What Is Diabetes?

The condition in which the body is not able to produce enough or any insulin, or cannot use the insulin produced or a combination of both is known as diabetes. In this condition the body is not able to get sugar from the blood into the cells, this, in turn, raises the level of sugar in the blood. Lack of insulin or insulin resistance raises the level of sugar in the blood. This leads to several health issues. 

 

Symptoms associated with Diabetes

Some general symptoms associated with diabetes include:

• Slow healing of even small wounds
• Fatigue
• Increased hunger
• Excessive thirst
• Frequent urination
• Itchy and dry skin
• Blurry vision 

 

What are the main types of Diabetes? 

There are three main types of diabetes:

• Type 1 diabetes
• Type 2 diabetes
• Gestational diabetes (diabetes during pregnancy)

 

Causes associated with different types of diabetes:

 

 

Complications associated with Diabetes:

Diabetes is a progressive disease and leads to several chronic complications, if not managed properly. Some of these complications may be life-threatening. 

• Eye damage
• Nerve damage
• Kidney damage
• Vessel disease can lead to heart stroke
• Amputations caused due to neuropathy or vessel disease
• Skin Problem
• Infections

 

Complications associated with gestational diabetes:

• Miscarriage
• Stillbirth
• Birth defect
• High blood pressure
• Preeclampsia (High blood pressure, sometimes associated with fluid retention and protein in urine)

 

Treatment of different types of Diabetes:

In any type of diabetes, the main goal is to keep your blood sugar level under control. Diet and exercise are key to managing diabetes. In case when these two alone are not able to work, medication and insulin are prescribed.

Treatment of type 1 diabetes: Insulin is necessary for the treatment of type 1 diabetes because the beta cells are permanently damaged. Blood sugar levels should be checked at least once in 24 hours. Proper monitoring and management of cholesterol, blood pressure, and other complications should also be done. 

Type 2 diabetes: The first line of treatment for type 2 diabetes involves diet and exercise. If these two alone are not able to manage blood sugar levels, medication is needed. We will discuss the treatment of type 2 diabetes in detail in this article.

 

Can Type 2 Diabetes be Reversed?

Once you are diagnosed with diabetes, it is a matter of worry as the disease is perceived as incurable.  But according to experts, if you follow your doctor and dietician and lose your weight, diabetes can be reversed in the early stage of progression, i.e, within 3 to 5 years of diagnosis. You will be able to manage your blood sugar levels without medications. 

 

The most important thing to remember is once you are diagnosed with diabetes, there is always a risk of developing high blood sugar due to beta cell problems and genetic factors. Various dietary treatments and exercises can drag type 2 diabetes into the remission phase (controlled blood sugar levels without medicine), but one should continue to follow a diet and always check their blood sugar levels. Otherwise, blood sugar levels can easily rise again. 

 

How to enter into remission:

Diet: Diet is the key to entering remission after being diagnosed with diabetes. Features of diet for the treatment of type 2 diabetes:

• Removal of sugar, sugary foods, sugary drinks, and trans fats.
• Inclusion of healthy fat, containing omega 3 fatty acids, having anti-inflammatory properties
• Restricting salt
• Whole grains to add complex carbs and unprocessed food items to the diet
• Adding low GI fresh fruits and vegetables to the diet
• Restricting alcohol or saying no to it
• Most importantly keep a check on your calorie intake to maintain a healthy weight.

 

This type of diet helps in:

•    Helps in symptom management
•    Healthy weight management
•    Makes you strong and flexible
•    Boosts overall physical health
•    Prevents you from complications associated with diabetes, including depression and anxiety.

 

A doctor or dietician can help you with dietary management and physical activities management. Carb management is the main tool in dietary management for the remission of diabetes. Some people follow a low-carb diet (less than 130 grams or 26% of total calorie intake per day), whereas others go for a ketogenic diet. However, the results of a ketogenic diet for diabetes management are contradictory, it helps in weight management. According to studies, ketogenic diets are not safe for everyone . Whole grains are rich in nutrients when compared with processed ones. They are also high in complex carbs that are beneficial in diabetes management. 

 

2. Physical activities: Regular exercise routine is very important for overall health. It helps lose weight and maintain healthy weight management. Once you start losing weight your symptoms start reversing. Start your journey with the help of a healthcare professional. He/she will guide you keeping the under given points in mind:

 

• Slow beginning: If you don’t exercise, start slowly. Set small goals and gradually increase the intensity and time duration.
• Brisk walking: Fast walking or brisk walking is very good exercise. It doesn’t require any equipment.
• Avoid the spikes and drops in blood sugar levels: A minimum of 30 minutes of exercise 5 days a week is necessary. Check your blood sugar regularly, especially after a workout session. Keep a snack on hand to prevent blood sugar drops while exercising. 

 

3. Weight Management: Both diet and regular exercise help in maintaining a healthy weight. By attaining and maintaining a healthy weight you have a better chance of diabetes remission because excess fat affects the production and use of insulin. The Sooner you start taking steps for remission after diagnosis of diabetes, the better the results. 

Just 5% weight loss in overweight or obese person leads to several positive changes, including:

• Improved blood sugar levels
• Decreased risk of complications arising due to increased blood sugar levels
• Lesser need for insulin or medicines if you are taking them

 

4. Medications: Although many people can manage their blood sugar levels by diet and exercise alone, some may need medications. The need for medication depends upon the person:

•  Age
• Overall health conditions
• Treatment goals

 

How much time does it take for diabetes remission:

First of all, understand the meaning of diabetes remission. Diabetes remission means HbA1C level lower than 48mmol/mol or lower than 6.5% without medication for at least 3 months. The time taken for remission depends upon several factors, primarily including BMI, initial blood sugar level, and the intervention taken by you.  According to a study, some steps may help you in the reversal of type 2 diabetes : 

 

• Restricting carbohydrate intake
• Reducing overall calorie intake
• Bariatric surgery

 Once in remission, you need to monitor and manage your glucose levels to remain in the remission phase. This is because diabetes is a progressive disease and can worsen over time.

If you have Type 2 diabetes, eating only during the day hours may help you

Diabetes patients may benefit from limiting their food intake to a 10-hour window during the daytime, according to new research.

In individuals with type 2 diabetes, the results of a time-restricted eating (TRE) program are beneficial, including a reduction in 24-hour glucose levels . In people with type 2 diabetes, a daily 10-hour TRE regimen for three weeks reduces glucose levels and extends the period spent in the normal blood sugar range." The findings of this study show the potential benefits of TRE in the treatment of type 2 diabetes, according to the study authors.

People who are obese or overweight may benefit by restricting their meal times, according to previous studies. Restricting food intake to less than 12 hours a day can lower blood sugar, improve insulin sensitivity, and promote fat burning, according to a study . 

Glycogen metabolism in the human body

When a person isn't eating, their body often uses glycogen as a source of energy.

Glycogen is found in the liver and muscles and is a form of carbohydrate storage. Glycogen will be depleted before free fatty acids may be used as a fuel source.

An increase in ketones may reduce inflammation and enhance insulin sensitivity and glucose levels as a result of this. Diabetics need to use intermittent fasting to burn fat for energy and reduce weight while improving insulin sensitivity as well as decreasing blood sugar levels. Intermittent fasting is a good strategy for weight loss. 

This practice is generally considered to be risk-free. Those with type I diabetes, a history of eating disorders, pregnant women, or children under the age of 18 are not advised to use it.

 

Foods to eat and avoid to manage diabetes

A diabetic person should include vegetables, beans, legumes, low-carb fruits, whole grains, dairy, meat, and other sources of protein in appropriate proportions. 

Vegetables are an excellent source of vitamins, minerals, and fiber and are the basis of a healthy diet. Beans, legumes, and pulses are good sources of protein and fiber. Although fruits can be high in sugar, go for low GI fruits as they are a great source of vitamins, minerals, and antioxidants. Whole grains also help manage diabetes. Dairy products are an excellent source of protein and calcium. However, the selection of dairy products should be done wisely. Proteins are essential for everyone. Like high fiber and high-fat foods, proteins are also digested slowly and hence result in a mild increase in blood sugar levels. 

A complete list of foods to be taken to manage blood sugar levels: 

 

 

In addition to unhealthy foods that should be avoided by a healthy non-diabetic person, a diabetic individual should also avoid foods that can cause considerable blood sugar fluctuations. Simple carbohydrates, saturated fats, trans fats, and sugar in the form of candy, ice cream, and cakes should be avoided. List of foods that should be avoided to manage diabetes:

 

• Packaged foods, including baked foods, chips, sweets, and desserts
• White rice
• White bread
• White pasta
• Sugary foods
• Sugary drinks
• High carb foods
• High GI fruits
• Salty foods
• Red meat
• Processed meat
• Alcohol

 

Read and understand the label of food packets wisely

 

• Read the list of ingredients on the food label: Just because a food claims to have less fat or sugar doesn't mean it has less of those ingredients. To get a clear picture of what a food is made up of, it is essential to read the nutrition label on the box.
• Keep an eye out for specifics about a person's diet: The most significant information for diabetics is the number of carbohydrates in each meal and the size of the portion.
• Calorie counting The total carbohydrate count may include dietary fiber, which is a type of carbohydrate. Because dietary fiber is not digested by the body, the total carbohydrate content of a meal can be reduced accordingly. Carbohydrates can be counted in a more precise manner using this method.
• Check out the list of ingredients: The ingredients are listed in decreasing order of their total content. Sugar is the primary component if it is at the top of the list.
• Sugar can be written by other names also: Corn syrup, fructose, and dextrose are just a few of the many names given to sugar in food. A wise consumer can make better decisions when armed with the knowledge of sugar.
• Artificial sweeteners should be kept to a minimum. There is evidence that artificial sweeteners can harm health and increase the desire to eat sugary foods .  Aspartame, sucralose, neotame, saccharin, and acesulfame potassium are some of the most popular artificial sweeteners.

 

     Referral Links:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566854/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566854/
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520897/
4. https://link.springer.com/article/10.1007/s00125-022-05752-z
5. https://www.healthline.com/health-news/experts-debate-whether-time-restricted-diets-are-more-effective-than-food-restrictive-diets
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2892765/