This post is dedicated to all those who are extra sweet by blood!
With the onset of modern lifestyles, lifestyle disorders come hand in hand, of which diabetes takes the cake (literally)! According to an article published in the Times of India newspaper in January 2016, “India is the world capital of type 2 diabetes”, with over 60 million patients.
The World Health Organization defines diabetes as “a group of chronic metabolic diseases, in which an individual’s blood sugar remains high (fasting blood glucose- above 126 mg/dl and two hour blood glucose- above 200 mg/dl)over a prolonged period of time”. Routine diabetes screening normally starts at age 45, but should now be done from the age of 30 itself.
The sugar disease, as it’s commonly known has become ubiquitous in almost every average urban household and some rural households in our country. Very surprisingly the chief cause appears to be a combination of overconsumption of carbohydrates & sugars and stress (Links between Stress and Obesity). The American Psychological Association defines stress as “any uncomfortable emotional experience accompanied by predictable biochemical, physiological and behavioral changes” Can the hectic work schedule and erratic shifts, timetables and easy availability of fast junk food be blamed for this? Yes, to some extent.
The culprit– According to a research paper by Melissa L. Harris, Christopher Oldmeadow, Alexis Hure, Judy Luu, Deborah Loxton and John Attia called “Stress increases the risk of type 2 diabetes onset in women: A 12 year longitudinal study using causal modelling”, Perceived stress is a strong risk factor for type 2 diabetes. They examined 12,844 women through the years of 1998, 2001, 2004, 2007 and 2010. Results revealed that a graded association was found between perceived stress and diabetes. Furthermore, hypertension, decreased physical activity and increased body mass index all were found to contribute towards the development of Diabetes. “Moderate/High stress levels were associated with 2.3-fold increase in the odds of diabetes three years later, for the total estimated effect.”
IN SIMPLER LANGUAGE:
When we stress about something we secrete cortisol which inhibits insulin from our pancreas to penetrate our cells from the blood stream thereby preventing them from releasing energy. This makes us eat more to feel energetic, but all that does is to add more glucose into our bloodstream, therefore increasing the blood glucose level. So if this happens in the long run we end up with perpetual high blood glucose level and eventually diabetes. Diabetes if improperly treated gives rise to retinopathy, increased risk of heart disease, gangrene and an overall loss of energy and interest in performing daily activities. So in order to manage diabetes, we must first aim to reduce our stress levels.
How do we manage it?
Diabetes being chronic can’t be treated, but merely managed so therefore self-monitoring is mandatory. This should be done at least once a month from the age of 30.
Diabetes management should follow a two-pronged approach aimed to tackle both physical and mental stress. The first step to tackle any disorder would be psycho-education, which is essentially an education given to diagnosed individuals and their caregivers to help empower them to deal with their condition optimistically. The next step would be to ensure adherence to medication and lifestyle changes which can be highly stressful initially. This can be done by maintaining daily activity journals and setting alarms to ensure taking medicines on time and perform stress reducing activities. Once every two months along with blood glucose testing, a stress, anxiety and depression screening test such as Goldberg’s General Health Questionnaire must be administered by a competent professional to monitor mental health.
The American Psychological Association recommends these 5 pointers apart from Metformin/Insulin medication:
- Taking a break from the stressor and get some rest for at least 20-30 minutes for your own self. In case of work stress one can talk to the superior to look for options to alleviate or work through issues one maybe having. Communication has proven to reduce stress. Decrease dependence on tobacco and ALCOHOL to deal with stress. (Excessive alcohol consumption has been linked to diabetes.)
- Exercise and Diet– it sets the endorphins pumping, reduces cortisol and burns extra calories, thereby reducing blood glucose levels all in one go! WHO BMI for Asians has been set between 18.5-23 kg/sq.m., and efforts must be made to achieve and stay within this BMI range for improving one’s quality of life A simple brisk walk, a swim, a jog, some gym or yoga when performed daily goes a long way in both preventing as well as managing weight gain once diabetes sets in. Eating small frequent meals (this prevents cravings and stress eating) which includes foods with high fiber, high protein and low glycemic index like jowar, bajra, ragi, whole grains, sprouts, nuts, fresh vegetables and some fruits with low sugar content (grapes are out of question) in combination with exercise is the way to go! Fibre rich foods also help secrete serotonin and melatonin which promote restful sleep which has been proven to reduce high blood sugar levels.
- Smile and laugh– “positive attitude is everything!” (‘Attitude is Everything’ by Brian Cavanaugh) After all you only live once and choosing to be happy about it is better than grumbling about it. Laughter therapy early in the morning is the perfect way to kick start a hectic day.
- Meditate mindfully– sitting in a cool and calm place seeking some solitude is a very rejuvenating experience (AROMATHERAPY makes meditation a much more enjoyable and rejuvenating experience). This can help everyone see new perspectives which may aid in stress reduction, develop self-compassion and forgiveness which are of paramount importance in releasing pent up emotions that may have been hampering the insulin production and absorption.
- Another rather successful, National Institute for Health and Clinical Excellence (NICE), UK recommended therapy is the mindfulness based cognitive behavior therapy which significantly reduces ruminative thinking patterns, affective symptoms and dysfunctional belief systems associated with anxiety and depression that increase diabetes. The individual is trained to go about life avoiding judgment and desire the change/escape the situation. Although mindfulness calls for radical changes it is most appropriate for a diabetic since there will be no conflicting side effects with his/her normal diabetes treatment.
- Social support– surrounding ourselves with loved ones or a group of similarly afflicted individuals who shower us with unconditional positive regard and acceptance is the best form of respite one can get from the hectic demands of our lives. If one cannot do this, then seeking professional help such as seeing a counselor or therapist is the best alternative.
One important aspect that I would like to touch upon on today i.e. 14th November, World Diabetes Day, is the use of artificial sweeteners made of Sucralose. They come with unpleasant side effects and can instead be replaced with a natural product with no known side effects called Stevia. Stevia leaf powder (green) is a natural sweetener from Brazil and it is zero calorie. It is a good alternative to sugar and artificial sweeteners. So people, say no to sugarcoating when you are advised by misinformed wellwishers (trust me they do mean well, just that they are misinformed) to merely trade in your box of sugar for a box of artificial sweetener as a quick fix to manage/treat diabetes.
Please do check out: Sugar Free Green Powder Stevia leaves Zero Calories 100% Natural 100gm – 1 Pack