There has been a marked and very visible spike in interest in exercise and recreational sports in India in the last five years. But Indians need to adopt an active lifestyle in even greater numbers if the country is to avoid the impending diabetes crisis. A study published in The Lancet medical journal on 22 June, called Diabetes: A Defining Disease Of The 21st Century states that 1.31 billion people are going to be afflicted by the chronic disease in 2050, up from 529 million people in 2021.
According to the International Diabetes Federation’s (IDF) Diabetes Atlas 2021, India accounted for one in seven of all adults living with diabetes in the world. It also estimates that 53% of diabetes cases go undiagnosed in India.
“We currently face a global diabetes epidemic caused by caloric excess,” says Dr. Pravin Kahale, a cardiology consultant at the Kokilaben Dhirubhai Ambani Hospital in Mumbai. The Lancet further states that by 2045, three in four adults with diabetes will be living in low and middle-income countries, such as India and its neighbouring nations. The increase in prevalence will be caused in part by a rise in obesity, leading to a spike in type 2 diabetes.
In 2021, type 2 diabetes accounted for 90% of all diabetes cases. “Type 2 diabetes is increasing at alarming proportions in India. Approximately 100 million Indians are diabetic and the figures are rising rapidly. About 30-40 million Indians are pre-diabetic and it is estimated that every second or third out of 10 Indians is diabetic,” says Dr. Archana Juneja, a consultant endocrinologist at the Kokilaben Dhirubhai Ambani Hospital in Mumbai.
Factors including high BMI, excessive food, tobacco and alcohol consumption, alongside low physical activity, are the main causes of type 2 diabetes. The good news is exercise is one of the easiest and most effective ways of managing type 2 diabetes. In fact, Dr. Chhavi Agrawal, associate consultant for endocrinology at Fortis Escorts, New Delhi, maintains that exercise is one of the most important pillars in diabetes management. She says that exercise is advisable even before starting diabetes medication among pre-diabetics.
Exercise can benefit diabetics in multiple ways, maintain medical and fitness experts. “It not only helps in controlling blood sugar levels, but it also reduces insulin resistance in the body, which leads to a reduction in diabetes medication and also delays the onset of various diabetes-linked complications, especially cardiac diseases,” says Agarwal.
Diabetes affects the musculoskeletal system impacting the patient’s flexibility, which results in muscle stiffness, adds Dr. Sunil Kumar Mishra, senior director of endocrinology and diabetes atMedanta Hospital, Gurugram. “People, especially diabetics, who exercise and are active are able to maintain the integrity of their muscles, limbs, spine, and joints. They also gain a sense of wellbeing,” says Mishra.
Juneja points out that exercising lowers blood glucose levels and also burns calories, which can lead to weight loss. The weight loss bit is key here as some experts maintain that this can actually help reverse diabetes, as demonstrated in a much cited study conducted in 2011.
The medical fraternity agrees that all diabetes patients should get between 20 to 40 minutes of moderate intensity exercise at least five days a week. Agrawal says they should never go two consecutive days without exercise. “A mix of exercises amounting to 150 minutes a week is recommended for diabetes patients. The activities should be of moderate intensity and include cardio such as brisk walking, cycling, jogging or swimming, and sports such as badminton and at least two days of strength training,” says Juneja.
Another important area they need to focus on is their food habits. “Even before beginning any fitness regimen, diabetics must optimise their diet,” says Mishra. This would mean consuming low calorie food and food items with a low glycemic index. They need to aim for a healthy and balanced diet, minimise processed and packaged foods and include more whole foods and vegetables in their diet.
Given all the hype about protein supplements these days especially among those who exercise and workout out, Mishra says those who suffer from diabetes should seek the advice of their doctors before beginning any high protein diet or supplements. “Our Indian food contains an optimal amount of protein that is adequate for the body's needs. Moreover, some diabetic patients may not require high amounts of protein. A high protein intake could also aggravate diabetes patients’ underlying kidney conditions. So, they should be careful about the protein intake,” warns Mishra.
Shrenik Avlani is a writer and editor and the co-author of The Shivfit Way, a book on functional fitness.
