According to the World Health Organization (WHO), 69.2 million people were suffering from diabetes in 2015. According to a study published in a leading newspaper, by 2030, nearly 98 million people in India may have Type 2 Diabetes.
Diabetes is a growing epidemic in India with an estimated 8.7% diabetic population in the age group of 20 and 70 years. There are many factors responsible for this rising prevalence of Diabetes and other non-communicable diseases such as rapid urbanization, sedentary lifestyles, unhealthy diets, tobacco use, and increasing life expectancy.
Consumption of foods with a high glycemic index like refined flour or those that contain minimal fiber content cause a spike in blood glucose levels and increase chances of insulin resistance thereby leading to Type 2 Diabetes.
Obesity and overweight are the most important risk factors responsible for Diabetes. A person with a bodyweight 10-20% above ideal body weight is considered overweight and above 20 % ideal body weight is considered obese. Thus, preventing obesity is a high priority for the prevention of Diabetes and other chronic diseases.
According to a study led by the University of Cambridge, people who achieve a weight loss of 10% or more in the first five years following diagnosis with Type 2 Diabetes are more likely to see their disease go into remission.
The study concluded that it is possible to recover from the disease without intensive lifestyle interventions or extreme calorie restrictions. Such studies can often be misleading because people with Diabetes receive mixed messages about weight loss from magazines, newspapers, friends, family, but the point is should nutrition therapy for Type 2 Diabetes be focused on weight loss or improved blood glucose control?
Is weight loss the absolute solution for improving blood glucose control? Although approximately 50% of men and 70% of women are obese at the onset of Diabetes, Diabetes is diagnosed in non-obese individuals as well, and many obese people never develop Type 2
Diabetes. Therefore, there is a probability that obesity combined with a genetic predisposition may be necessary for Type 2 Diabetes to develop. Moreover, as the disease progresses from insulin resistance to a stage where there is not enough insulin produced, it often is too late for weight loss to improve blood glucose control dramatically.
As the disease progresses, when medications, including insulin, need to be combined with nutrition therapy, the goal shifts to the prevention of weight gain. It is not only the weight of your body that matters but where that extra weight is stored. People with more weight around the middle are particularly at risk of developing Diabetes.
The distribution of body fat classifies body types into three categories. These are android (apple shape), intermediate and gynoid (pear shape). People with more weight around the abdomen and larger waists have apple-shaped bodies. Pear-shaped bodies carry more weight around the hips and have a thinner waist. Apple-shaped bodies are at a greater risk for Type 2 Diabetes whereas fat in the hips and legs (as seen in pear-shaped bodies) is linked to healthier metabolic profiles.
So body shape is an important factor in determining the risk of developing Diabetes.
In the end, setting realistic weight goals and aiming for moderation is generally the best approach: eating a healthful diet, being more physically active, and monitoring food intake and maintaining blood glucose records to ensure that blood glucose levels are under optimal control and medications can be added or adjusted when needed. Eating complex carbohydrates such as whole grains and legumes and being physically active improves blood glucose control independent of body weight and weight loss.