There are different types of diet that could be followed depending on daily routine to promote weight loss. Examples of few types of diet followed for Diabetes remission are:.Low calorie diet (LCD).Low carbohydrate diet (LCBD).Ketogenic diet.Intermittent fasting.Meal replacementNote: All these diets are to be followed only under medical supervision to avoid complications like gall stone formation and alterations in cholesterol..carbohydrate, protein and fat and micronutrients like vitamins and minerals. Depending on the activity level and gender daily caloric requirement varies from 2000 to 2400 kcal per day. For Indian adult men it is 2400 Kcal/day and for Indian adult women it is 2100 kcal/day. About 50-60 per cent of the total calories is derived from carbohydrates, 15-20 per cent from proteins and the remaining 20-25 per cent from fat. Low calorie dietIn low calorie diet (LCD), the total calories vary from 1000-1500 Kcal/day and in very low calorie diet (VLCD) less than 800 Kcal/day is consumed to achieve weight loss. In a VLCD regimen, all meals are replaced with a liquid diet formulation providing about 800 kcal/day. This is followed for about 12 weeks. After 12 weeks, a reintroduction phase is implemented where structured solid foods is reintroduced to maintain the weight loss.Most of the LCD and VLCD diets contain foods which deliver 50-60 per cent of energy from carbohydrates (130 gm/day), essential fatty acids to meet the daily requirement and high biological value protein (1.2-1.5gm/kg body weight) to prevent the lean body mass loss. Vitamins and minerals are usually supplemented to meet daily micronutrient needs.Low-carbohydrate dietIn low-carbohydrate diet (LCBD), less than 26 pre cent of energy is derived from carbohydrates or less than 130 gm/day of carbohydrates/day. Here either the protein or the fat consumption increases to compensate for the decrease in the carbohydrate content. Rapid weight loss is seen in the first 6 to12 months. This is probably due to increased feeling of satiety secondary to increased protein and fat consumption and hence less hunger and less food intake, resulting in caloric deficit.Keto dietKetogenic (Keto) diet is a form of low carbohydrate diet where carbohydrate consumption is only about 20-50 gm/day or only 10 per cent energy coming from carbohydrates. Usually carbohydrate in the food is broken down to glucose for energy utilization. Excess glucose which is usually stored as glycogen in the liver, is also depleted in this keto diet.In Keto diet, the source of energy switches from carbohydrate to fat. The fat is broken down to fatty acids and is mobilized from adipose tissue causing weight loss. These fatty acids are converted to ketones and used for energy. Nutritional ketosis refers to this condition where ketone bodies (acetoacetate, acetone and beta- hydroxybutyrate) are formed causing measurable ketones in blood and urine.Note: People taking SGLT2 inhibitors (Sodium Glucose Co-transporter 2 inhibitors like Empagliflozin, Canagliflozin and Dapagliflozin) should not follow keto diet as it may precipitate a condition called Euglycemic ketosis.Intermittent fastingIntermittent fasting includes different regimens like eating two meals a day, eight hours apart with 16 hours overnight fasting. For example:. 10 am: brunch. 10 am - 6 pm: butter milk or lemon juice or coconut water. 6 pm: dinner. 6 pm - 10 am: fastingAnother regimen includes eating normal 3 meals with snacks alternating with a day of fast when only 800 kcal is consumed on that day. For example:. Monday, Wednesday, Friday and Sunday:3 meals with snacks. Tuesday, Thursday and Saturday: total calorie intake is 800 calories Meal replacementMeal replacement formula rich in protein with combination of macro and micronutrient can be used to replace either 1 or 2 meals, thereby cutting down the total daily calorie intake. This is especially ideal for people who lead busy schedules or those who travel a lot. SustainabilityInsulin is an anabolic hormone and causes the body to store fat. Type 2 Diabetes is characterised by insulin resistance. This requires the body to increase insulin production. Irrespective of the diet followed, weight loss secondary to calorie deficit causes decreased insulin production because of increased insulin sensitivity. This improves the cardio-metabolic status of the individual. The key is to maintain the weight loss to maintain Type 2 Diabetes remission. So following a diet which can be continued in the long term is ideal.An example of a healthy diet which can be followed for a long time is Mediterranean diet. This diet contains food rich in whole grain carbohydrate along with fruits and vegetables, protein (like eggs, fish and lean meat chicken) and unsaturated fat like olive oil and nuts. It is clear that Mediterranean diet is sustainable when compared to low carbohydrate diet, even though the latter may show results faster.Daily physical activityDiet helps to lose weight and exercise helps improve blood glucose control besides keeping the person fit. People with Type 2 Diabetes are able to produce insulin but insulin is not as sensitive because of excess abdominal fat. Hence a greater amount of insulin is needed to lower blood glucose levels.While exercising, blood glucose level decreases as it is utilised without the help of insulin. Abdominal fat also decreases thereby increasing insulin sensitivity. Thus exercise acts in multiple ways to improve blood glucose control. Weight loss can be maintained both by continuing with the diet and by exercising regularly..Recommendations for good blood glucose control are:. a daily brisk walk for about 45 to 60 minutes, five times a week. strength training exercise twice a week like lifting weights or resistance training exercise using bands Medication and surgeryThere are several anti-obesity medications available which can help with the weight loss. However, these medications will have side effects and the weight loss is maintained only as long as the patient continues to take the anti-obesity medications.Bariatric surgery will definitely help with the weight loss and remission of diabetes.However, this may last from 2 to 5 years. With the patient gradually regaining the weight, diabetes recurs in these individuals too.Back to Mrs XMrs X: Doctor, can I reverse my Diabetes diagnosis?Doctor: Of course, given that you have been recently diagnosed with Type 2 Diabetes and that both obesity and unhealthy lifestyle are causing this condition. There is a high potential to go into remission. Type 1 Diabetes (usually common in children) occurs due to the deficiency of insulin secretion and is not reversible.Mrs X: What should I do to lose weight?Doctor: First and foremost, a healthy low carbohydrate, protein rich diet needs to be followed to help with the weight loss. This should be substantiated with exercise, simple brisk walking about 45 minutes every day about 5 times a week is recommended. If you have knee pain, you can try water aerobics, so that calories are still burnt without added burden of knee pain, while doing water aerobics.We can consider medications that treat both diabetes and help with weight reduction. However once these medications are stopped then the lost weight is regained. Examples of such medications are oral semaglutide and injection liraglutide. First line of anti-diabetic medication after diet and exercise, oral metformin can also be started, even though weight loss with this medication is not that significant.Mrs X: What should be my long-term goal?Doctor: Please continue to maintain healthy lifestyle with low carbohydrate diet, exercise and continue to maintain the lost weight, with which diabetes remission occurs. Once in remission, please do not relax any of the above. Would like to reiterate, once the lost weight is regained, diabetes will recur. Hence the long term goal is stay fit by following the above tips.Mrs X: Will my son develop Diabetes too?Doctor: Given that Type 2 Diabetes, is both genetic and lifestyle disease, yes he is definitely at risk to develop Type 2 Diabetes. However, if he follows the instructions given today like following healthy life style, losing weight with low carbohydrate diet and exercising regularly, he can definitely postpone the age of developing diabetes or may not even develop diabetes.Mrs X: What should I do next?Doctor: Please have your eyes and kidneys checked. Even though, you are newly diagnosed with Type 2 Diabetes. We need to make sure that these organs have not been affected as symptoms do not develop in the beginning stages. You can email those reports to me.Next you must visit a dietician who will offer dietary guidance by providing a personalised diet chart and educating about the kind of food to avoid.Mrs X: When should I follow up with you?Doctor: In 3 months. Please test yourfasting blood sugar, PP and HbA1c and bring those reports with you.reduced by 9 cms (97 to 88 cms). Her HbA1c reduced from 7.2 to 5.5 per cent without taking any anti-diabetic medications for 3 months. She achieved Diabetes remission successfully.Type 2 Diabetes is a chronic progressive disease with progressive decline in the beta cell function. Studies like DiRECT and ReTUNE have shown that this beta cell function can be revived with weight loss and thereby helps with diabetes remission.People with Type 2 Diabetes have a higher potential to reach diabetes remission with weight loss. This is especially true, in the early years (within 5 years) after diagnosis. The key is to continue to stick to the same routine which helped with Diabetes remission to continue to maintain the remission.To concludeMrs X started a low calorie diet (less than 1000 calories a day) along with physical activity of brisk walking about 1 hour a day. Her weight reduced from 93 to 84 kilos, lost about 6 per cent of her total body weight and her waist circumference
There are different types of diet that could be followed depending on daily routine to promote weight loss. Examples of few types of diet followed for Diabetes remission are:.Low calorie diet (LCD).Low carbohydrate diet (LCBD).Ketogenic diet.Intermittent fasting.Meal replacementNote: All these diets are to be followed only under medical supervision to avoid complications like gall stone formation and alterations in cholesterol..carbohydrate, protein and fat and micronutrients like vitamins and minerals. Depending on the activity level and gender daily caloric requirement varies from 2000 to 2400 kcal per day. For Indian adult men it is 2400 Kcal/day and for Indian adult women it is 2100 kcal/day. About 50-60 per cent of the total calories is derived from carbohydrates, 15-20 per cent from proteins and the remaining 20-25 per cent from fat. Low calorie dietIn low calorie diet (LCD), the total calories vary from 1000-1500 Kcal/day and in very low calorie diet (VLCD) less than 800 Kcal/day is consumed to achieve weight loss. In a VLCD regimen, all meals are replaced with a liquid diet formulation providing about 800 kcal/day. This is followed for about 12 weeks. After 12 weeks, a reintroduction phase is implemented where structured solid foods is reintroduced to maintain the weight loss.Most of the LCD and VLCD diets contain foods which deliver 50-60 per cent of energy from carbohydrates (130 gm/day), essential fatty acids to meet the daily requirement and high biological value protein (1.2-1.5gm/kg body weight) to prevent the lean body mass loss. Vitamins and minerals are usually supplemented to meet daily micronutrient needs.Low-carbohydrate dietIn low-carbohydrate diet (LCBD), less than 26 pre cent of energy is derived from carbohydrates or less than 130 gm/day of carbohydrates/day. Here either the protein or the fat consumption increases to compensate for the decrease in the carbohydrate content. Rapid weight loss is seen in the first 6 to12 months. This is probably due to increased feeling of satiety secondary to increased protein and fat consumption and hence less hunger and less food intake, resulting in caloric deficit.Keto dietKetogenic (Keto) diet is a form of low carbohydrate diet where carbohydrate consumption is only about 20-50 gm/day or only 10 per cent energy coming from carbohydrates. Usually carbohydrate in the food is broken down to glucose for energy utilization. Excess glucose which is usually stored as glycogen in the liver, is also depleted in this keto diet.In Keto diet, the source of energy switches from carbohydrate to fat. The fat is broken down to fatty acids and is mobilized from adipose tissue causing weight loss. These fatty acids are converted to ketones and used for energy. Nutritional ketosis refers to this condition where ketone bodies (acetoacetate, acetone and beta- hydroxybutyrate) are formed causing measurable ketones in blood and urine.Note: People taking SGLT2 inhibitors (Sodium Glucose Co-transporter 2 inhibitors like Empagliflozin, Canagliflozin and Dapagliflozin) should not follow keto diet as it may precipitate a condition called Euglycemic ketosis.Intermittent fastingIntermittent fasting includes different regimens like eating two meals a day, eight hours apart with 16 hours overnight fasting. For example:. 10 am: brunch. 10 am - 6 pm: butter milk or lemon juice or coconut water. 6 pm: dinner. 6 pm - 10 am: fastingAnother regimen includes eating normal 3 meals with snacks alternating with a day of fast when only 800 kcal is consumed on that day. For example:. Monday, Wednesday, Friday and Sunday:3 meals with snacks. Tuesday, Thursday and Saturday: total calorie intake is 800 calories Meal replacementMeal replacement formula rich in protein with combination of macro and micronutrient can be used to replace either 1 or 2 meals, thereby cutting down the total daily calorie intake. This is especially ideal for people who lead busy schedules or those who travel a lot. SustainabilityInsulin is an anabolic hormone and causes the body to store fat. Type 2 Diabetes is characterised by insulin resistance. This requires the body to increase insulin production. Irrespective of the diet followed, weight loss secondary to calorie deficit causes decreased insulin production because of increased insulin sensitivity. This improves the cardio-metabolic status of the individual. The key is to maintain the weight loss to maintain Type 2 Diabetes remission. So following a diet which can be continued in the long term is ideal.An example of a healthy diet which can be followed for a long time is Mediterranean diet. This diet contains food rich in whole grain carbohydrate along with fruits and vegetables, protein (like eggs, fish and lean meat chicken) and unsaturated fat like olive oil and nuts. It is clear that Mediterranean diet is sustainable when compared to low carbohydrate diet, even though the latter may show results faster.Daily physical activityDiet helps to lose weight and exercise helps improve blood glucose control besides keeping the person fit. People with Type 2 Diabetes are able to produce insulin but insulin is not as sensitive because of excess abdominal fat. Hence a greater amount of insulin is needed to lower blood glucose levels.While exercising, blood glucose level decreases as it is utilised without the help of insulin. Abdominal fat also decreases thereby increasing insulin sensitivity. Thus exercise acts in multiple ways to improve blood glucose control. Weight loss can be maintained both by continuing with the diet and by exercising regularly..Recommendations for good blood glucose control are:. a daily brisk walk for about 45 to 60 minutes, five times a week. strength training exercise twice a week like lifting weights or resistance training exercise using bands Medication and surgeryThere are several anti-obesity medications available which can help with the weight loss. However, these medications will have side effects and the weight loss is maintained only as long as the patient continues to take the anti-obesity medications.Bariatric surgery will definitely help with the weight loss and remission of diabetes.However, this may last from 2 to 5 years. With the patient gradually regaining the weight, diabetes recurs in these individuals too.Back to Mrs XMrs X: Doctor, can I reverse my Diabetes diagnosis?Doctor: Of course, given that you have been recently diagnosed with Type 2 Diabetes and that both obesity and unhealthy lifestyle are causing this condition. There is a high potential to go into remission. Type 1 Diabetes (usually common in children) occurs due to the deficiency of insulin secretion and is not reversible.Mrs X: What should I do to lose weight?Doctor: First and foremost, a healthy low carbohydrate, protein rich diet needs to be followed to help with the weight loss. This should be substantiated with exercise, simple brisk walking about 45 minutes every day about 5 times a week is recommended. If you have knee pain, you can try water aerobics, so that calories are still burnt without added burden of knee pain, while doing water aerobics.We can consider medications that treat both diabetes and help with weight reduction. However once these medications are stopped then the lost weight is regained. Examples of such medications are oral semaglutide and injection liraglutide. First line of anti-diabetic medication after diet and exercise, oral metformin can also be started, even though weight loss with this medication is not that significant.Mrs X: What should be my long-term goal?Doctor: Please continue to maintain healthy lifestyle with low carbohydrate diet, exercise and continue to maintain the lost weight, with which diabetes remission occurs. Once in remission, please do not relax any of the above. Would like to reiterate, once the lost weight is regained, diabetes will recur. Hence the long term goal is stay fit by following the above tips.Mrs X: Will my son develop Diabetes too?Doctor: Given that Type 2 Diabetes, is both genetic and lifestyle disease, yes he is definitely at risk to develop Type 2 Diabetes. However, if he follows the instructions given today like following healthy life style, losing weight with low carbohydrate diet and exercising regularly, he can definitely postpone the age of developing diabetes or may not even develop diabetes.Mrs X: What should I do next?Doctor: Please have your eyes and kidneys checked. Even though, you are newly diagnosed with Type 2 Diabetes. We need to make sure that these organs have not been affected as symptoms do not develop in the beginning stages. You can email those reports to me.Next you must visit a dietician who will offer dietary guidance by providing a personalised diet chart and educating about the kind of food to avoid.Mrs X: When should I follow up with you?Doctor: In 3 months. Please test yourfasting blood sugar, PP and HbA1c and bring those reports with you.reduced by 9 cms (97 to 88 cms). Her HbA1c reduced from 7.2 to 5.5 per cent without taking any anti-diabetic medications for 3 months. She achieved Diabetes remission successfully.Type 2 Diabetes is a chronic progressive disease with progressive decline in the beta cell function. Studies like DiRECT and ReTUNE have shown that this beta cell function can be revived with weight loss and thereby helps with diabetes remission.People with Type 2 Diabetes have a higher potential to reach diabetes remission with weight loss. This is especially true, in the early years (within 5 years) after diagnosis. The key is to continue to stick to the same routine which helped with Diabetes remission to continue to maintain the remission.To concludeMrs X started a low calorie diet (less than 1000 calories a day) along with physical activity of brisk walking about 1 hour a day. Her weight reduced from 93 to 84 kilos, lost about 6 per cent of her total body weight and her waist circumference
