Written by Shashikant Iyengar, Metabolic Health Coach
Shashikant Iyengar is a Metabolic Health Coach from India, specializing in low-carb/ketogenic diets to help clients worldwide manage chronic health conditions, including the remission of type 2 diabetes, obesity, hypertension, and mental & neurological disorders. He offers personalized, evidence-based guidance to empower lasting health transformations.
India, often referred to as the "Diabetes Capital of the World," is witnessing an alarming rise in the prevalence of Type 2 diabetes. With over 100 million people currently living with diabetes & 125 million with prediabetes, and this number is expected to rise exponentially, the situation has reached epidemic proportions. The burden of Type 2 diabetes in India is not only a public health challenge but also an economic one, with the costs of managing diabetes and its complications placing a significant strain on the healthcare system.
Prevalence of type 2 diabetes in India
The prevalence of Type 2 diabetes in India has been rapidly increasing over the past few decades. According to the ICMR data published in The Lancet, 11% of the adult population in India is currently living with diabetes. The prevalence is even higher in urban areas, where it reaches up to 14%, compared to the rural areas. This urban-rural divide can be attributed to the differences in lifestyle, dietary patterns, and access to healthcare services.
The prevalence of diabetes varies across different states in India, with southern and western states like Tamil Nadu, Kerala, and Maharashtra reporting higher rates. This regional variation is influenced by genetic predisposition, lifestyle choices, and socio-economic status.
Dietary patterns and their impact on diabetes
The traditional Indian diet, rich in carbohydrates, is a significant contributor to the rising incidence of Type 2 diabetes. A typical Indian meal often includes staples like rice, wheat, and starchy vegetables, which are high in carbohydrates. The consumption of refined sugars, processed foods, and sugary beverages has also increased, further exacerbating the problem.
In urban areas, the adoption of a more Westernized diet, characterised by high consumption of fast food, sugary drinks, and processed snacks, has led to an increase in obesity, a major risk factor for Type 2 diabetes. Conversely, in rural areas, where physical activity levels are higher and dietary patterns are more traditional, the prevalence of diabetes is lower but still rising due to changes in lifestyle and food habits.
Complications and challenges in managing type 2 diabetes in India
The complications associated with Type 2 diabetes are numerous and can be life-threatening if not managed properly. These include cardiovascular diseases, kidney failure, nerve damage, and vision loss, among others. In India, the management of diabetes is particularly challenging due to several unique factors:
Lack of awareness and education: Many individuals, especially in rural areas, are unaware of the symptoms and complications of diabetes. This lack of awareness often leads to delayed diagnosis and treatment.
Limited access to healthcare: In rural areas, access to healthcare facilities and diabetes management resources is limited. Many individuals cannot afford regular check-ups or medications, leading to poorly managed diabetes.
Cultural and dietary preferences: The traditional Indian diet, which is high in carbohydrates, poses a significant challenge in managing blood sugar levels. Many people find it difficult to modify their diet due to cultural preferences and the availability of affordable, healthier options.
Economic constraints: The cost of managing diabetes, including medications, insulin, and regular monitoring, can be prohibitive for many people, especially those from lower socio-economic backgrounds. This often leads to inadequate management and a higher risk of complications.
The potential of low-carb and ketogenic diets in managing diabetes
In recent years, there has been growing interest in low-carb and ketogenic diets as effective strategies for managing Type 2 diabetes. These diets focus on reducing carbohydrate intake and increasing the consumption of healthy fats and proteins, leading to better blood sugar control and weight management.
Low-carb diets: A low-carb diet typically limits carbohydrate intake to around 100 grams daily. This reduction in carbohydrates forces the body to use stored fat for energy, leading to weight loss and improved insulin sensitivity. Studies have shown that low-carb diets can significantly reduce HbA1c levels, a marker of long-term blood sugar control, and help individuals with diabetes achieve remission.
Ketogenic diets: The ketogenic diet is a more restrictive form of low-carb diet that aims to induce ketosis, a metabolic state where the body burns fat for fuel instead of carbohydrates. This diet involves consuming around 70-75% of daily calories from fat, 20-25% from protein, and only 5-10% from carbohydrates (20-30 grams per day). The ketogenic diet has been shown to improve insulin sensitivity, reduce blood sugar levels, and promote weight loss, making it a promising option for managing Type 2 diabetes.
Unique advantages of low-carb and ketogenic diets in the Indian context
The potential benefits of low-carb and ketogenic diets are particularly relevant in the Indian context, where the traditional high-carb diet is a significant contributor to the diabetes epidemic. Some unique advantages of these diets for Indians include:
Compatibility with Indian foods: Contrary to popular belief, low-carb and ketogenic diets can be adapted to Indian cuisine. Foods such as paneer, eggs, leafy greens, ghee, and coconut are all low in carbohydrates and can be incorporated into a low-carb or ketogenic meal plan.
Reduction in medication dependence: Many individuals following low-carb or ketogenic diets have reported a reduction in the need for diabetes medications, including insulin. This can be particularly beneficial for individuals in India who face economic constraints in accessing medications.
Improved blood sugar control: By reducing carbohydrate intake, these diets help stabilize blood sugar levels, reducing the risk of hyperglycemia and its associated complications. This is especially important in India, where the high-carb diet contributes to frequent blood sugar spikes.
Weight loss and improved metabolic health: Obesity is a major risk factor for Type 2 diabetes, and low-carb and ketogenic diets have been shown to promote weight loss and improve overall metabolic health. This can help prevent the onset of diabetes in high-risk individuals and improve outcomes for those already diagnosed.
Conclusion
The current situation of Type 2 diabetes in India is a cause for concern, with the prevalence of the disease continuing to rise at an alarming rate. The traditional high-carb diet, coupled with a lack of awareness, limited access to healthcare, and economic constraints, presents significant challenges in managing diabetes effectively.
However, the potential of low-carb and ketogenic diets offers a promising solution. By reducing carbohydrate intake and improving insulin sensitivity, these diets can help individuals with Type 2 diabetes achieve better blood sugar control, reduce medication dependence, and improve overall health. As awareness of these dietary approaches grows, they could play a crucial role in addressing the diabetes epidemic in India and improving the lives of millions of people living with the disease.
Read more from Shashikant Iyengar
Shashikant Iyengar, Metabolic Health Coach
Shashikant Iyengar is a prominent advocate for metabolic health in India, known for his expertise in low-carb/ketogenic diets. With multiple certifications in the low carb/ keto space & 35 years of pharma selling in Abbott & Pfizer, he brings a wealth of knowledge to his practice. He has co-organized India's 1st ever low-carb conference along with Anup Singh the pioneer of low carb in India. This conference called as Metabolic Health Conference has significantly influenced the country's approach to managing metabolic disorders. He actively contributes to educating the public & healthcare professionals via social media like Twitter, LinkedIn, Instagram, Facebook & conferences. He is a leading figure in the global metabolic health community.
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