronic condition of diabetes. Many of the patients in Ward No115 or G Ward as I call it, which is the ward for senior citizens in trouble with their health. Most are struggling with the various results of long-standing diabetes and its outcome…soon it becomes numbers game. Most are seeking decreased levels of HbA1c and increased HDL cholesterol (the good cholesterol); most are already on dialysis which is a point of no return to normalcy in the body and it’s all a matter of prolonging life with medi-care as also kidney transplant for which there is a long queue.
But we return again and again to the fact that we just do not know how to eat right and over time there is not enough natural insulin in the body to deal with all the high blood sugar circulating in body beautiful unable to make it into cells for energy production…that’s where it begins. Your first symptoms of pre-diabetes or if happily neglected is constant fatigue, frequent urination (lots of ketones in it, when there is insufficient insulin in blood fats break down into ketones and you will lose weight even if you don’t want to lose weight), you feel worn out and fragile, irritated, your eyesight hazy …wound don’t heal.
Diabetes is an endocrinology system-related disease. Diabetes I is children whose pancreas for some reason has stopped functioning in the production of normal insulin. Genetics too plays a role. There is so much to understanding diabetes and it is probably the most studied dysfunctional metabolism. Diabetes is huge in India and if neglected it leads to a host of things not worth looking forward to as you grow old and older – sores on your feet turning gangrenous, medicines which will take a toll on vital organs slowly, your eyesight may be affected and so on.
ICMR STUDY
THE Indian Council of Medical Research (ICMR) and Ministry of Health & Family Welfare jointly conducted a study in the country, the largest epidemiological research-based study on diabetes in the country. Diabetes is a chronic non-communicable disease (NCDs) in all 28 states, 2 Union territories and capital city Delhi. In the study 1,13, 043 people participated and the results briefly: Goa has the most significant prevalence of diabetes at 26.4% while Uttar Pradesh is at 4.8%. The ten worst states vis-à-vis diabetes are – Kerala at 25.5%, Chandigarh – at 2.04%, Delhi at 17.8%, Tamil Nadu at 14.4%, West Bengal at 13.7%, Sikkim at 12.8%, Punjab at 12.7%, Haryana at 12.4%.
There is a diabetes crisis in India with 101 million people with diabetes and another 136 stated to be pre-diabetes, that is they are vulnerable to turning into full-blown diabetes patients sooner or later. Of these figures 8.4% are men while 12% are women, meaning women suffer more from diabetes.
In Goa statistics of 26.4% 32.7% are men and 33.5% women patients. Diabetes is clearly a consumerist story with people consuming more than need, want any even greed – in a nutshell we overeat most times and suffer from obesity and that’s one of the key reasons for escalating blood sugar day in and day out, till the pancreas goes on strike and stops producing insulin. Then bingo, you are diabetic and in need of diabetes medicines of which metformin is a major medicine.
PROLONG LIFE
YOU may prolong life with metformin and a slew of other drugs, later be dependent on dialysis and even a kidney transplant. But between all that you will see you skin ulcerating, you eyesight being affected, your feet dying with onset of gangrene conditions. It’s really no fun being a diabetic when you will forever be in a confusion of what you may eat and what you may not eat – no refined carbohydrates foods like rice, potatoes, sugar, bread, jams, no junk foods out of packets naturally, etcetera. No fruit! Stick to more protein foods, proteins are the bricks of body building with their nine and then other amino acids.
At the GMC Ward No115 senior patients suffering from diabetes are getting protein supplements in the form of “Protinace” Enzotein Plus Powder which is “100% whey protein, protease, MCT, Vitamins & Minerals.” It is not tasty of course and one could make it a little more tasty by just preparation methods! There are also low glycemic Prohance biscuits for immune and health and boosting energy – the most expensive biscuit of them all at Rs500 or so by way of “food for special dietary use.”
Vegetarian patients are especially advised to eat more protein like there is no vegetarian or vegan protein. Some say vegetarian protein of the green peas kind, of the soy tofu kind and mushrooms kind is better than why protein which is hard to assimilate. What is the truth? Anyone done any research? Some say you want more amino acids, eat apples, eat banana, they have all the amino acids! By all means go for a banana and an apple a day to keep diabetes away.
One way or another we must chase diabetes away from our cooped up, hunched over a computer or hand phone lifestyles of today. Work your muscles in the sun a bit every morning for your entire nervous system too rides on them! Be an educated diabetes patient and half the battle is won.
A new approach to diabetes…
It is in Dr Neal Barnard’s path-breaking book `Reversing Diabetes’ that we hear of a scientific proven system for reversing diabetes without drugs! This is the new approach to diabetes being practiced out in the countries of the West today, the book presents a revolutionary method for preventing, controlling and reversing diabetes based on key research findings. It has changed our understanding of the disease which takes a high toll of humans today.
Dr Barnard’s message is short and sweet: Change your menu, chuck your drugs. How you eat is a critical factor to diabetic remission in diabetes, although mind you, he is not knocking drugs when necessary. His book is very educative for all of us, make time to read it and practice, practice, practice, get it right for yourself.
The new idea is quite old now (except perhaps in India where the junk food industry is growing in leaps and bounds with cash registers ringing merrily for tomorrow we die). The good doctor makes for fascinating anecdotal reading too, he says, “My father, Donald M Barnard, MD, spent his entire life treating diabetes. He grew on a family farm in the Midwest but soon realised that the cattle business was not for him. He decided to go to medical school, and after training at Boston’s famed Joslin Clinic, he began work at a community hospital. He became known as the diabetes expert for the surrounding area. But he and other doctors – and their patients – often found diabetes puzzling and frustrating.”
He recounts a telling comment made by the clinic’s founder, Elliott P Joslin, MD, about diabetes research: “Gentleman, we don’t need a big research grant. What we need is a new idea.” This was in the 1950s when the disease was exploding worldwide with more than 400 million people living with diabetes. There were many studies and then starting in 2003 came the powerful nutritional plans to combat diabetes. They proved that food is your best medicine in the fight against diabetes, say it was an idea whose time has come back. Millions of people followed the new menu carefully and cut calories and limited carbohydrates. Things worsened before they improved.
It’s a story worth reading up and soon there were easy-to-follow plan with a simple diet guidelines which works. The book offers several sample case studies by way of inspiration or diabetics.
To take just one case, we have Nancy who read about the research study in an advertisement and came forward: “Two years after her diagnosis, her doctor put her on her first diabetes medication. Eventually, her doctor felt she needed two medications. Still her food glucose level continued to rise. As she entered our study, her haemoglobin A1C level –the key index of blood glucose control, which ought to be below 7.5 percent – was an unhealthy 8.3 percent.”Nancy joined the study because she liked the focus on food rather than on drugs.
A few months down the line (as she began to follow the study’s diet recommendations), “After years of going up and up and up, the trend started to reverse. After 11 weeks, she stood on the scale: She had lost 14 pounds. And when she rolled up her sleeve and we checked her A1C, we found that it had dropped from 8.3 percent to 6.9 percent. All in about 3 months’ time. Her insulin sensitivity was returning.
“Nancy’s blood sugar continued to fall. In fact, it fell so much that it became clear that her medications were now too strong for her. The combination of the drugs she had been taking, along with the new, powerful diet changes, actually left her blood sugar too low. It was time to reduce her medications. But as we cut back on her doses, it turned out not to be enough. After several more months, we had to stop one of them altogether….
“A little more than a year after joining the study, she was 40 pounds lighter. She stopped her diabetes medications, and yet her A1C is better than it was before – 6.8 percent at her last test.” The payoff is just incredible, says Nancy.
All this and much more. What’s the new diet all about to save diabetes from the path of perdition? It’s a healthful low-fat vegan diet favouring foods with a low glycemic index — wholegrain bread, fruit, sweet potatoes, oatmeal and bran cereals, beans, lentils, peas, leafy veggies, barley, bulgur, parboiled rice, some kinds of pasta …all are low-GI food. Go check it out or read up some more of Dr Neil Barnard’s books. He has proved that fat-laden greasy meals today mean insulin resistance and diabetes tomorrow!
A few interesting recipes from `Reversing Diabetes’ by Neal Barnard, MD, FACC…
(In 7 days of healthful meals the ingredients used are oat meal with apples, soy milk, black-eyed peas and sweet potatoes, rye or sprouted grain breads, salads, fruit smoothies, lentil soups, steamed broccoli, berries, soy yogurt, quinoa and bulgur, spinach hummus, tofu scramblers…couscous pilaf and Thai-styled coleslaw. Etcetera. Say it’s possible to live without diabetes!)
