Can diabetes be reversed? Here are some food choices and healthy lifestyles that can help
An expert from Happiest Health elaborates on whether diabetes may be reversed by eating choices and a healthy lifestyle.
FollowBinoy Valsan leads the vertical that covers diabetes, heart, obesity, and endocrinology for Happiest Health, Dr Ambrish Mithal (chairman and head, endocrinology and diabetes, Max Healthcare Hospital, New Delhi and Dr Mohan’s Diabetes Specialities and president of the Madras Diabetes Federation
Type 2 Diabetes can be managed by making healthier food choices and combining it with an active lifestyle, top doctors tell Happiest Health, Covid-19 exposed a non-communicable pandemic that the world — especially India — was living with. With the International Diabetes Federation estimating that 537 million people (at least 74.2 million of them in India alone) are living with diabetes and 90 per cent of them have type 2 diabetes, Happiest Health set out to find ways to tackle this problem through diet and exercise alone.
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“In the 1980s, there was this talk that fats and cholesterol were the worst forms of food for humans, and the whole world shifted to a carb-rich diet,” said Dr Ambrish Mithal (chairman and head of endocrinology and diabetes, Max Healthcare Hospital, New Delhi) at a webinar organized by Happiest Health on November 14 (World Diabetes Day), 2022.
“Refined carbohydrates replaced fats — instead of good-fat-rich food replacing bad fats. The exponential rise in type 2 diabetes is due to changes in lifestyle and body weight. There is a direct link between central obesity [abdominal obesity] and the risk of diabetes.”
Refined carbohydrates: the real reason for type 2 diabetes
Experts point out that hidden sugar in refined carbohydrate-rich food is the culprit behind the rising tide of type 2 diabetes.
Most South Asian countries, including India, follow diets dominated by white rice, wheat, refined flour (maida) and other refined carb-rich food.
Replacing the bulk of those simple carbs with complex carbohydrates and adding protein (lentils, lean meat), healthy fat (ghee, avocados etc.), certain nuts and seeds (like almonds, walnuts, chia and pumpkin seeds etc) and fibre-rich fruits (plum, pear, orange, apple etc.) would be the ideal diabetes-friendly diet to follow.
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“Adding fibre makes a big difference as it slows down the speed with which glucose gets absorbed in the body,” Dr Mithal said at the webinar. He also added that modernisation and urbanisation have led to fibre-rich nutrients from most forms of complex whole grains being replaced with easy-to-absorb ones.
“The wheat we get in our villages still has the bran and is healthier. But it is ‘carefully’ removed when it is processed to be made palatable for the urban modern Indian. Same is the case with rice husk,” Dr Mithal added.
Central obesity and type 2 diabetes
Dr V Mohan, chief diabetologist, Dr Mohan’s Diabetes Specialities and president of the Madras Diabetes Federation, said this to Happiest Health in June 2022: “It is well known that obesity — especially central obesity, that is, fat in the abdominal area — is associated with diabetes,” he said. “When you have excess fat around the abdomen, most of it would be visceral fat [fat inside the abdomen], while some of this would be subcutaneous fat [outside the abdomen, below the skin].”
This fat can lead to an inflammatory condition called steatohepatitis in the liver. This could lead to insulin resistance, rendering the insulin in the body ineffective for glucose metabolism.
Dr Mohan said that the excess fat deposition in the liver and abdominal cavity spills onto the pancreas to rendering it incapable of producing enough insulin.
“When this occurs, the secretion of insulin also gets reduced,” Dr Mohan said. “With both these defects – that is, decreased insulin secretion and insulin resistance — the stage is set for diabetes.”
Remission and not a reversal, say experts
Dr Mithal told the Happiest Health webinar that ‘reversal’ is factually incorrect and the right term to use is ‘remission’ since one could not be sure about the long-term effect. Most people in the 25-30 age group who are diagnosed with diabetes are often obese and could achieve remission from diabetes by significantly altering their diet and lifestyle.
“Remission can go away (anytime) and diabetes can come back again,” said Dr Mohan. “Reversal, on the other hand, implies a total cure of the condition; such a thing rarely happens as diabetes is usually a progressive condition.”
However, both said that medications prescribed by doctors should not be ignored.
Tips for better management of type 2 diabetes
1. Include fibre, and leafy veggies in the diet
2. Avoid refined carbohydrates and processed food
3. Adopt an active and healthy lifestyle
4. Reduce stress
Symptoms of type 2 diabetes
1. Excessive thirst and dry mouth
2. Unexplained bouts of fatigue
3. Frequent urination
4. Slow healing of wounds
5. Recurring skin infections
6. Blurred vision
7. Numbness in hands and feet
