An algorithm to keep diabetes at bay

HYDERABAD: With 72 million people in India suffering from diabetes (Source: International Diabetes Federation), it does not come as a surprise that India has earned the moniker ‘Diabetes Capital of the World’. This high rate of prevalence has pushed doctors and nutritionists to work on an overdrive to control this lifestyle disease that has no magic cure.

However, the expression of the disease in India is not similar to other countries. Due to the vast differences among dietary habits in India, researchers have found that there is no one-size-fit-all diet chart for India to control diabetes. This is where the concept of transcultural diabetes nutrition algorithm (tDNA) comes in.

tDNA is an algorithm to provide solutions for diabetes control based on dietary habits and cultures of different groups of people.  Dr Jeffrey Mechanick, Medical Director of Marie-Josee and Henry R Kravis Center for Cardiovascular Health at Mount Sinai Heart in New York, US, has been working on tDNA for years now. He also serves as a Director of Metabolic Support in the Division of Endocrinology, Diabetes and Bone Disease at Icahn School of Medicine at Mount Sinai.

Explaining the need of the algorithm, Dr Mechanick says: “There are several drivers for diabetes, which include stress, genetics and lack of exercise. But the main reasons behind the rapid rise of this disease in India are high intake of carbohydrates as compared to proteins, and increased consumption of fast food. Indians also need to keep track of food items with high glycemic index. This is the only healthy way we can arrest the onset of diabetes.”

Stating that diabetes control needs to be customised for various geographical locations in India, Dr Mechanick says: “To build our algorithm, we have divided India into north, south, west, central, east and north-east zones. The dietary habits are different in all these regions and we provide solutions keeping the differences in our mind.”

Illustrating one of the peculiar expressions of diabetes in India, Dr Shashank Joshi, who is a diabetologist and a Padma Shri awardee, gave the example of what doctors call ‘Kerala Diabetes’. “This is a kind of diabetes found among the lower income groups in Kerala. Their carbohydrate intake is very high because they consume a lot of cassava, but their protein intake is low. Cassava generally gets detoxified in the liver by protein, but this does not happen in their case because of the low levels of protein in the body. This leads to calcium build-up in the pancreas, leading to diabetes.”

So is there really no cure for this disease right now? Dr Mechanick answers: “There are a few doctors who do advocate bariatric surgery to cure diabetes, but the efficacy of this method is yet to be proven. Also, remissions are high in such cases. Thus, the only ways to deal with diabetes is to prevent and control it by adopting a few lifestyle changes. Eat your food slowly, avoid consumption of calories late in the night, avoid highly processed carbohydrates and exercise regularly.”