Dr. Harsh Kumar

Type 2 diabetes, the type of diabetes which is common in adults, is a disease of insulin resistance, a condition in which the body produces insulin but does not use it effectively. When people have insulin resistance, glucose builds up in the blood instead of being absorbed by the cells, leading to type 2 diabetes or prediabetes. Insulin resistance is associated with excess body weight and often gives rise to metabolic syndrome, also called insulin resistance syndrome, is a group of traits and medical conditions linked to overweight and obesity that puts people at risk for both CVD and type 2 diabetes.

Losing excess body weight,therefore helps people with diabetes and prediabetes in several ways

-Weight loss results in less insulin resistance in the body so that blood sugar is better controlled
-Weight loss also results in decreased blood pressure and better blood lipid profile thus reducing the heart risk
-Weight loss results in positive changes in mood and behavior and gives a sense of control over the disease

Therefore, the guidelines, by expert agencies in diabetes care, recommend that

-Overweight/obese people should try to lose weight and get their BMI< 23; this target is suitable for people with less burden of excess weight (BMI up to ~ 25)
-For people who are morbidly obese (BMI greater than 27.5 or more in people of Indian subcontinent), initial target is to lose 5-10% of body weight within six months to year
-Gradual weight loss is recommended, for which a moderate calorie restriction of 500 calories is advised, but in severely obese people a calorie restriction of up to 1000 calories
-The radically restrictive diets such as low carb, low fat, Atkins etc. have not been found to be superior for either weight loss or sugar/cholesterol control over other diets
-Adherence to the calorie restricted diet is single most important factor for weight loss maintenance
-Recommended level of exercise for all adults (150 minutes/week of moderate-intensity exercise and 2-3 sessions of resistance exercise/week) help in greater weight loss when combined with a dietary calorie restriction of 500 calorie/day. But, for exercise alone to produce weight loss, 225-400 minutes of moderate intensity exercise is needed
-Drugs or surgery for weight loss may help in people with higher BMI (greater than 27.5 for drugs and greater than 32.5 for weight loss surgery), if you fall in these groups, you should discuss the use of these measures with your doctor

Thus, if you are diabetic or prediabetic and are overweight, you should get into a weight loss program to reduce your health risk.

There is an age old saying that drinking water during meals will disturb your digestion and dilute stomach juices. Advice, that floats around generally, states that you should have water at least 30 minutes after you have had a meal. Studies have been carried out on this subject to find out how true or false these claims are.

• Levels of stomach acid: The claim is that if you drink water during the meal it will dilute the stomach acids, which are required to break the food down. However, doctors have stated in clinical trials that water doesn't tend to have any effect on the levels of stomach acid at all.
• Stomach and digestion process differs from person to person: This might be a thing of personal choice as habits differ from person to person. Also what is tolerable for one person may not be to another. It usually comes down to how your digestive system reacts to drinking water. Some people have claimed that drinking water while consuming food can make them feel bloated. There are no scientific studies proving this and it could be a psychological effect as well.
• Other side of the story drinking water can fill up your stomach before or during a meal: While drinking water may not have adverse effects on digestion, it can fill up the stomach by volume and decrease appetite. Doctors will also suggest drinking a good amount of water just before a meal if you are trying to lose weight as it can suppress your appetite.

Proved pros of drinking water:
Most clinical trials and studies by doctors have proven that drinking small to moderate amounts of water during the meals will help your digestion rather than impeding it. 
Some of the advantages are:

1. Liquefies food in the stomach
2. Helps in nutrient absorption
3. Prevents constipation
4. Stop bloating
5. Softens stool
6. Ensures Lubrication of the digestive tract
7. Helps you control your hunger signals and thus can help you in losing weight

Thus it can be summarized that drinking water during meals is a personal choice and doesn't really have any adverse effects. In fact, drinking moderate amounts of water when having food may actually be beneficial for you. However, if you are not comfortable with this and would prefer drinking after meals, as long as your digestive system is adjusted to it, there are no adverse effects to this as well.