Dietary changes can lead to diabetes remission: ICMR study

HYDERABAD: A recent national study funded by the Indian Council of Medical Research (ICMR) that included responses from 18,090 adults found that making minor dietary changes can result in diabetes remission (which does not mean reversal) and prevention.

Previous studies showed that people in the southern and eastern states of the country consumed excess carbohydrates, particularly white rice, while those in the northern and western states consumed refined wheat. Excess carbohydrate consumption has been linked to an increased risk of Type 2 diabetes. The majority of Indians' diets consist of 65 to 70 per cent carbohydrates and little protein.

The ICMR-INDIAB study was conducted across the country and included data from 29 states and two Union Territories. It is India's largest epidemiological study on diabetes. According to the study's findings, diabetes remission (reversal) can be achieved if carbohydrate content is reduced to 49 to 54 per cent, while protein intake is increased to 19 to 20 per cent, and consumption of fat is maintained at 21 to 26 per cent.

Carbohydrate content of 54-57 per cent, protein content of 16-20 per cent, and fat content of 20-24 per cent would suffice to prevent progression from pre-diabetes to diabetes.

"Unlike previous studies that have recommended a very low (near zero) carbohydrate intake, which is unsustainable in the Indian context, our results show that even a modest reduction in carbohydrate intake with an increase in protein, along with healthy fats, can help to both reverse diabetes as well as prevent its progression," said Dr R.M. Anjana, primary author of the study and vice-president, Madras Diabetes Research Foundation (MDRF).

The study's findings have been reaffirmed by city doctors. Dr Gowri Sankar Bapanapalli, consultant general physician and diabetologist at SLH Hospitals, explained the distinction between remission and total reversal. According to him, remission means that sugar levels have returned to normal for the time being. This occurs as a result of dietary and lifestyle changes. He stated that when conditions change, the levels can rise again.

Dr Sankar added that, while the terms remission and reversal were frequently used interchangeably, reversal of diabetes was not currently possible because the damage suffered by various parts of the body, including the pancreas, would not return to normal.

Dr Sandeep Devireddy, consultant endocrinologist at KIMS Hospital, stated that remission is possible in patients who are not severe diabetics and only have mildly elevated sugars or are borderline diabetics. In addition to reducing carb intake, they would need to lose 5-10 per cent of their body weight and implement strict lifestyle changes. He stated that if the patient's changed lifestyle was not followed after remission, diabetes could relapse.

What and how much to consume?

65-70% carbs: Composition of diet of most Indians  

Diet for remission of diabetes:

Carbs – 49-54%
Protein – 19-20%
Fat – 21-26%

Diet to prevent progression from pre-diabetes to diabetes:

Carbs – 54-57%
Protein – 16-20%
Fat – 20-24%