Did you know three out of every four Indians are struggling with their blood sugar levels? The country has over 101 million people diagnosed with diabetes. Globally, there are over 589 million adults living with diabetes, a number projected to surge to 853 million by 2050. These figures establish diabetes as a public health priority. While medication is crucial in this condition, effective management demands a comprehensive lifestyle intervention where a mix of nutrition, physical activity and consistent habits work synergistically to improve long-term health outcomes. Nutrition, in particular, holds a powerful influence over blood sugar levels, weight and heart health.
An insightful discussion, ‘Nutrition Control: The Next Step in Diabetes Management’, brought to you by Abbott India, with experts – Dr. Jeffrey Mechanick, Endocrinologist and Professor of Medicine at Mount Sinai Hospital, USA, and Prof Agnes Siew Ling Tey, Ph.D., Senior Lead, Clinical Science and Nutrition at Abbott’s Asia Pacific Nutrition R&D Centre – explores why nutrition is one of the cornerstones of holistic diabetes management.
Lack of awareness — The biggest hurdle
One of the biggest challenges in diabetes management is a lack of awareness. This gap is pronounced in the pre-diabetes stage, the crucial period before diagnostic sugar levels are reached. Dr. Mechanick said: “It’s really about awareness. Probably half of patients with Type 2 diabetes in India are just unaware… But when you look at the part of diabetes that occurs before the sugars actually hit those levels for diagnosis, we call it pre-diabetes. Could be as high as 80 to 90 per cent of Americans are unaware. So how are you going to bend the curve if the patients aren’t aware?” This lack of early screening means that many individuals only discover their condition when complications arise, making management significantly more complex.
The three pillars of a healthy lifestyle
“Lifestyle is definitely the most important part of diabetes care,” said Prof Agnes. She addressed three lifestyle factors that have the largest impact on diabetes outcomes. First is good nutrition, which is the base of a good life. The focus must be on low glycemic carbohydrates or foods that prevent rapid blood sugar spikes. These include whole grains, legumes and brown rice. Diabetics must also minimise intake of sugar-sweetened beverages, desserts and refined grains. Secondly, physical activity is vital. To counter the effects of prolonged sitting, regular physical activity like brisk walking, yoga and strength training can help improve insulin sensitivity and manage weight. Finally, quality sleep directly influences metabolic health. People must aim for at least 6 to 8 hours of quality sleep per day to support better glycemic control.
It is not just about what you see on your plate. Dr. Mechanick stressed that diet should be understood as a holistic dietary pattern, not a collection of isolated “good” or “bad” foods. The goal is to consume a balanced whole-foods, diet over time.
“You really need to look at foods in aggregate. What is a human being consuming over a defined or predefined period of time?… It should be a prudent diet. It should be whole foods. We should try as best we can to eliminate processed foods. Probably not skip meals, probably not have a big meal very late in the day so our food intake matches our own biological rhythms,” he said.
Some key nutritional adjustments can include focusing on healthy, low glycemic index carbohydrates (fibres, plants), choosing healthy proteins not associated with unhealthy saturated fats (from dairy, fish, or legumes) and prioritising intake of healthy fats like monounsaturates and polyunsaturates (found in plants and fish). Importantly, he emphasised the need for cultural adaptation, recognising that American or Western guidelines may not be suitable for Indian, Southeast Asian, or Latin American diets.
Diabetes-specific formulas to bridge the nutritional gap
While general healthy eating is crucial, diabetes-specific nutritional formulas (DSNFs) offer a targeted solution for managing nutritional needs and glycemic control. Prof Agnes explained: “They are specifically designed for people with diabetes to address their nutritional needs and also to help glycemic control in these patient groups. Diabetes specific formula actually has a slow release carbohydrate system, unique fibre blend and also high protein and with the good fats that are important for people with diabetes.” DSNFs provide portion control and ensure the right nutrition in the right proportion, which is a significant advantage for individuals who struggle with the daily complexities of meal planning. The latest formulas are scientifically designed with key features.
“The advent of advanced medications has sometimes created the misconception that pharmacology can replace healthy living. Dr. Mechanick clarified that even the most sophisticated therapies are meant to complement—not substitute—intensive lifestyle changes. He emphasised that lifestyle intervention remains the foundation of chronic disease management, with pharmacotherapy serving as a supportive measure rather than a shortcut.”
He added that while these medications offer health benefits, protecting the heart and kidney, they are intended as an aid to a comprehensive lifestyle plan, not a license to continue unhealthy behaviour.
The path forward
The experts concluded with three key principles: personalisation, comprehensiveness, and the central role of nutrition. Dr. Mechanick stressed that diagnosis and management should be tailored to each individual and encompass all pillars of lifestyle medicine—nutrition, physical activity, sleep hygiene, stress management, and community engagement. Prof. Agnes highlighted that for both pre-diabetics and diabetics, nutrition forms the foundation of care. She noted that medical nutrition therapy is clinically proven to help patients achieve treatment goals and urged practitioners to rely on robust clinical evidence. The consensus: while medication remains important, intensive lifestyle intervention—anchored in scientifically validated nutrition—continues to be the cornerstone of diabetes management.
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