Price of sedentary lifestyle

Anoop Misra, diabetologist, AIIMS, addresses some of the common concerns in an interview
with Aruti Nayar

Our body cells need glucose, which produces energy for daily life. Our body converts whatever we eat into glucose (sugar) after digestion. Insulin, a hormone produced by the pancreas, allows glucose to enter the blood cells, and then metabolises it, thus maintaining body functions and blood glucose levels. Insufficiency of insulin, or loss of its action, causes blood glucose to rise, thus causing diabetes.

There are several factors that are responsible for this tendency. These include a sedentary lifestyle and improper eating habits. Frequent consumption of junk food or calorie-dense foods such as cheese burgers, pizzas, cold-drinks, chips and French fries may lead children to childhood obesity and, in turn, to an obese adulthood. An increase in the body fat leads to less action of insulin, as well as increases several other toxic substances in the body. This increases risk of heart disease, diabetes, and syndrome X (see box) at a young age.

Insulin dependent diabetes mellitus or Type I occurs in a younger age group. In this case insulin therapy is required for the utilisation of glucose to convert food into energy. The patient with this type of diabetes can not survive if insulin is not given.

Non-insulin dependent diabetes or Type II generally occurs in the later age group when either there is inadequate insulin or its action is impaired. This type is treated by "Oral Hypoglycemic drugs" (glibenclamide, Metformin). Insulin therapy is given only if blood sugars are too high and not controlled.

Gestational diabetes – It occurs during pregnancy and those suffering from it are at a high risk of developing diabetes later in life.

Sometimes, in tropical countries like India, the endocrine gland, pancreas shrinks and gets riddled with stones. The deficiency of insulin in such situations causes diabetes.

To keep diabetes in control, the following points should be adhered to:

Drug /insulin therapy- The medicine therapy of DM is highly individualised and depends upon the type of diabetes, age and general condition of the patient and associated problems.

Diet- Diet is the cornerstone of diabetes management. All diabetics should be given a diet chart that is individualised and flexible.

Physical activity- Physical activity is important because it boosts fitness levels while reducing blood glucose and blood pressure levels. Walking of 30-45 minutes per day is desirable.

Self blood glucose monitoring (SBGM)— Close monitoring of blood glucose levels is important so that the correct doses of medicine/insulin can be administered at proper time and interval.

Please note that none of the above can replace proper diet, exercise, and medicines. They can only be used in addition to the above and not as a substitute for them.

Methi: Effectiveness of these seeds is mentioned in ayurvedic literature. A teaspoonful of these seeds can be gulped daily with a glass of water. These seeds can also be used in chutney or its leaves can be eaten as a vegetable. Soaked seeds can be dried and crushed into powder form. One tea spoon twice a day with milk could be effective. About 50 to 100 fenugreek in daily diet in amounts of 50 to 100 gm may help in the management of diabetes.

Karela: This vegetable contains a high dosage of "plant insulin"which has been found to be of some use for lowering blood sugar levels. The best method of consuming this plant insulin is to have the juice of three to four karelas. Cooked as an ordinary vegetable also it proves quite effective. Karela is one of the best foods for diabetes. Use karela with the seeds. The powder of the dried fruit can also be used.

Jamun: This fruit could be effective in checking diabetes. The fruit is delicious and may be taken in adequate quantities during the season. Off season, 2-3 gm of the stone of this fruit can be powdered and taken. This stone contains a glucoside, jambolin, which prevents the conversion of starch into sugar.

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