How a diabetes education programme helped this 33-year-old go into remission
The Indian Express | 2 months ago | |
The Indian Express
2 months ago | |
Would you call it a diet or an extreme challenge? More than a litre of cola every day. No breakfast. Packaged juice instead. More juice, more syrups. Only one big meal at 5 pm: Two large pizzas, burgers and more junk. No dinner. That’s how 33-year-old Sohit Chaturvedi, who had just started his biotech firm, lived his days in 2017. Till the day he was diagnosed with liver fibrosis, extreme diabetes, plaques in his heart and told that, given his family history of diseases and early mortality, he wouldn’t live long. That was the moment of reckoning. Today, his diabetes is in remission and he is off medication. “No new plaques, no diabetes and holding still for a year now,” he says, pleased with the biggest milestone of his life. Having been part of a diabetes management education programme, he is now a part-time diet counsellor for his friends, family and colleagues. “Indians live with a sickness burden of their own making and it is in our hands to reclaim our lives,” he says.With diabetes education, patients have been reported to have been in remission for up to 15 years. Of course, under watch. Tending to his garden at his Sainik Farms house and in between playing with his daughter, Chaturvedi recalls the time he set up his firm. “Since it was involved in bio-manufacturing with photosynthesis, I worked in the diurnal range between 5 am and 5 pm. This involved rigorous physical activity. Tired, I would binge in the evening, sleep by 8 pm and wouldn’t feel hungry in the morning. The sugar in colas and juices kept me supercharged. You could say that other than munching, I would have a proper sit-down, huge meal at 5 pm, something I would look forward to. It was always about eating out or ordering in, I rarely had home-cooked food. Sometimes I would go without food for 20-odd hours, living entirely on juice,” says Chaturvedi.The alarm bells rang in 2018, when he was diagnosed with liver fibrosis. Having had a fatty liver since his teenage years, he thought he could shake it off. When he couldn’t, he consulted a dietician but seeing no improvement, stuck to it for only a year. “I didn’t know back then that though I kept to meal timings, what I was eating was all wrong,” says he.That realisation came in the summer of 2020, in the middle of the pandemic, when a numbing sensation in his leg was bothersome enough for him to reach out for the blood glucose monitor. “With a family history of diabetes and cholesterol, I thought I should test my sugar levels. My post-meal reading came to 300 mg/dL, when it should not be more than 140 mg/dL. The reading after two hours of eating a meal came to 360 mg/dL, which should be less than 180 mg/dL. I tried dietary corrections but the levels kept going up to frightening proportions,” says Chaturvedi. As his HbA1c levels rose to an astounding 10.1 per cent, he showed up at the OPD of Dr Ambrish Mithal, Chairman of Endocrinology and Diabetes, Max Healthcare. Apart from medication, he placed Chaturvedi in a diabetes reversal programme led by diabetic educator and dietitian Shubhda Bhanot.“First of all, we got our patient to adhere to a three-meal pattern, then got him to eat small meals every two hours. What you eat is much more important than how much you can eat. We changed the food pattern and its sequencing to fibre first, protein in the middle and carbohydrates last. Since he is a vegetarian, we put him on salads before every meal followed by a protein-rich yogurt and then vegetables and rotis made with a mixed flour comprising wheat (30 per cent) wheat bran (20 per cent) and chickpea flour (20 per cent),” says Bhanot. What the fibre-first approach does, she explains, is add bulk, satiety and delay the digestive process and the release of sugar. “Fibres reduce the glycaemic index over time and there are no sudden sugar spikes unlike those caused by ingesting carbohydrates first. Some other alternatives could be having psyllium husk or apple cider vinegar before meals. Protein, either as tofu or chicken/fish for animal food lovers, promotes satiety too. So by the time you come to rice and vegetables, your stomach is almost full and executes portion control on its own,” she adds.Chaturvedi says the new meal plan almost showed immediate results, with his sugar levels dropping within two days. “And seeing the results, I stuck to it. For breakfast it is chickpea flour, oats and quinoa pancakes. I learnt poha is bad because flattened rice has starch while sooji or semolina is refined flour. I have given up breads and potatoes, snack on salads, sprouts and nuts. I begin my day with fenugreek seed-soaked water, six unpeeled almonds and two walnuts, all of which lower blood sugar. My diet worked better than the medication and now I am off it,” he adds.While he depended on heavy medication for the first three months, it was scaled down gradually. Dietary management and a sound exercise regime meant that his counts came down. “Bhanot helped pull me back from the precipice over one-and-a-half years through discipline. I was determined not to be dependent on insulin. From barely four hours, I now sleep eight hours at least three times a week. I am regular with my exercises, have taken to running, walk 3,000 steps a day and have lost weight. But I am maniacal about counting the calorie value of whatever I eat. Even in social situations, where some indulgence happens, I take a quick five to ten-minute walk after it to ensure that I wear out the extra calorie load,” says Chaturvedi.As a diabetes educator, Bhanot has a ground rule about indulgence. “There is nothing called a cheat day. I tell patients that they would only end up cheating themselves. I also put my patients through a realistic module of lifestyle management pivoted around their lives. I will never advise somebody not used to early mornings to wake up at 5 am. I set goals with the patient concerned. The idea is to equip them to self-manage their condition, interpret their blood glucose counts, understand how their medications work and manage a sudden crisis,” she says. Chaturvedi now gets all his senior staff tested for blood sugar at his own expense every year. “We cannot let diabetes ruin our work and lives,” he says.
