Today about 10 crore people in India are diabetic and another 13.5 crore people are considered as pre-diabetic. From the blood sugar HbA1c level, below 5.7 are considered as non-diabetic, between 5.7 to 6.4 are considered as pre-diabetic and 6.5 and above are considered as diabetic according to the current norms.

With almost 23.5 crore people getting into the diabetic bracket, it should be a matter of concern to all citizens, health care providers and the government.

The 2 year covid period resulted in people forced to remain housebound, without much an activity and consuming food without restrictions which is now showing its impact by most of the people growing obese or diabetic. This state of affairs has arisen because of excess insulin being created in the body to take care of the excessive glucose generated from the food intake, the inactivity and stress level.

To be warned of any impending onset of diabetes, it is necessary to not only find out the glucose level but also the insulin level in the body. Insulin is that hormone which reaches the glucose generated from the food to the trillions of cells in the body. In some cases, even though the person is not yet identified as diabetic as per current norms, his or her insulin creation might be quite high.

According to diabetes experts, the blood steam in our body is supposed to maintain limited glucose level of say 5gms. But in reality, as we generate much higher level of glucose from each of the food items we consume, the higher level of glucose is handled by the body through insulin. According to Dr.Pramod Tripathi, a diabetes reversal specialist, 1 plate of poha generates about 5 tsp of sugar, 1 plate of upma generates 5 tsp of sugar and one alu paratha is likely generate between 6 to 10 tsp of sugar. When this high level of sugar is infused into the body through food, it is a miracle that our body is able to handle this onslaught. One tsp of sugar works out to 4.2 gms. Which means every plate of poha or upma or idli adds 21 gms of sugar in our blood.

But where insulin resistance occurs i.e., where insulin is not able to push the glucose generated from the food into the cells on account of different factors, the level of glucose remains high in the blood. This is called insulin resistance. This state of insulin resistance results in Type 2 Diabetes. This is measured in two levels viz., fasting and post-prandial.

According to the latest ICMR guidelines, Fasting sugar levels should be between 80 mg/dL to 130 mg/dL for a non-diabetic person and post prandial sugar level should be below 180 mg/dL.

But the most important criteria for insulin resistance is not only blood sugar but insulin creation itself. For higher level of glucose created, higher level of insulin is required. Hence, Pancreas creates more insulin. Even in a non-diabetic person, his/her blood sugar level (HBA1c) may be within the normal range but as higher level of insulin gets generated, it will result in formation of fat within the body. This fat in course of time will lead to other problems like blood pressure, thyroid, heart attack etc., which in course of time leads to type 2 diabetes, if not prevented in time.

How to identify the insulin level?

The best way to identify insulin level in the body is to carry out a fasting insulin test / c-Peptide test. This will indicate the level of insulin getting created.

According to diabetes reversal experts, if fasting insulin is within the range of 2.6 to 5.6 to 6 μU/mL,(microunits per millilitre) it is considered normal. Anything higher than 5.6 should be a cause of concern as this indicates the body is becoming insulin resistant.

How to prevent generation of excess insulin and ultimately diabetes?

Sr.No.	Action
1	First step is to find out the level is insulin getting generated by your body by doing a fasting insulin test. If it is within range, there is no cause for alarm. But if it exceeds 5.6, then it indicates occurrence of insulin resistance requiring immediate dietary modification and lifestyle change as prescribed by ICMR.
2	Keep a check on the portion of food intake. Because you are not a diabetic, you may be tempted to eat all types of food, anywhere, anytime but it is essential to keep the portion under check so that the insulin generation can also be kept under check. While there may be no restriction on your eating anything available and which you like, first ask yourself, how many teaspoons of sugar am I consuming in this portion of food?

Sr.No.	Action
3	Carryout a change in the diet to reduce the intake of carbohydrates so that the glucose generation in the body gets restricted. At the same time increase the intake of proteins and good fats to supplement for the energy requirement. Refined items of carbohydrates in the form of starch which will get digested in the stomach quite fast as a result, glucose generation and its circulations becomes faster. As these carbohydrates generate sugar faster, more insulin will be required to regulate their flow to the trillions of cells in the body. More insulin means it creates inflammation inside the body, which in turn shuts down fat loss, resulting in formation of more fat inside the body. This is a vicious cycle.
4	If you are a smoker, quit smoking. If you consume alcohol, limit it’s intake.
5	Do exercises every day. Exercise is the best way to keep your body fit. Take the example of Cricketers like Virat Kohli or film stars like Salman Khan, Shahrukh Khan, Akshay Kumar etc. They all do intensive exercises in the gym. If you are unable to go to the gym, find out exercises which you can do at home or outside and the time frame for it. Exercises should normally cover muscles of the upper, middle and lower body. By reducing carbohydrates in your meal and increasing the intake of proteins, coupled with exercises, the body will take good shape and will be fit.
6	Get adequate and sound sleep. Lack of proper sleep is one of the important factors which lead to insulin resistance. Ensure to get 6 to 8 hours of sleep according to age.
7	Manage your stress. Stress can be acute and chronic affecting people differently. Acute stress is caused by a specific event. Chronic stress is caused by an ongoing situation like job related stress, or a relationship related issue. Stress can also be caused by traumatic events like a disaster or physical abuse. It can also be related to finance. Failing health could also be another cause for stress. Stress affects us physically, emotionally, behaviourally. Best way to deal with stress is doing regular exercises, meditation and deep breathing, prioratising tasks to set realistic goals, connect with friends, family for emotional support and engage is relaxation activities like hobbies, reading, travelling, connecting to nature etc.

By doing these small changes, you will succeed in avoiding any impending disease or disaster. Like the quote says “A stitch in time saves nine”, taking timely action in preventing the onset of diabetes, will be definitely help you to live a long and happy life.