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Diabetes

Written and reviewed by
Dr. Hemalata Arora 91% (72 ratings)
MBBS, MD - Internal Medicine, DNB (General Medicine), Board Certified in Internal Medicine
Internal Medicine Specialist, Mumbai  •  22 years experience
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Hello,

I am Dr. Hemalata Arora. I am an MD physician and infectious disease specialist. Today, I would like to speak to you about diabetes and give a little insight about how diabetes happens and how we can manage it without too many medications and insulin and such things. Diabetes, as we have heard, is a lifestyle disease. What does lifestyle disease mean? Lifestyle disease means it is the result of some of the choices that we have made in terms of diet, in terms of exercise or not doing exercise, in terms of stress and our working hours, alcohol consumption, etc. These are our lifestyle choices and as a result of these choices, we get some diseases. Diabetes is the major one of those. You also may have heard that diabetes can be of type 1 and type 2 kinds. Now, type 1 is genetic in origin and affects very few people and is usually treated only with insulin. We shall not talk about that one today because that is not the major public concern.

The public health concern of major importance is diabetes type 2. To understand diabetes type 2 we must understand the word insulin resistance. What does that mean? when we consume sugar of any amount immediately the pancreas releases insulin and causes the sugar to be removed from the blood into the cells of the muscle where it is used for energy. Now a little amount of sugar at infrequent intervals and insulin is able to handle it very well. If the sugar is being consumed more regularly when I say sugar it also means other carbohydrates, especially the simple ones because the sugar comes immediately into the blood like when we have fruit juices or sweets or any maida products or such things. When the sugar comes immediately into the blood, the insulin spikes immediately and the sugar is pushed into the cells. When the sugar is pushed too much into the cell, then the cell start becoming little resistant. What does this mean? this means more insulin is required to push the same amount of sugar into the same cell, the cell is resistant. Now, where does resistance develop from?

There is some inherent changes that happen in the cell and it also happens because of fat. Now there is the link between obesity and diabetes. When we keep on consuming more foods, our sugar content as well as fat content, we start depositing more fat. When the fat is deposited the fat doesn't just sit there and do nothing. It actually releases some inflammatory chemicals which then go and affect these muscle and liver cells which are supposed to take in the glucose. what do they do? they change ever so slightly the structure of the insulin receptor, making the insulin that is floating around in the blood difficult for it to bind with these receptors and cause the glucose to be getting into the cell. Thus, developing insulin resistance. So what happens then is more and more insulin required, secreted by the pancreas to do the same function. After some point, after maybe 10 to 15 years or 5 to 10 years of insulin resistance then diabetes can set in. This is really how diabetes sets in, it can be called a slow food poisoning in one way or the other, especially refined carbohydrates poisoning.

What is the solution, how can we reverse this, is this even possible to reverse? yes, very much possible to reverse, what we must do is to reduce the constant stimulus to insulin for a reasonable amount of time so that the body is able to reset this whole process again and maybe become more insulin sensitive. Can we use medications to treat diabetes? Yes everyone is using medicines to treat diabetes but what the medicines do? what medicines do, is to stimulate the pancreas to secrete a little bit more insulin so that some more help is given. Still they also stimulate the kidneys to excrete sugar so that literally the sugar that is coming in, is secreted or they help the stomach or the intestine don't observe the carbohydrates that we are putting in and instead we pass them out in the stool. So this is the role of the medicines but the main thing that should be changed, which is the only way to actually help reverse the disease, is to change what we eat.

Reduce the number of refined carbohydrates and sugar that we eat and certain kinds of oils that we eat and then we have a good chance of reversing this diabetes. This has to be something which is pervasive and done almost continuously for the rest of the person’s life to be able to make this change. Along with this exercise and other lifestyle changes as in stress mitigation are extremely helpful. This is what I would like to speak about. Is diabetes reversible? yes it is and the way I have told you is basically with diet. What dietary changes specifically small and big can be done, it is mostly revolving around sugars and simple sugars, refined carbohydrates and such foods. Whole grains are better, vegetables are excellent and some kinds of non-vegetarian food is also very good. The rest of the food that we eat everything packaged and such should be avoided as much as possible. I hope this was helpful.

Thank you!

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