Diabetes with Delight
Call it a developmental disorder. Once the affliction of the idle rich, diabetes has become a familiar spectre in every home, smuggled in by a sedentary lifestyle and a diet rich in added sugars and processed foods, fortified with preservatives, emulsifiers, stabilisers and artificial colours and flavours. Development has democratised the elite disease, and it is commonplace to find executives, their electricians and their domestic help jogging together in the morning in public parks. Their doctors have all told them to run for their lives.
The spread of the human belly is widening in direct proportion to the widening of the middle class, taking it by surprise. Diabetes is a lifestyle disorder and, in most cases, the long-term solution depends on a lifestyle response. But diabetes has been medicalised, with patients depending primarily on consultations and prescriptions, while part of a sustainable solution lies elsewhere, in the kitchen, the home, and yoga and laughter clubs.
This book from one of India’s foremost teachers and practitioners of internal medicine is a welcome rationalisation, arming patients and their families with the information they need to tailor their lives for the prevention or management of diabetes. Misra dismisses fad diets, which exist mainly to improve the revenues of celebrity dieticians and the media they populate. Instead, he provides the tools for patients to craft their own diet — the categorisation, calorific value, glycaemic index and glycaemic load of foods, the effects of spices and condiments, and even recommended alcohol limits.
The section on fitness is of general value, busting a number of myths — the morning is not necessarily the best time for exercise, muscle will not turn into fat if you stop exercising, abdominal exercises do not shed belly fat, they only increase abdominal muscle tone. The prescribed exercises would be useful even for healthy middle-aged people — they would keep them that way.
Diabetes is spreading faster than public knowledge about the condition, and short chapters focused on specific risks arm patients and their carers to make informed choices — how to manage insulin while crossing time zones, how to reduce the risk of cancer, why all diabetics should get flu and pneumonia shots, and why a patient should assume that every new symptom or condition owes to diabetes until proven otherwise. While insisting on the need for routine medical supervision, Misra releases the patient from unthinking dependence on the doctor. But the eerily cheerful title could throw browsers in bookstores.