Special thosai set.
A recent study, the Abbott Food, Spikes and Diabetes Survey, suggests that 70% of individuals managing diabetes in urban India may not be carefully managing their food intake. This survey, conducted by Ipsos India on behalf of Abbott, involved over 4,100 participants aged 36 to 65 with Type 2 diabetes (diagnosed for over 18 months) from various socioeconomic backgrounds across eight major cities. The study aimed to understand their eating habits, the impact of meals on blood sugar fluctuations, and its effect on diabetes management. Detailed interviews helped researchers analyze participants’ diets, monitoring practices, and exercise routines. Custom bowls and glasses were used to accurately measure food and drink portions, converting them into grams and calories.
The survey revealed several important findings. A significant 62% of individuals with diabetes are overweight or obese, exceeding the recommended BMI of 22.9 for Indians. Alarmingly, nearly half (46%) are classified as obese. The average BMI for men is 24.1 (overweight), while for women, it is 25.3 (obese). Over half (55%) received their diagnosis before 45, with a notable 17% diagnosed before 35.
Disturbingly, almost two-thirds (65%) of participants have uncontrolled blood sugar levels, with their latest readings exceeding the target range for both fasting and post-meal situations. Blood sugar levels appear heavily influenced by food choices and meal frequency. Additionally, 62% manage other health conditions, with hypertension being the most prevalent (40%). Notably, nearly 70% of those with diabetes for over five years reported at least one additional health concern, with eye and nerve disorders being particularly common in this group.
Despite the recommendation to monitor blood sugar through fasting and two-hour post-meal tests, almost 40% of participants only conduct one test, typically fasting. Furthermore, the average time between eating and testing post-meal blood sugar is 58 minutes, falling short of the recommended two hours.
Leading experts highlight the importance of both fasting and post-meal blood sugar monitoring. Dr. V Mohan, Chairman and Chief Diabetologist at Dr. Mohan’s Diabetes Specialities Centre in Chennai, emphasizes that while fasting blood sugar reveals liver glucose production, post-meal levels indicate glucose disposal. Controlling both is crucial, especially post-meal levels due to their link with cardiovascular disease. Professor Shashank R Joshi, President of the Indian Academy of Diabetes & Senior Endocrinologist at Lilavati Hospital in Mumbai, stresses the significance of post-meal blood sugar control in India, attributing it to the higher glycemic load of the typical Indian diet.
The survey revealed that 70% of participants consume meals with an imbalanced carbohydrate ratio. Their average meal consists of 68% carbohydrates, exceeding the suggested 60% guideline. While the average daily calorie intake aligns with the National Institute of Nutrition’s recommendation for sedentary to moderate activity (2,534 Kcal for men and 2,634 Kcal for women), the primary source of these calories is concerning. Most calories originate from simple carbohydrates, which lack fiber.
Professor Shashank highlights that India’s high carbohydrate consumption, observed in the STARCH study, is confirmed by the Food, Spikes and Diabetes Survey. Roti, rice, and other cereals are identified as primary carbohydrate sources. Dr. Mohan points out that polished white rice constitutes a significant portion of calorie intake among Chennai residents, contributing to the diabetes surge. He emphasizes the need for carbohydrate control, as excess carbohydrates lead to post-meal blood sugar spikes. This surge in blood glucose, especially after consuming carb-heavy meals, overworks the insulin secretion, potentially leading to insulin depletion and severe diabetes.
The survey also shed light on eating patterns. 80% of participants eat three to four meals daily, with a four-and-a-half to seven-hour gap between meals. A significant delay between waking up and having breakfast was observed, averaging three-and-a-half hours. Professor Shashank stresses the importance of reducing this gap and consuming a breakfast rich in whole grains or balanced meal replacements.
Dr. Mohan emphasizes the need for early breakfast consumption, as prolonged periods without food after dinner can disrupt hormone balance. He recommends smaller, more frequent meals for better diabetes management.
Source: Abbott infographic. Cities covered: Mumbai, New Delhi, Kolkata, Chennai, Lucknow, Bengaluru, Hyderabad and Trivandrum.
Festive occasions pose additional challenges. 30% of respondents admitted to dietary leniency during these times. Sweets, rice, potatoes, and ice cream are among the top indulgences, further complicating diabetes management. Fasting is also common, with 10% of respondents, primarily women, observing fasts, mostly weekly. Alarmingly, nearly half (45%) skip diabetes medication while fasting, and 54% consume only one meal on fasting days. Professor Shashank points out that these fluctuating eating patterns during festivals contribute to glucose spikes.
The survey highlighted the lack of physical activity among respondents. Only 40% engage in any form of exercise, with walking being the most prevalent (93%).
Bhasker Iyer, Vice President of Abbott, emphasizes the significance of diabetes management in India and highlights Abbott’s commitment to advancing understanding and awareness. He believes that the study’s insights will empower individuals to take control of their diabetes and lead fulfilling lives.
Individuals seeking guidance on managing their diabetes through diet can take advantage of free professional advice tailored to Indian cuisine by giving a missed call to 0777 1003 003 in India.
View the associated infographic
*About the Abbott Food, Spikes and Diabetes Survey:
Conducted in eight major Indian cities (Mumbai, New Delhi, Kolkata, Chennai, Lucknow, Bengaluru, Hyderabad, and Trivandrum), the survey involved randomly selected interviews with 4,148 adults aged 35 to 65 diagnosed with Type 2 diabetes for at least 18 months. The study included 1,867 men and 2,281 women. Structured interviews were conducted to gather data on dietary habits and patterns, monitoring practices, and factors influencing diabetes management. Custom-sized bowls, plates, and glasses were used to precisely measure food intake, which was then converted into grams and calories using Dr. Mohan’s Atlas of Indian Foods.
**Conversion and classification of the meal plate done with the support of Dr Mohan’s Atlas of Indian Foods (First ed., 2013). The book features more than 200 foods eaten across regions in various portion sizes along with main nutritional values.
***Normal BMI: 18.0-22.9 kg/m2 , Overweight: 23.0-24.9 kg/ m2 , Obesity: >25 kg/m2 : Consensus Statement for Diagnosis of Obesity, Abdominal Obesity and the Metabolic Syndrome for Asian Indians and Recommendations for Physical Activity, Medical and Surgical Management (February 2009) : A Misra, P Chowbey, BM Makkar, NK Vikram, JS Wasir, D Chadha, Shashank R Joshi, S Sadikot, R Gupta, Seema Gulati, YP Munjal for Consensus Group
****Target range: fasting blood sugar - 70 – 130 mg/dl; post-prandial sugar, done after two hours – less than 180 mg/dl: American Diabetes Association. Diabetes Care 2013;36(1):s11-s66
*****National Institute of Nutrition – Dietary Guidelines for Indians (Second ed., 2011); page 15 – ‘What is a balanced diet?…..a balanced diet should provide up to 60% of total calories from carbohydrates, preferably from complex carbohydrates’.
******National Institute of Nutrition – Dietary Guidelines for Indians (Second ed., 2011); Annex 3 - Recommended Dietary Allowances for Indians (Macronutrients and Minerals): Man – 60 kg body weight: 2,320 – 2,730 Kcal/day; Woman – 55 kg body weight: 1,900 – 2,230 Kcal /day