Treatment and Prevention of Type 2 Diabetes

‘Beat Diabetes’ by Prevention and Better Management

World Health Day 2016 is about prevention and better management of diabetes. Type 2 Diabetes, which is around 90% of all Diabetes, is a largely preventable condition that is rapidly increasing throughout the world; mostly among the affluent in countries like India and in the economically deprived sections of the developed world. Obesity, poor diet and lack of exercise are the main reasons for this rise.

Simple lifestyle measures including doing regular exercise, eating healthy diet and maintaining normal body weight have been shown to be effective in preventing or delaying the onset of type 2 diabetes by up to 50%.

If a patient has developed diabetes, then the emphasis should be on better management of their condition by early diagnosis, regular check-up of various organ dysfunctions and appropriate treatment to prevent complications of diabetes. Treatment of type 2 diabetes can be inexpensive if international and national guidelines are followed, and the total initial monthly cost of effective first line treatment can be as low as under Rs. 50 per month.

There are three main ways to reduce risk of developing diabetes: Not being overweight, having a healthy diet and exercising regularly.

Try to keep your Body Mass Index (BMI) under 25 if you are overweight. Waist measurement should be kept under 80cm (31.5inches) for Women and 90cm (35inches) for Indian men to be within the healthy range.

Eat fewer calories and burn more energy through physical activity to achieve these targets.

Try and achieve a balanced healthy diet over a day or even a week incorporating the following principles in your diet:

• Eat at least five portions of a variety of fruit and boiled or steamed vegetables a day.
• Drink plenty of water between 3 and 4 litres a day during summer.
• Keep total volume of carbohydrate intake under 1/3^rd of your total daily food portion.
• Choose low-fat and low-sugar option of dairy or dairy alternatives (e.g. yoghurts)
• Regularly have beans, pulses, fish, eggs, meat and other protein in moderation.
• Choose unsaturated oils and spreads and eat in small amounts.
• Eat foods high in fat, salt and sugar like chocolate, cakes, biscuits, sugary soft drinks, butter, ghee       and ice cream less often and in very small amounts.

Avoid comfort snacking if you are stressed, having late nights or watching TV or reading books.

Avoid eating out frequently. One full meal at a restaurant can have more than a whole day’s recommended calorie intake. Order smaller portions only and have either starters or desserts, but not both. To compensate for the excess calorie intake, try and be more active and avoid high calorie foods for the next few days.

An easy way to exercise is to make activity part of everyday life, like walking to work, taking stairs or cycling to get around, doing household chores like washing clothes by hand, dusting or mopping the floor (moderate intensity activities). Participating in sports including swimming or exercising in a gym (vigorous intensity activities) are even better – try and combine these two types of activities over a week to total at least 150 minutes.

Avoid excessive sedentary behaviour like watching TV and using a computer or smartphone for long hours. If you have exercising equipment at home, try to use it regularly while watching your favourite programme on TV.

Early diagnosis of type 2 diabetes is very important to prevent organ damage and further complications. If you have risk factors including being overweight, sedentary, over 25, having a close family member (parent, brother or sister) who has type 2 diabetes etc or you have symptoms suggestive of diabetes like excessive urination, excessive thirst, blurring of vision, tiredness, wound infections etc, you should get tested immediately.
In the early stages, lifestyle changes can be sufficient and you may not need any medication to treat your condition.

You may eventually need to take medication to help control your blood glucose levels. Initially, this will usually be in the form of tablets, and can sometimes be a combination of more than one type of tablet. The cost for vast majority of patients should be low if they are on the recommended medications. Doctors should follow National and International guidelines in prescribing medicines. That will keep cost and medical complications low and will help patients in long term.

To reduce the risk of developing other serious health conditions, patients may be advised to take other medicines, including medicines to control high blood pressure and high cholesterol, low-dose aspirin to prevent stroke and other medications if you have the early signs of diabetic kidney disease. Your doctor should be able to tell you your risk of developing heart attack and stroke and prescribe medicines accordingly.

If you have type 2 diabetes, you will need to take a reading of your average blood glucose level about every two to three months by the HbA1c test to help guide your treatment. You may need other tests depending on your condition and medications used.

Remember, ‘prevention is better than cure’, and it is very true for type 2 diabetes. Together we can beat diabetes by prevention and better management.