Diabetes, a complex and widespread condition, continues to challenge millions globally. For those newly diagnosed, questions about living a healthy and long life often arise. Can diabetes be reversed? How can complications be avoided? And how can patients live well despite their condition? To address these pressing concerns, Drug Today Medical Times spoke with one of India’s leading diabetologists, Prof. S.V. Madhu, Head of the Center for Diabetes, Endocrinology, and Metabolism at University College of Medical Sciences and Guru Tegh Bahadur Hospital, Delhi. Prof. Madhu shares insights into diabetes reversal, management, and the latest advancements in treatment.

DTMT: Diabetes reversal is a hot topic right now. Is it truly possible, and under what circumstances?

Prof. Madhu: Yes, diabetes reversal has been a subject of much debate and excitement. Recent research shows that it’s possible, but only under specific conditions. The key finding is that individuals who lose around 15 kilograms of body weight can regain some insulin production. Previously, it was thought that once lost, insulin production in diabetics couldn’t be restored, but now we know that it’s achievable for some people.

However, this possibility is limited to those with Type 2 diabetes diagnosed within the past six years, who are not on insulin therapy, and who have not developed significant complications like damage to the heart, kidneys, or eyes. Even in such cases, reversal doesn’t mean a cure—it’s remission. The patient must adhere to a strict, healthy lifestyle to maintain this remission. Any weight gain or lapse in lifestyle could bring diabetes back.

DTMT: What does “remission” mean in the context of diabetes? Is it a permanent solution?

Prof. Madhu: Remission means that blood sugar levels return to a non-diabetic range without the need for medication. But it’s not a permanent solution or a cure. It’s a delicate balance that requires lifelong commitment to a healthy lifestyle. If the individual regains weight or neglects their health, diabetes can return. So, while remission offers hope, it demands discipline and sustained effort from the patient.

DTMT: Managing diabetes comes with its challenges. How can the overall well-being of diabetic patients be ensured?

Prof. Madhu: Well-being goes beyond controlling blood sugar levels. It’s about helping patients live a quality, happy, and fulfilling life. Many people with diabetes face unique challenges. For instance, children with diabetes may feel isolated or struggle to manage their condition in school. Adults, especially working professionals, may find it hard to stick to medication schedules or a proper diet due to their busy lives.

Support systems are essential. Patients need regular follow-ups with doctors or nurses, and in some cases, psychologists can help them cope with the stress or depression that often accompanies diabetes. Families and caregivers also play a vital role in offering encouragement and ensuring patients stick to their treatment plans. With the right support, diabetics can lead normal and productive lives.

DTMT: Staying hydrated is essential for everyone, but it’s particularly crucial for diabetics. What are your recommendations?

Prof. Madhu: Proper hydration helps in managing blood sugar levels and overall health. Diabetics should drink plenty of water and can include unsweetened beverages like lassi or chaach in their diet. However, fruit juices should be avoided due to their high sugar content. Including water-rich vegetables like cabbage, tomatoes, and cucumbers is also beneficial. Staying hydrated is a simple yet effective way to support overall well-being.

DTMT: Stress is a part of modern life, but how does it relate to diabetes?

Prof. Madhu: Stress and diabetes are closely interlinked. Prolonged stress—whether from family issues, work pressures, or financial concerns—can increase the risk of developing diabetes. Similarly, living with diabetes can itself be a source of stress, creating a vicious cycle.

We often recommend stress management techniques like yoga, meditation, or engaging in hobbies that bring joy. These practices not only reduce stress but also improve overall health. Patients who manage their stress effectively often find it easier to control their blood sugar levels.

DTMT: Diabetes and hypertension are often mentioned together. What’s the connection?

Prof. Madhu: Diabetes and hypertension are like siblings—they tend to go hand-in-hand. If someone is diagnosed with diabetes today, there’s a high chance they’ll develop hypertension within a few years, and vice versa. Obesity is a major contributing factor, but even individuals without obesity can experience this connection.

Patients with both conditions need to be extra vigilant about their health. Regular monitoring, maintaining a healthy weight, and adhering to prescribed treatments are essential to prevent complications like heart disease.

DTMT: Is there any connection between thyroid disorders and diabetes?

Prof. Madhu: While thyroid disorders aren’t directly linked to diabetes, they are commonly observed in diabetic patients. For instance, hypothyroidism or hyperthyroidism can sometimes complicate diabetes management. Regular thyroid screening is advisable for diabetic patients to address any underlying issues promptly.

DTMT: What advancements in diabetes treatment have emerged in recent years?

Prof. Madhu: The field of diabetes treatment has seen significant progress. Earlier, there were only two kinds of medications for diabetes. Now, we have eight to ten types of drugs, many of which offer additional benefits like weight management. These medications are tailored to the specific needs of each patient, improving outcomes and quality of life.

For instance, newer drugs not only control blood sugar levels but also help reduce cardiovascular risks, which are common in diabetic patients. These advancements make it easier to manage the condition effectively.

DTMT: What are some uncommon symptoms of diabetes that people should be aware of?

Prof. Madhu: Diabetes often develops silently, so it’s crucial to be vigilant. Symptoms like repeated infections, slow-healing wounds, and watery eyes can be indicators. Unfortunately, many people don’t notice these signs until the disease has progressed.

We recommend that anyone above 30 years of age undergo regular blood sugar screenings, even if they don’t have symptoms. Early detection can make a huge difference in managing the condition and preventing complications.

DTMT: How can diabetes complications, like kidney damage, be prevented?

Prof. Madhu: Uncontrolled diabetes can lead to kidney damage, but this typically takes 10 to 15 years. The best way to prevent such complications is by keeping blood sugar levels under control through medication, diet, and exercise. Regular kidney function tests can also help in early detection and management.

DTMT: What role does lifestyle play in diabetes prevention?

Prof. Madhu: Lifestyle is everything when it comes to diabetes prevention. Maintaining a healthy body weight, eating a balanced diet, and exercising regularly are non-negotiable. Studies have shown that even 40 minutes of yoga daily can significantly reduce the risk of developing diabetes. Prevention is always better than cure, especially for a condition as complex as diabetes.

DTMT: Thank you, Prof. Madhu, for sharing your expertise.

Prof. Madhu: My pleasure. Raising awareness about diabetes is crucial, and I’m glad to contribute. With the right knowledge and support, we can empower people to lead healthier lives despite the challenges of this condition.