How to avoid Diabetes- The Elders Diary 1

How to keep Diabetes away

PART I

Over the past few months, after reading a few interesting research papers and talks with a few friends from the scientific community and from holistic health communes made me pen this learning. Having studied Hormones for my MS- the one most infamous affliction caused by any one hormone, Insulin (actually by the lack of) in my field of study, made Diabetes the easy choice for an essay.
Diabetes mellitus, commonly called ‘Diabetes,’ is the condition that occurs when the body loses its ability to control blood glucose. Uncontrolled sugar due to reduced production or lack of Insulin or increased Insulin Resistance (IR)  causes havoc with every organ in the body, and its damage is permanent. 

This article focuses on Type II Diabetes, which is what happens when young adults to elders get afflicted, and what one can do to spot its signs upto a decade earlier and prevent or delay its onset.
Why Diabetes drew my attention, is because it’s the most destructive ‘condition’ that one could have- heart disease being the first mal-effect, followed by nerve, vascular, ocular and kidney damage, many of which could occur concurrently, apart from recurrent skin infections- everything that takes a toll on the hospitals, your own finances, your overall health with the new research showing that in addition to the above, Arthritis, Alzheimers' and a few other musculo-skeletal diseases could have their genesis with Diabetes- making it possibly the most expensive affliction to treat worldwide.
Approaching the 50’mark, I am quite surprised by the number of friends, acquaintances who suffer from this malady. I try and present a few points on diet, general fitness, and lifestyle modifications that could help keep diabetes away.

For starters- lets just try a few simple tests.
1. Lie down on the floor- on your back, arms by your side- now get up using the least amount of limb support- the lesser the better. If you need to roll over get on your hands and knees to then sit up, you have required the maximum- four points. If  you are able to sit up, by just folding your knees under you- you are amongst the fittest- two point of touch- and for those using a hand to support them while rising- 3 points of contact- well- you need to work on getting up using only two points.
2. Stand straight, close your eyes, hands by your sides, extend one leg forward. With your eyes closed, rotate your ankle clockwise and anti-clock ten times. Repeat with other leg, keeping eyes closed.
You will be surprised to see how many need three to four points of contact to get up and how many lose their balance when completing ten ankle rotations.
3. A quick walk test - normal people can walk a distance of 400–700 meters in 6 minutes. A 6-minute walking distance of less than 300 meter is simple and useful predictor of poor physical health, and often a very big warning towards a cardiac issue as well.

The brief logic to this- these tests are kind of home check to see  your core muscles, and your sense of balance and a quick check of your hearts condition. It’s the fastest check to let you know where you stand on a general physical ‘shape.’ There are hundreds of other exercises and ways to test for this- but these two can be done even while reading this article. Also, the article is to be treated as a ready reckoner, and by no means an alternate to your Doctor.

Research indicates two things- the genetic bias of Type II Diabetes can be generated in a single generation, and that grandparents not having diabetes may not help you, if your parents are binging on fast food, low on exercise- the two main contributors to causing Diabetes along with genetics. So be careful of what you eat, you are also creating a possibility for your progeny to have the predisposition to diabetes.

Given in brief- these three factors- genetics, food quality and exercise (lack of)- everyone scoffs and says ‘Oh, yes. I know what needs to be done.’ But no one does anything.
 I have a brief analogy to give. Smokers, if you tell them to quit, they retort-
‘What will happen? Cancer?’
To quote a friend of my fathers, the late Dr Shree Bhandare, a very popular Ortho Surgeon-
“Lung Cancer happens to the lucky, others get emphysema or chronic bronchitis- where even death will fear to come quickly. How you will suffer is upto God, but suffer you will. Quit while you can.”
The same applies for Diabetes.

The knowledge of what diabetes can do will abound in every household or social circle, with someone or the other suffering from arthritis, further aggravating his diabetes with the ever popular prednisolone,
friends who take off their shoes and keep scratching their socks as the persistent athletes foot wont go away, the injury to the toes that wont heal, and many many such silent irritants that we will choose to ignore.
Do not ignore these signs.

What do you do?
What one does is the following- carry out three tests-
a) Insulin levels (at fasting)- to be under 5 microunits/milliliter
b) an HbA1C  to be less than 5.6
c) Post prandial  Glucose Level (two hours after lunch)-should be around <120 mg/dL, but upto a max of 140 mg/dL.
You cannot cheat on one of these tests, and remember they are for your good health not anyone elses’.

A brief interpretation of results-
a) Insulin levels of >5 will be a sign of hyperinsulinemia, an unnecessary elevated level of Insulin, even when the body was at rest. This means that you are very high probability diabetes event.
b) a HbA1c >5.6-7 means again that you are in that pre-diabetic zone, with a value >8 meaning that you would need American legalese stating ‘additional action needed,’ euphemistically meaning Doctors intervention required and possible medication too.
c) Glucose values are- Normal Fasting 70-100 mg/dL and post prandial 100-140 mg/dL. Glucose levels of >140 mg/dL are almost a sure shot indication that you are a borderline diabetic and your medication (if any), exercise and diet control are not working in sync. Levels in the 190-200 mg/dL  range, or greater are just a indicative of a phenomenal increase in your risk levels for all complications associated with Diabetes and need urgent, if not immediate medical intervention.
You will be surprised to know that nearly 80% of Diabetes cases are detected more by accident than due to actual concern for the same. In the interest of your health ensure that all results are taken with a comprehensive view and not individually as there could be underlying metabolic disorders that could be causing these numbers.

PART II.

So what does one do- 

A. Simple basic exercise-
This is the least effort for the most effective results- Do the following every day.
1. Squats 4 sets of 20
2. Crunches- 2 sets of 20
3. Push ups 4 sets of 20 and
4. Sit-ups 2 sets of 20.
5. Plank exercises for your core- two or three reps till you total about 2 minutes of plank time.

You could take about 4 weeks to work up to this quantum by increasing the load every week. This should not take you more than 20-25 minutes and you are on your way. Encourage your child, sibling, friend to do this with you. Maintain a slow and steady rhythm. Once you are able to do this daily, you should replicate it in the evening before dinner as well. IF you are on any medication, consult your Doctor before starting on any exercise routine.
Any more exercise is a bonus. Swimming, walking, running, jogging- any.

These kind of exercises causes micro-tears in muscle fibers have two beneficial effects to the body- the need for ATP to be generated for energy to repair is the most easy to quantify and for those knowing that the glycolytic pathway and its associated Krebs Cycle keeps utilizing the Glucose in the body. This continual use of Glucose then reduces the stress on the Pancreatic beta cells to produce Insulin which would be needed to convert the surplus Glucose to fat. Apart from this, a little known effect seen almost within 48-72 hours of beginning exercise is the jump in the production of the hormone Follistatin- a glycosylated protein hormone, that plays an important role in muscle mass increase.

B. Simple lifestyle changes-
Park your car in the farthest parking lot, climb the last 5 floors to your house/office, descend the first five floors, keep a chart of stretching exercises that you can indulge in at your desk, cubicle- and do that every so often to keep the muscles in use. The increased activity helps your motor function, keeps your senses alert- sight, smell, balance, hearing and keeps your cognitive function in a learning mode- just like playing chess or solving crosswords and puzzles are believed to delay age-related dementia.

C. Starve.
Jokes apart.  This is serious work. Skip a meal a day, replace it with a fruit, do two days of the week on a 500-700 Calorie/day diet- like the 5:2 diet advises, eat before 7 or 8 in the evening to maximize starvation time. It may sound difficult, but salads, lentil soups and fruits will keep you in that range. The holistic believe that every religion from Islam to Hinduism preaches this- dieting and starvation in one form or the other. Few follow this advise of ‘fasting’ in other words- so I try and simplify this- by asking you to cut down on the meals in a little more ‘easy’ manner. Science is working on huge topic called ‘calorie restriction’ in primates and humans and Google will be glad to give you additional reading on how oxidative stress and chronic inflammation are reduced.
This basically means- that you proportion your food, across the week, and though binging has its mal-effects, and if you cannot avoid the ‘weekend whisky warrior’ or  ‘lounge lizard’ phenomena- then on  Sunday- just eat fruit all day long, and give your system literal ‘rest.’ A proper menu is required to ensure that you do not starve yourself off essential nutrients and create a whole other problem.

D. Remember.
One of the simplest ways to get to a better lifestyle is to start remembering what is it that you did, like climb the stairs when you came home, when was the last time you downed  pegs of a single malt, ro simpler things like, are you purple in the face when you are done tying your shoe laces. Sitting in your sofa, sagging with old age, is it a teeth gritting effort to propel yourself out of the bucket of softness that your backside is stuck in? Three pages into a novel at night, as you asleep that you cannot remember the last word you read- or if the page number was 253 or 337. These simple day-to-day activities that will serve as a barometer for your own fitness. Along with a reduction of a ‘point of contact’ as mentioned in the start of this article, you would be well on your way to avoiding diabetes, or if not- delaying it for a fruitful life for atleast another decade, free of worry.

In addition to this, as if the damage by Diabetes itself was not enough- Diabetes is now believed to be among the precursors for two diseases- Alzheimers and Prostate Gland Cancer due to its effects on levels of IGF-1 and Estradiol. There is a lot of technical data and stuff on this topic, but I have tried to keep it simple.
You don’t want to get old, and not remember how to pee.
And if you remember, not be able to.

 Stand up and exercise.

NOTE
Do not ever self diagnose your ailments, the numbers here are to prompt you to take a Doctor opinion faster than you usually would.
As regards, ayurvedic or home remedies, you could continue on them as in the least, they will have a palliative effect. These will not replace Allopathic medication.
Do not ever self medicate and never stop any allopathic medication based on anything you read. Always consult your Doctor. If in doubt, get a second opinion.