Type II Diabetes is a lifestyle disease. Does this mean that fixing your lifestyle can help reverse the diabetes too?
It is possible to reverse, or at least remit diabetes, but it's not just as simple as 'fixing your lifestyle' and ridding yourself of the disease.
It's World Diabetes Day, and on this week's episode of News and Views, FIT sits down with Dr Shashank Joshi, endocrinologist, diabetologist, and the Chief scientist at Twin Health - a digital diabetes support platform.
He also talks about the exciting new tech-based therapies in diabetes treatment that can make the process much more patient-friendly.
Below are some snippets from our conversation.
Indians, Type 2 Diabetes, and Tech Innovations
FIT: How bad is the situation in India as far as the diabetes burden is concerned?
Dr Shashank Joshi: India has the second largest population of people living with diabetes. Currently, around 77 million people in India are living with diabetes and an equal number are living with prediabetes.
It's important to recognise that we are seeing an explosive growth of people living with diabetes in our geographic location, and therefore it's an urgent call for action.
The bigger challenge that we are facing is that every second person, that is 50 percent of people living with diabetes don't know that they have diabetes. They are undiagnosed. That's really the challenge that's hitting us.
FIT: You you seeing younger people get diagnosed with diabetes than before?
Dr Shashank Joshi: In general, it's familial. If your father or mother has diabetes, your chance of getting diabetes is almost 90 percent. If one parent has diabetes, it's 70 percent. If any of your relative has diabetes - like grandparents, uncle, aunty, it's almost 30 percent.
So people who have family members who have diabetes shouldn't start screening at the age of 30 and 40. They should start screening at the age of 20.
If your family has someone with diabetes, or your waist circumference is more than 80 cm for women, and 90 cms for men, you should test for diabetes every year after the age of 20.
FIT: I've also heard people say that Diabetes skips generations, or that if the father has diabetes, it's more likely for the daughter to have it than the son, and if the mother has diabetes, it's more likely that the son will get it. Is there any truth to these theories?
Dr Shashank Joshi: No, No. There is no truth in this. There is no evidence base to that. The only thing we know is that it is independent to the gender. It doesn't have a gender selection at all, but crosses through generation.
It is cleearly transgenerational because your risk is much higher if your parents have it, but there is no gender selection at all.
Another common myth is that type one diabetes is reversable. That's not true. Type 2 is very much reverable.
FIT: How can Type 2 diabetes be reversed?
Dr Shashank Joshi: It's not easy. if someone has been diagnosed with type 2 diabetes, there is research to show that we can look at attempting remission if we do it within the first decade of diagnosis.
It is particularly gpoing to work in a younger population.
But, they will only stay in remission as long as there is lifestyle correction. If you again falter on lifestyle, you'll get the diabetes back.
While reversal means you have cured the disease and become normal, remission means it can relapse again, and mone needs to constantly go through a maintenance programme.
We are doing a trial which is in its third year now, where we are using technology that is capable of telling patients - eat less, eat right, sleep more, under a coach's or a doctor's supervision with medication reduction, lifestyle correction, precision nutrition, precision physical activity, precision medication, modifying the gut microbiome, we are able to attempt to make remission.
Listen to the full episode here.
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