Dr Swaroop Hegde is one of Mumbai's foremost diabetologists, Mumbai who has an unconventional approach to the disease. Over the past two decades, he has helped thousands of patients control their blood sugar levels through a multi-pronged approach. He spoke to S Balakrishnan on issues related to diabetes. Excerpts:
We are witnessing an epidemic of diabetes in the country. It is said that one out of every three Indians is a diabetic. What are the three main causes of that?
The main causes of the rising incidence of diabetes in India include: Lifestyle changes: Increased urbanisation and economic development have led to more sedentary lifestyles and higher consumption of unhealthy diets rich in processed foods, sugars and fats.
Genetic predisposition: Indians have a higher genetic susceptibility to diabetes, which, when combined with lifestyle factors, increases the risk significantly.
Obesity: There is a strong correlation between obesity and Type 2 diabetes. The rising rates of obesity due to poor diet and lack of physical activity contribute significantly to the diabetes epidemic.
These days several diabetes reversal programmes are being conducted. It is claimed that diabetes, specially Type 2, can be completely cured. Is it possible?
Type 2 diabetes can often be managed and, in some cases, reversed through significant lifestyle changes. These include:
Diet: Adopting a low-carb, high-fibre and whole-food diet can help manage and sometimes reverse Type 2 diabetes.
Exercise: Regular physical activity helps improve insulin sensitivity and reduce blood sugar levels.
Weight loss: Reducing weight can significantly lower blood sugar levels and improve overall health. However, the possibility of “reversing” diabetes depends on the individual's commitment to these lifestyle changes and their overall health condition.
It is important to note that “reversal” does not mean a permanent cure but rather effective management that can result in normal blood sugar levels without medication.
It is believed that metformin, which is the standard medicine recommended for diabetes, is harmful to the kidneys. Your take on this?
Metformin is generally considered safe and is a first-line treatment for Type 2 diabetes. It has a good safety profile, but there are concerns regarding its use in individuals with existing kidney problems because it is excreted through the kidneys. In patients with severe renal impairment, the risk of lactic acidosis increases. However, in patients with stable chronic kidney disease, metformin can be used safely under careful medical supervision.
It is alleged that the readings of blood sugar level to determine diabetes was manipulated by pharma majors to boost sales of their medicines.
There have been allegations that pharmaceutical companies manipulated the thresholds for diagnosing diabetes to expand the market for their drugs. However, the diagnostic criteria for diabetes are established by international bodies such as the American Diabetes Association (ADA) and the World Health Organization based on extensive clinical research.
While it's important to remain critical and vigilant about potential conflicts of interest in the healthcare industry, the established criteria are grounded in research to ensure accurate diagnosis and treatment.
Are non-vegetarians more prone to diabetes than vegetarians?
There is some evidence to suggest that vegetarians may have a lower risk of developing Type 2 diabetes compared to non-vegetarians. Plantbased diets tend to be higher in fibre, antioxidants and lower in unhealthy fats, which can improve insulin sensitivity and reduce the risk of diabetes.
However, diet quality overall is more important than specific dietary patterns. A balanced diet, whether vegetarian or nonvegetarian, that includes whole grains, lean proteins, and healthy fats is crucial for diabetes prevention.
You often say that one should have the right attitude towards life if one is to stay healthy. Can you elaborate?
A positive attitude towards life and health can significantly impact overall well-being and disease management. This includes:
Stress management: Chronic stress can negatively affect blood sugar levels and overall health. Techniques such as mindfulness, meditation and yoga can help manage stress.
Motivation and Adherence: A positive attitude helps individuals stay motivated and adhere to their treatment plans, including medication, diet and exercise.
Mental health: Good mental health supports better physical health. Addressing issues like depression and anxiety can improve overall health outcomes and quality of life.
In summary, while there are many factors contributing to the rise of diabetes and its management, adopting a healthy lifestyle and maintaining a positive attitude are crucial for prevention and effective management of the disease
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