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• Personal Growth

December 2007

By Jamuna Rangachari

With millions joining its ranks by the day, diabetes is fast turning into a modern-day epidemic. a judicious use of alternative and conventional therapies can help one manage it well and lead a  perfectly normal, active life

Diabetics Alert…

• Explore alternatives to keep your sugar level under control. However, even when it has stabilised, do check your sugar levels regularly
• Take special care of your skin and feet
• Make a daily walk and physical exercise a part of your routine
• Practice oil pulling : In the morning before breakfast on an empty stomach, take one tablespoon of oil (preferably sesame) in the mouth. Move oil slowly in the mouth,  rinsing or swishing for 15 to 20 minutes, and then spit it out and rinse mouth thoroughly.
• Drink a glass of water in the morning
• Be very conscious of your diet. Consume a lot of vitamins, minerals and fibrous food, and 1,500 to 1,800 calories with the following break-up:
  • 225 to 275 gm carbohydrates that will yield 900 to 1200 calories
  • 35 to 45 gm of fats that will yield 325 to 400 calories
  • 10 to 80 gm of protein that will yield 275 to 325 calories
• Avoid caffeinated drinks
• Be well stocked with recommended foods to take care of hunger pangs in the appropriate manner
• Practice meditation.

Go Yoga
Pawanamuktasana
Lie down on your back and stretch both your legs. Now leaving the left leg stretched on the ground, bend your right leg at the knee, and bring the bent knee near the chest. Now inhale and press your bent leg on your chest with both hands, which should be interlocked. Keep the breath full in your belly and go on pressing the leg on it. Stay in this position for some time. Now start exhaling, lift your head and try to touch your bent knee with your nose. Inhale and bring your head back in the normal position; also take the leg down and exhale. Repeat this process with your right leg, and then with both the legs.

Ardha Matsyendra Asana
Sit in any comfortable cross-legged position. Straighten the legs out in front. Bend the right knee and bring the heel of the right foot close to the left hip. Inhale and bend the left knee upward and place the left foot flat on the floor to the right of the right leg with the ankle touching the right thigh. While turning the spine to the left, straighten the right arm bringing it around to the outside of the left knee, and grasp the left foot with the right hand. Turn your head as far as possible to the left, and bend the left arm behind your back. Keep your spine, neck and head aligned and continue to exert effort at turning to the left. Repeat the posture for the other side by reversing directions.

Paschimottanasana
Sit on a mat with your legs stretched straight out in front of you. Breathe out. Slowly bend forward, trying to touch your feet. Don’t bend your knees. If you feel a constriction while bending, straighten up slightly and then try and bend further forward. Don’t push yourself too hard. You may not be able to get very far if you are a beginner. Don’t get impatient and push yourself too hard. You will only injure your muscles. Just bend forward as far as you can go. It is important that you hold this pose. There is no point in just bouncing back and forth. Exhale, while returning to normal position.

Viparita karani mudra
Lie flat on your back and keep your legs together, and your arms on their respective sides. Inhale, press your palms down, and raise your legs slowly together, without bending the knees or raising the hands till they are perpendicular to the floor. Exhale completely. Inhale deeply and exhale slowly. While exhaling, press the palms down again, and without bending the knees or raising the head, move the legs towards the head. While doing this, raise the hips and the small of the back also from the floor, and curve up the lower part of the spine. Bring the legs parallel to the root. Take a deep breath and breathe normally a few times. Bend the arms at the elbows and support the slanted trunk with the palms which should press the upper portion of the posterior on each side. Inhaling, bring back the legs again perpendicular to the floor, using the elbows as a fulcrum. Exhale and breathe normally. Keep the knees straight and the feet together. Fix your gaze on the tips of the big toes. Maintain this position for about three minutes. Return to the starting position in the reverse order.

Dhanurasana
Lie on your face, legs together, hands straight by the side of the thighs, chin resting on the ground. Fold the legs at the knees and bring them on the thighs. Knees must remain together. Bring your hands backward and hold the toes of respective legs with the thumb and forefinger of the respective hands. Raise your legs a little up and simultaneously raise your head and chest. Holding the toes, pull the legs towards ears and bring the toes near the ear. Gaze in front. While returning to this original position, loosen your hands, take legs backward, let the thighs touch the ground, leave the toes and ultimately bring the legs and hand to the first position.

The other asanas that are useful are sirshasana, sarvasangasana,  tadasana, mandukasana, supta pawanmuktasana, trikonasana, katichakrasana, matsyasana, yogamudrasana, mayurasana, navkasana and paschimottanasana.  Among the pranayamas, Kapaal bhati and anuloma viloma pranayama is recommended.

* It is advisable to learn the yoga asanas under the guidance of a practitioner.

Food for Health
Recommended allopathic diet (1,500 – 1,600 calories)
Early morning: 1 cup of non-sweetened milk, 1 cup of herbal tea, 1 slice of bread or 1 idli.
Mid-morning: 1 cup of buttermilk or some fruit.
Lunch: 2 small chapattis (with 1 teaspoon ghee), 1 cup of cooked vegetable, 1 cup of dal, salad of raw vegetables that can be consumed without restriction (see below), 1 cup of buttermilk or curd.
Afternoon: 2 slices of wholewheat bread, or 2-3 non-sweet biscuits.
Dinner: 1 cup of boiled rice or khichri (with 1 teaspoon ghee), 1 cup of dal or curry, 1 cup of cooked vegetable, salad of raw  vegetables that can be consumed without restriction (see below), 1 cup of buttermilk or curd.
Before retiring: three-fourths to 1 cup of non-sweetened milk.

Binge away!
The following vegetables – cabbage, cauliflower, cucumber, brinjals, karelas, ladies’ fingers, tomatoes, radish, chillies, are not at all restricted for diabetics as the carbohydrate content of these vegetables is very low. Such vegetables can be taken as much as desired in the raw form; however they should not be consumed more than a cupful if cooked.

Wonder foods
Karela (bitter gourd)
This is sometimes called a plant insulin as it contains insulin-like qualities, and lowers the blood and urine sugar levels. Needless to say, it should be consumed liberally by diabetics.

Methi (fenugreek seeds)
Methi seeds soaked and sprouted can be consumed with the water in which it is soaked for best results. Powdered methi with unsweetened milk would also be helpful.

Curry leaves
Ten fully grown curry leaves consumed every day is therapeutic.

Amla (gooseberry)
With a lot of vitamin C content, amla adds a lot of resistance in diabetics. What’s more, powdered  methi with amla juice on an empty stomach can stave off diabetes if taken regularly.

Neem, tulsi and belpatra are great for keeping sugar levels under control. Boil ten leaves of each in water and have it every day on an empty stomach.

Will I live forever almost like a vegetable?” thought Shanti Taneja, who, due to diabetes, had eczema and severe pus formation in her legs, causing a grotesque swelling for the last 10 years. Continually on medicines, her blood sugar remained high at 250 mg/l, and the additional medication she had to take for her other problems made her extremely weak. She could not move about comfortably, felt extremely tired, and so depressed that she almost lost the will to live. As a last resort, she decided she must try alternative therapies, and honed on to Naturopathy. The results were miraculous. Just after a month of Naturopathy therapy with Delhi-based Dr Salila Tiwari, she lost 10 kilograms and was back on her feet. Her sugar level became absolutely normal at 120 mg/l in six months. Regular yoga, pranayama and a disciplined diet drastically low on sugar has ensured that, at the age of 66, she is much more energetic than even non-diabetics. “I am certain that with my new lifestyle diabetes is history for me,” she says with a confidence that comes from having been off medicines ever since.

If Shanti Taneja can free herself of diabetes, so can you. And that is a wonderful hope to clutch to as India progresses ever more rapidly to justify its dubious distinction of being the world’s diabetes capital, according to the World Health Organisation.

India is expected to have 57 million diabetes patients by 2025, thanks to erratic work schedules and improper food habits. The ‘lifestyle disease’ – known to be restricted to urban population in the country till a few years ago – has now invaded rural India as well, with as much as 3 per cent of the total rural population being diagnosed with diabetes.

What and how?
Diabetes is of two types, one which is characterised by excretion of large amounts of very dilute urine, called diabetes insipidus, but the one which is most common and often referred to when we say diabetes, is diabetes mellitus.

Diabetes mellitus is of three types, type 1 (which occurs at a young age), type 2 (which occurs in people above 40), and gestational diabetes (which occurs rarely during pregnancy). All the types have similar signs, symptoms, and consequences, but different causes and population distributions.

The cause of the disease is mainly unproven, though there are many hypotheses and risk factors such as increasing age, obesity, physical inactivity, and a family history.

Whatever the type may be, the root cause of the disease is that the pancreas does not make enough or any of the hormone insulin, or does not use the available insulin effectively, causing the level of glucose in the blood to remain too high.

The classic triad of diabetes symptoms is polyuria, polydipsia and polyphagia, which in common parlance are frequent urination, increased thirst, and increased appetite respectively. Symptoms may develop quite rapidly (within weeks or months) in type 1 diabetes, particularly in children. However, they develop much more slowly in type 2 diabetes, and may be quite subtle or completely absent. Type 1 diabetes may also cause weight loss (despite normal or increased eating), and irreducible fatigue. These symptoms can also manifest in type 2 diabetes in patients whose diabetes is poorly controlled.

Type 1 diabetes, in which insulin is not secreted by the pancreas, is directly treatable only with injected or inhaled insulin, although dietary and other lifestyle adjustments are part of management. Type 2, the most common one, as it usually affects people over the age of 40, is managed with a combination of diet, tablets, injections and, frequently, insulin supplementation.

Early detection of the disease can make a lot of difference, and hence, regular tests are advisable for all, particularly if one has a family history, is constantly feeling tired and emaciated, with significant weight-loss for no apparent reason, or is having urinary complaints that are not otherwise explained.

The complications
Diabetes, unfortunately, can bring with it a range of problems, from minor issues to chronic illnesses:

• Hypoglycaemia that is derangement of functions that can range from vaguely “feeling bad” to coma and (rarely) permanent brain damage or death
• Ketoacidosis when cells do not have sufficient glucose to meet their metabolic demand
• Nonketotic hyperosmolar coma – a rare type of coma
• Cardiovascular disease, in which the risk of a heart attack is doubled
• Renal failure that could lead to a requirement for dialysis, or even organ transplantation
• Eye problems, particular ly in the retina
• Diabetic neuropathy, where nerves are damaged.
• Microvascular damage, which may cause impotence and poor healing. Poor healing of wounds, particularly of the feet, that could even lead to gangrene and amputation.

This may sound alarming, but it is better to be aware of the gravity of the situation and take active steps for recovery than to exist in a false sense of security. Yes, diabetes has grave consequences, which is why it is vital that you scroll through the options given below, and find a method that will help you to actively manage it, and inshallah, be free of it too! The difference between allopathy and alternative therapies lies in one important mental consideration – you need to exercise your will for the latter. Alternative therapies demand that you take active interest in your well-being, and in fact, take responsibility for it. That is their challenge, but once we learn to rise to it, we will be rewarded not just with better health, but also with a greater confidence in our ability to steer our health.

The Pressure Techniques
“Even with medication, my sugar level which was detected at 300 mg/l did not come below 250 mg/l,” says Deepti Parekh from Bangalore. As she also suffered from hypoglycaemia, the dosage of medicine could not be increased, and she endured attacks of shivering, break-out of sweat and considerable fatigue. With the help of Ketan Shah, a renowned Acupressure practitioner in Bangalore, the level stabilised at 120 mg/l, though medicines are still required. “Acupressure is marvellous,” she says, admitting to feeling much more in control of her life. Mr J Vohra, distributor of surgical equipment in Bangalore, too echoes the same sentiment as he has been able to bring down his sugar levels drastically, and halve the dosage of medication with Mr Shah’s help.

“The entire approach on treating diabetes is different in Acupressure,” says Mr Shah. Unlike Type 1 and Type 2 classification, this ailment is classified based on the organs that are affected. The first type of problem is when people drink much more water than before, and also feel tired and sleepy after food. These are the symptoms of spleen weakness, and hence by activating the spleen through its Acupressure point, the pancreas also get activated. The second type is that of excessive urination, leg pain and loss of weight which is due to bladder weakness, and hence activation of the bladder point and spleen point helps. Skin allergy and itching with diabetes is due to lung weakness, and therefore it is the lung point that is to be addressed. Body pain and sleepiness is a clear symptom of liver weakness, and it is this that is to be addressed.  When sex drive reduces, leading to even impotency, the points to be addressed along with the spleen are the kidney, the pituitary and pineal glands. Finally, when there is a burning sensation in the feet, leg pain and pins and needle sensation in the foot region, activation of points on the small intestine area are extremely beneficial. “The identification of the specific organ to be addressed leads to almost miraculous results,” he avers, and always ensures that diagnosis is done keeping this in mind.

“Reflexology cannot cure but can surely keep diabetes under control,” says the sprightly 86-year-old Mr I P Bahl, the doyen of Reflexology in India. A diabetic himself, he does take medication, but has managed the ailment so well that his energy levels would put many youngsters to shame.

“It’s such a relief that I feel normal and am able to walk even barefoot now,” says Mrs Jaya Subramanian from Secunderabad, who found it extremely difficult to move around and needed special footwear when her blood sugar galloped to 350-400 mg/l.  She is now much better with her sugar count dropping to 200 mg/l in just 20 days of Sujok therapy with Mr Amarjeet Singh, a Sujok practitioner in Mumbai. Sujok is a variation of Acupressure/ Acupuncture that works on the hands and feet.

Mr Singh uses colours, seeds, semi precious stones, star magnets, along with pressure simulation to get the required result. Micro needles for needling, if required, are injected by him personally, but if the patient cannot come to him, injectors that can give the required simulation are sent. Studying the symptoms helps him diagnose and chart out specific treatments for the patients. Amazingly, many patients, like Jaya Subramaniam, have been treated without a face-to-face interaction.

Naturopathy
Naturopathy combines yoga, pranayama, cleansing routines like enema and steam bath to stave off the excess matter, and activate the pancreas. As per its principles, all ailments are due to the malfunctioning of our digestive, absorptive, assimilative or eliminatory organs, and the aim is to activate and decongest the pancreas.

Shanti Taneja, as we saw earlier, has had an amazing recovery, and so has Rita Rawat, 44, who has gone off medicine ever since her Naturopathy treatment this January, and swears by her new lifestyle adapted since then. The recommended Naturopathy diet is as follows:

Early morning: 1 glass of water followed by lime and honey mixture
Breakfast: 1 glass of fruit juice and fruits
Lunch: 2 small chapattis made from aata that combines 1 kg jowar, 1 kg barley, 1 kg bajra, 1 kg corn, 1 kg black channa, 1 kg soya bean and 250 gm methi, 1 cup of cooked vegetable, 1 cup dal, salad of raw vegetables.
Afternoon: One glass of vegetable juice or coconut water.
Dinner (at around 7.30 pm):2 small chapattis made with mixed flour as above, 1 cup of cooked vegetable, salad of raw vegetables.

The other points to be kept in mind always are that the ratio of vegetables should be more than cereals, sprouts are to be consumed in large quantities, and rice, if consumed, should be unpolished. A weekly non-cereal day is highly recommended, and so is a daily walk, yoga and pranayama.

Homoeopathy
Homoeopathy works on matching the profile of the patient with the right prescription. Arsenicum album, Bryonia alba, Rhustox, Nat. Sulph, Phosphorus and Syzygium have been found to be effective in various cases of diabetes. But careful profiling is a must. As Deepak Kashyap, who specialises in integrated medicine, cautions, “The choice of exact remedy matching the patient is extremely important, and therefore, care should be taken that one consults a good Homoeopath before going ahead with Homoeopathy. Dr Nitin Shah, a Homoeopath in Mumbai, concurs saying, “Diabetes is a complex disease, and therefore, the patient should be profiled carefully before any drug is prescribed.” He further cautions that regular sugar tests must continue to be taken even after the level has stabilised. “With careful profiling, a drop in sugar levels can be seen within three months,” says Dr Raman, a Homoeopath in Chennai, a diabetic himself  At the age of 62, he was diagnosed with diabetes with sugar levels varying between 250 and 280. Now, with Homoeopathy and Ayurveda, his sugar remains controlled between 90 and 140 and he is fit and active at the age of 75.

Ayurveda
“I recommend Mersina of J&J Dechane to all my diabetic patients as it is extremely effective in controlling the other complications of diabetes, like liver and kidney weakness,” says Dr Raman, who believes firmly in focusing on the good of the patient, and not be limited by labels of the therapy one is practising.

“Within a month, my sugar count has dropped by 40,” says Mrs Veda Rao from Bangalore, who is confident that her sugar levels will soon be perfectly manageable with the help of Dr Balamurali Krishna of the Amrutabharatichikitsalaya,Bangalore. The kendra run by Sri Ramachandrapura Mutt, uses Ayurvedic medicines along with distilled cow urine, believed to have anti-diabetic properties, and therefore a catalyst for healing.

As soon as tests revealed diabetes in its nascent stage, Dr Kapoor (name changed), an allopath in a leading hospital in Delhi, approached Mr Kashyap and brought his sugar levels under control with Ayurveda within 20 days. So much so that when he went for another sugar test the following month, his colleagues exclaimed on comparing the two reports, “This is quite unbelievable. One of the tests is not yours!” Mr Kashyap rates Ayurveda as the best option for diabetes, saying, “Though consulting a practitioner is the best, even off-the-shelf remedies such as Shilaprameha Vati of Vyas, X Diaba of Surya and Swami Ramdev’s Madhulnashini Vati are effective.

Diet and Lifestyle
Universally, everyone agrees that diet is the most important factor in healing or even managing diabetes. If one can cultivate the discipline to abide by dietary regulations, diabetes is likely to come under control.

Ironically, diet is one area where a diabetic does not get adequate guidance. The instructions are limited to prohibiting or curtailing the use of refined sugar, jaggery, rice, potatoes and fried eatables. However, besides the things to be avoided, a diabetic should also be supplied with a list of things to be eaten, the right amounts of those foods, and the proper timings for taking those foods.
Some diabetics, heeding the advice of their relatives or friends, observe fasts or opt for fad diets consisting of one or two food articles. This gradually leads to depletion of vitamins and minerals stored in the body, and gives rise to symptoms of that deficiency. Besides, sooner or later, the tongue may rebel against a monotonous diet.

The fact, however, is that a diabetic can choose his diet from a variety of food articles. He need not stay away from the tastes he likes. Similarly, he need not consume food that is entirely different from that prepared for the rest of his family. Wheat, rice or bajra are similar in their nutrient contents. Likewise, most vegetables have similar nutrients. Thus, there is no reason why a diabetic should eat the same cereal or the same vegetable day after day.

Blood Sugar Chart

*All values are in milligrams

For the diabetic, an ideal diet is one in which 55 to 60 per cent consists of carbohydrates, 20 to 22 per cent of fats and 18 to 20 per cent of proteins. Further, a diabetic should receive a larger than usual quota of vitamins and minerals, and it is also desirable that the fibre content of the diet is high. For if a diet is rich in fibre, the absorption of glucose through the intestines is slowed down. Consequently, the blood sugar level rises gradually. The pancreas  is able to cope with such a situation very easily. Vegetables, fruits, whole cereals, and whole pulses are excellent sources of fibre. By removing bran from the flour, by eating polished rice, by keeping away from fruits-vegetables, and by consuming processed, refined and soft foods, we invite not only diabetes but also other diseases, right from constipation to cancer.

On the basis of the above, the calorie break-up of a meal needs to be taken into account, and a diet plan for the whole day planned. In fact, there are even some foods that one can consume in an unrestricted manner, and wonder foods that can actually be therapeutic (see box).

Skin and Foot Care
Increased chances of contracting an infection, inadequate blood-supply, and impaired sensations are the three factors which endanger a diabetic’s skin and feet. A diabetic should wash and dry his skin well, and always remain alert to prevent an injury to the skin. He should take extra care while scratching his skin or while shaving. He should see that his skin does not graze against the wall or a rough surface. In spite of all precautions, if the skin is injured, the wound should not be allowed to get infected,   and he should take immediate action.

“Care for your feet more than your face,” is a motto diabetics will do well to heed. The feet should be washed twice a day with soap and warm water. While washing the feet, the nails, the toes, and the skin between the toes should be minutely observed. The feet should then be wiped dry with a soft cloth. In diabetics, the skin between the toes easily gets injured or infected with fungus. So a diabetic, after washing his feet, should apply a cream or an ointment like lanolin between his toes. Further, a diabetic should never move barefoot. In his home, he should wear light slippers. While going out, he should wear soft (e.g., canvas) shoes. Tight or pointed shoes are not desirable for a diabetic because they obstruct blood circulation, heels are a no-no, and new shoes should initially be worn only for short periods so that a bite does not develop.

Physical Exercise
There is no doubt that brisk, long walks in the morning and evening for at least 45 minutes a day, are not just beneficial, but absolutely necessary for diabetics. As Dr Tiwari says,  “No matter what the therapy, the crucial factor is to digest what one has eaten, and therefore, exercise is absolutely mandatory.”

Yoga
Beyond regular walks, if one incorporates a regular yoga practice, there could be nothing better.

“It is best to start your yoga therapy with the simple stretches called the pawan muktasana series,” says yogacharya Shameem Akthar, who advises that one should then move on to poses that are more effective.

The two most important glands to be addressed in asanas are pancreas and pituitary, and hence all inversion exercises are helpful. With the natural pressure on the abdomen exerted by these poses, the sluggish glands are revitalised, and the pancreas particularly, which is on an overdrive in this problem, is rejuvenated.

“Sugar levels also act up due to stress, and so rest and relaxation is of utmost importance,” points out Salomi Sheth, a certified yoga instructor in Mumbai, who has found that physical exercises alone do not help, and that a holistic approach that relaxes the mind and body is called for.

It is this approach that yoga centres follow across the board. For instance, the teachings at the Sivananda Centre are based around the ‘Five Points of Yoga’ which are proper asanas, proper breathing or pranayama, proper relaxation through the savasana or corpse pose, proper diet that is, a vegetarian diet, positive thinking, and meditation.

Towards integration
As we have seen, a variety of techniques and therapies work together to keep the disease at bay and lifestyle changes are crucial here. Mr Ketan Shah, the Acupressure practitioner, strongly recommends oil pulling for improving one’s metabolism. Dr Raman, the Homoeopath, recommends an Ayurvedic medicine along with Homoeopathy and the required levels of allopathic medication. Maybe diabetes might turn out to be the catalyst for integrated medicine, bringing together the strengths of all systems for the good of the patient.

It is not just systems of medicine that are integrated in diabetes management. The body-mind connection manifests so strongly here that it leaves very little room for doubt. Every diabetic goes through a  period in which his sugar levels are well controlled, the prescribed diet is followed, regular walking happens, and so on. However, the mind takes over, and the patient who was complacent with good sugar controls, craves again for food. A hunger signal that used to be there when sugar reached say a level of 70 mg/dl is now received at a level of 130 mg/dl. Low-fat diets increase craving, and also make the patient at least partially insulin resistant. It is clearly seen, therefore, that insulin resistance is as hormone driven as one’s libido, and is greatly affected by feelings of stress, happiness and bliss.

Louise Hays in her book, Heal Your Life, points out the probable cause of diabetes as a longing for what might have been, a need to control, deep sorrow, and a feeling that no sweetness is left in one’s life. She suggests practising the affirmation: “This moment is filled with joy. I now experience the sweetness of today.” “Diabetes is associated with suppressed anger,” says Martin Brofman, in his book, Anything Can be Healed.  He explains that as the pancreas is on the feeling (left) side of the yellow chakra, the issue has to do with the lack of balance between one’s feeling and state of being, as well as the need for control.

Clearly, from the holistic perspective, the need for control, or the perceived lack of it, is central. And the solution is to let go, to accept things as they are. This is not easy and requires inner work. Make the commitment to go within and investigate your inner domain – your thoughts, feelings, reactions, and so on. Get to know yourself. Find out who you are, what are your longings, your hurts and so on. The inner self longs to be acknowledged, and given conscious attention. That apart, it is in knowing yourself that you unleash your inner stores of knowledge, wisdom, strength and even healing. Among the methods most often advocated for inner work is meditation, of which there are many types. Affirmations of feeling loved, and of accepting one’s life and one’s relationships can also be deeply healing and consoling.

Hope comes in many forms. Choose whatever suits you best or try a smorgasbord of options. Go