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Reversing diabetes through Diabetes Prevention Program


Summary: Diabetes is a slow progressing chronic illness which is preventable if detected in pre-diabetic stage. A person is termed diabetic if fasting plasma glucose is more than 126 mg/dl or 2 hour plasma glucose is more than 200 mg/dl or random blood glucose is more than 200 mg/dl with symptoms. Chronic diabetes with uncontrolled blood glucose levels leads to various ill effects including organ damage so that's where role of prevention comes into play and holds greater importance than pharmacotherapy. Diabetes once set in is an irreversible condition which is dealt with pharmacotherapy or insulin supplementation as per blood glucose levels. Hence, diabetes prevention is the best approach which includes exercising regularly, consuming a diet rich in protein and fibers and avoiding high sugar diet with timely spaced low calorie meals. This article deals with the importance of diabetes prevention during the pre-diabetic stage so spare few minutes to save yourself and your close ones from the daily hustle of pharmacotherapy or expensive insulin injections.



Diabetes is a chronic disease that is either due to inadequate insulin release from the pancreas or peripheral insulin resistance in the body. Type 2 diabetes is prevalent in the age group 45 years and above. Type 1 diabetes also known as complete deficiency of insulin is result of autoimmune destruction of beta cells of the pancreas and such people need insulin injections lifelong.

It can be a very daunting condition to live with considering the potential dangers that come along with it which include:

1. Hyperglycemia: prolonged presence of high blood sugars in the blood can cause damage to blood vessels and organs, thus increasing the risk of severe health complications

2. Significant increase in the risk of developing cardiovascular diseases. People with type 2 diabetes are four times more likely to develop cardiovascular diseases like stroke, heart attack and peripheral vascular disease.

3. Kidney damage: Poorly managed diabetes can lead to diabetic nephropathy, and in severe cases can progress to end-stage renal disease, requiring dialysis or kidney transplantation.

4. Nerve damage: diabetic neuropathy primarily affects the feet and legs, leading to numbness, tingling, pain, and loss of sensation.

5. Visual impairments

6. Increased risk of infection


The peak age for being diagnosed with type 1 diabetes is around 13 to 14 years, but people can be diagnosed when they are much younger (including babies) and older (even over 40). (1)


An estimate suggests that in India, there are approximately 77 million people above the age of 18 years who are suffering from diabetes (type 2) while nearly 25 million are prediabetic (at a higher risk of developing diabetes in the near future). (3)


Is it possible to prevent diabetes?

Can the complications of diabetes be averted?

The answer is yes. It is possible because before the development of diabetes, the patients are in a stage called prediabetes. In this stage, the blood sugar level is fluctuating between those of normal and diabetic level.

A prediabetic person, without the inclusion of lifestyle modifications in their daily routine, is at a much higher risk of developing diabetes later. Every country has its own diabetes prevention program which an at-risk individual can easily avail.

​Normal reference range

Impaired glucose tolerance

Fasting plasma glucose levels

<100 mg/dl

100-125 mg/dl

2hour post prandial plasma glucose levels

<140 mg/dl

140-199 mg/dl

Random blood glucose levels

<200 mg/dl

-

HBA1c

<5.6

5.7 to 6.4

Who are at risk for prediabetes and T2DM? (4)

Modifiable risk factors- Overweight, obesity, sedentary lifestyle, glucose intolerance, metabolic syndrome

Non modifiable risk factors- Ethnicity, Polycystic ovary syndrome, History of gestational diabetes, Age, Gender, Family history of Type 2 diabetes


Why is prevention important?

Prevention is better than cure. If we treat a prediabetic person with just lifestyle modification the risk of developing diabetes can be reduced. Early intervention and prevention of type 2 diabetes has a huge impact on the patient's life by increasing the life expectancy and reducing the disease morbidity and mortality. In terms of finances too, preventive measures are certainly more cost effective than long term treatment plans.


Diabetes prevention strategies.

Lifestyle modification -The goals are:

1. Lose at-least 5 to 7% of your body weight.

2. Get at least 150 minutes of physical activity each week.

3. Physical activity should be of moderate intensity such as biking, brisk walking, dancing, climbing, stairs, swimming, and lifting weights.

Dietary changes - It is best to aim for consuming 3500 calories per week. Opting for nutrient-dense foods that are low in calories, fat and sugar, but high content of fiber and water is the way to go. Additionally, one can also prioritize foods that are rich in essential vitamins, minerals, and protein.










Conclusion

Since diabetes is a chronic disease, it is best to prevent it, especially if one has impaired glucose tolerance or has a risk factor for prediabetes. With lifestyle modification and dietary changes alone, one can prevent diabetes and save themselves from the multitude of health complications and financial burden that tags along with the disease.


References.

1. https://www.cdc.gov/diabetes/basics/diabetes-type-1-diagnosis.html#:~:text=The%20peak%20age%20for%20being,older%20(even%20over%2040)

2. Crandall JP, Knowler WC, Kahn SE, Marrero D, Florez JC, Bray GA, Haffner SM, Hoskin M, Nathan DM; Diabetes Prevention Program Research Group. The prevention of type 2 diabetes. Nat Clin Pract Endocrinol Metab. 2008 Jul;(7):382-93. doi: 10.1038/ncpendmet0843. Epub 2008 May 20. PMID: 18493227; PMCID: PMC2573045.

3. https://www.who.int/india/health-topics/mobile-technology-for-preventing-ncds

4. https://www.cdc.gov/diabetes/prevention/about-prediabetes.html


Writer Dr Nishat syeda

Editor Dr Dhruv Barai

Promotor Dr Grishma Sharma

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