The Truth About Sugar and Heart Disease: Beyond Cholesterol

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The Truth About Sugar and Heart Disease: Beyond Cholesterol

When we think about heart disease, cholesterol levels usually steal the spotlight. But in recent years, scientists have uncovered a hidden culprit that may be as dangerous—if not more so—than cholesterol: excess added sugar.

It’s not just the occasional dessert that’s the problem. The everyday sugar hidden in your soda, flavored yogurt, ketchup, or breakfast cereal could be quietly damaging your cardiovascular system.

How Much Sugar Is Actually Dangerous?

Research published in JAMA Internal Medicine shows that people who consume 25% or more of their daily calories from added sugars are almost three times more likely to die from heart disease than those who keep sugar to less than 10% of their calories.

To put that into perspective:

  • If you consume 2,000 calories a day, 25% from added sugar equals about 125 grams or 31 teaspoons of sugar—roughly the sugar in two 500 ml bottles of soda.
  • Even one sugary drink per day has been linked to an 18% higher risk of cardiovascular disease.

A Swedish study involving nearly 70,000 adults found that sugary drinks were especially dangerous—far more harmful than occasional sweet snacks like cookies or chocolate. The lowest heart risk was seen in people who indulged in sweets only occasionally, while regular drinkers of sodas and sweetened juices faced a sharply higher risk of stroke, heart failure, and irregular heart rhythms.

Why Sugar Is So Damaging to Your Heart

  1. It Messes with Your Blood Lipids
    Excess sugar raises LDL (“bad”) cholesterol, lowers HDL (“good”) cholesterol, and increases triglycerides—a fat in the blood linked to blocked arteries.
  2. It Promotes Weight Gain
    Sugar is loaded with “empty calories”—energy without nutrients—which can lead to obesity, itself a risk factor for high blood pressure, type 2 diabetes, and heart disease.
  3. It Triggers Chronic Inflammation
    Over time, consistent high sugar intake causes low-grade inflammation inside your blood vessels, making it easier for fatty plaques to form—a process known as atherosclerosis.
  4. It Overloads Your Liver
    Too much sugar, particularly fructose found in sweeteners and sodas, is processed by the liver, leading to non-alcoholic fatty liver disease. This can worsen insulin resistance and impact heart health.
  5. Liquid Sugar = A Hidden Danger
    Calories in liquids don’t trigger feelings of fullness, meaning you often consume more without realizing it. This makes sodas, sports drinks, and sweetened coffees a double threat—empty calories plus overconsumption.

The Domino Effect on Heart Health

High sugar intake can set off a dangerous chain reaction that leads to serious conditions, including:

  • Heart Attacks (Myocardial Infarction)
  • Stroke (both ischemic and hemorrhagic)
  • Heart Failure
  • Aortic Aneurysm
  • Atrial Fibrillation (irregular heartbeat)

What’s alarming is that these risks are present even if you’re not overweight—meaning sugar’s effects go beyond just weight gain.

Do You Need to Quit Sugar Completely?

Probably not—unless you already have advanced heart disease or diabetes. The research suggests occasional sweet treats in a balanced diet are unlikely to cause harm.

The real problem is frequent and excessive intake, especially from sweet drinks and ultra-processed foods.

Think of sugar like alcohol: a small glass of wine occasionally isn’t a health crisis—but regular overconsumption is.

How to Reduce Your Sugar Intake Without Feeling Miserable

  • Follow the 10% Rule: Keep added sugars under 10% of your total daily calories. For most adults, that’s less than 50 grams (about 12 teaspoons) per day.
  • Target Drinks First: Cut soda, energy drinks, sweetened fruit juices, and flavored coffees—they’re the biggest sugar source for many people.
  • Choose Whole Foods: Opt for whole fruits, milk, and plain yogurt—it’s the natural fiber or protein that slows sugar absorption.
  • Read the Labels: Sugar hides under names like high-fructose corn syrup, dextrose, maltose, cane juice, molasses, and more.
  • Rewire Your Sweet Cravings:
    • Sweeten foods naturally with fruits or spices (like cinnamon).
    • Gradually reduce sugar in your tea or coffee to retrain your taste buds.
  • Don’t Rely on Exercise Alone: Physical activity is crucial, but it can’t erase the harmful metabolic effects of excess sugar.

A Quick Reality Check on Popular Drinks

Drink

Approximate Sugar Content

500 ml regular soda

50–55 grams (12–14 tsp)

Flavored iced tea (bottle)

35–45 grams (9–11 tsp)

Fancy coffee with cream/syrup

30–40 grams (7–10 tsp)

Sports drink (500 ml)

30–34 grams (7–8 tsp)

250 ml fruit juice

20–25 grams (5–6 tsp)

Bottom Line

High sugar intake—especially from drinks—isn’t just a “weight gain” issue. It directly impacts your cholesterol profile, blood pressure, inflammation levels, and liver health, all of which can set the stage for life-threatening heart problems.

If you’re serious about protecting your heart:

  • Prioritize cutting back on sugary drinks
  • Watch for hidden sugars in packaged foods
  • Enjoy treats in moderation
  • Build meals around whole, nutrient-rich foods

Even small changes—like replacing one soda a day with water—can have long-term benefits.

Dr. Karthik Munichoodappa
 MBBS, CCEBDM, P.G. DIP. IN DIAB. (U.K.)
Diabetes Care Physician
DiaFine – Karthik Hospital, Bangalore, Karnataka



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Diabetes and Portion Control: How to Eat Healthy Portions

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Diabetes and Portion Control: How to Eat Healthy Portions

Proper portion control plays a vital role in managing diabetes. In India, where servings are often generous and food is a central part of celebration and daily life, learning to eat the right portion sizes can support blood sugar control and overall well-being.

Why Portion Control Matters in Diabetes

Diabetes is directly linked to how the body processes carbohydrates and other nutrients. Eating large portions—especially of high-carb foods—can lead to spikes in blood sugar levels. Consistently eating more than your body needs may also contribute to weight gain, which is another risk factor for insulin resistance and poor diabetes control.

Practicing portion control helps to:

  • Stabilize blood sugar after meals
  • Prevent overeating
  • Support weight management
  • Make room for balanced meals with all key nutrients

Common Portion Pitfalls in Indian Meals

Traditional Indian meals are delicious but often come in big helpings—think large bowls of rice, extra chapatis, or a mountain of pulao. Serving sizes can quickly add up at home, festivals, or when dining out.

Common pitfalls include:

  • Overfilling plates with rice, biryani, or pulao
  • Multiple chapatis or parathas in one meal
  • Generous servings of fried snacks
  • Unlimited helpings during social gatherings
  • “Clean your plate” culture from childhood

Practical Ways to Practice Portion Control

1. Visual Portion Guides

Use your hand as a simple measuring tool:

  • Fist: Amount of cooked rice or whole grains (about one cup)
  • Palm: Serving of protein (paneer, chicken, fish)
  • Thumb: Fats like oil, ghee, butter, or nuts
  • Cupped hand: Fruits or non-starchy cooked vegetables

2. Use Smaller Plates and Bowls

Switch to plates that are 8–9 inches wide (instead of large thalis) and use small bowls for rice or dessert. This helps you feel satisfied with less food while preventing over-serving.

3. Fill Half Your Plate with Vegetables

Prioritize non-starchy vegetables (like bhindi, lauki, spinach, carrots, cabbage, cauliflower, etc.) to add volume and fiber. They are low in calories and carbs, making them safe for more generous portions.

4. Measure Carbohydrates

  • Rice or chapati: Limit rice to ½–1 cup cooked, or 1–2 small whole wheat chapatis per meal.
  • Breads: Avoid double/triple servings of naan, paratha, or puri—stick to one or split with someone.
  • Snacks: Take nuts or roasted chana in a small bowl, not straight from the packet.

5. Don’t Skip Meals

Skipping meals can lead to increased hunger later, making you more likely to overeat at your next meal.

6. Practice Mindful Eating

  • Chew slowly to savor flavors and recognize when you are full.
  • Avoid distractions such as TV or mobile phones during meals.
  • Pause between servings and wait for a few minutes before considering a second helping.

7. Plan Treats in Advance

Enjoy traditional sweets and festive foods in controlled amounts. Share desserts or take just a small piece to satisfy cravings without excess.

Portion Control in Indian Restaurants and Buffets

  • Choose thali options with a higher proportion of salad or vegetables.
  • Limit refills of rice, biryani, or high-carb dishes.
  • If eating out, request half-portions or share large items.
  • Avoid all-you-can-eat buffets and instead opt for a la carte meals.

 

Final Tips

  • Portion control doesn’t mean eating tiny amounts—it means eating the right amount for your health needs.
  • Preparing food at home gives you better control over portions and quality.
  • Keep measuring cups or spoons handy to portion servings accurately until you develop a good sense of serving sizes.

Remember: Consistency with portion control, along with healthy food choices, will make a big difference in how you control your blood sugar and sustain your energy and health in daily life.

Dr. Madhusudan R.L.
Consultant Physician and Diabetologist
MBBS., D. Diabet, Fellow in Diabetology
(S Johns Hopkins University USA)

 

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Diabetes and Sleep: Why Sleep Matters

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Diabetes and Sleep: Why Sleep Matters

When it comes to managing diabetes, most people focus on balanced meals, physical activity, and medication. But one key piece of the puzzle often gets overlooked—sleep. While we often see sleep as “rest for the body,” in reality it’s one of the most powerful tools we have to maintain overall health, especially when living with diabetes.

Sleep and Diabetes: A Two-Way Relationship

The link between sleep and diabetes isn’t one-directional—it works both ways. Poor sleep can worsen blood sugar control, and poorly managed blood sugar can, in turn, interfere with sleep.

  • Short sleep duration (less than 6 hours) has been linked with higher fasting glucose, increased HbA1c levels, and reduced insulin sensitivity.
  • Too much sleep (over 9 hours) can also indicate or contribute to underlying health challenges, including obesity and insulin resistance.
  • According to the Centers for Disease Control and Prevention (CDC), adults should aim for 7–9 hours of quality sleep each night.

This balance matters because your body is hard at work during rest—repairing cells, regulating hormones, and restoring energy, all of which are crucial for diabetes management.

How Poor Sleep Affects Blood Sugar

  1. Insulin Sensitivity Declines
    Studies show that after just one night of insufficient sleep, the body becomes less efficient at using insulin. This means glucose stays in the bloodstream longer, raising blood sugar levels.
  2. Cortisol Spikes
    Sleep deprivation increases cortisol—the “stress hormone”—which in turn raises blood sugar. High cortisol also makes it harder to lose visceral (belly) fat, a risk factor for type 2 diabetes.
  3. Appetite Control is Disturbed
    Poor sleep reduces leptin (the hormone that signals fullness) and increases ghrelin (the hormone that signals hunger). This hormonal change creates stronger cravings for carbohydrate-rich and sugary foods.
  4. Energy and Motivation Drop
    Feeling overly tired often leads to skipping workouts, grabbing quick unhealthy meals, or late-night snacking—all of which disrupt healthy routines.

Common Sleep Disorders in People with Diabetes

People living with diabetes often face sleep challenges beyond the typical tossing and turning.

  • Obstructive Sleep Apnea (OSA):
    Strongly linked with type 2 diabetes, OSA causes repeated breathing interruptions during sleep. Left untreated, it not only makes you feel tired but also worsens insulin resistance and blood pressure.
  • Restless Legs Syndrome (RLS):
    Due to nerve damage (diabetic neuropathy), many people experience unpleasant sensations in their legs that make it hard to fall asleep.
  • Nocturia (Frequent Night Urination):
    High blood sugar increases the urge to urinate, leading to multiple trips to the bathroom at night and disrupting deep sleep cycles.
  • Nighttime Hypoglycemia:
    People on insulin or certain medications may experience sudden dips in blood sugar at night, which can cause night sweats, nightmares, or sudden awakenings.

Why Prioritizing Sleep is Essential

Getting consistent, quality sleep supports:

  • Better glucose control: Stable blood sugar throughout the day and improved HbA1c readings.
  • Heart health: Reduced risk of high blood pressure, stroke, and heart disease.
  • Weight management: Sleep helps regulate appetite and energy expenditure.
  • Mental well-being: Adequate rest lowers anxiety and depression risk, which are often higher in people living with diabetes.
  • Stronger immunity: Sleep deprivation weakens the immune system, making infections (which people with diabetes are more prone to) harder to fight off.

Sleep Hygiene Tips for People with Diabetes

If sleep has been a challenge, here are proven strategies you can start with:

1. Set a Consistent Schedule

Go to bed and wake up at the same time daily—even on weekends. This helps your body establish a healthy internal clock.

2. Design a Sleep-Friendly Environment

  • Room should be dark, cool, and quiet.
  • Use blackout curtains or an eye mask.
  • Keep electronics out of the bedroom to reduce blue-light stimulation.

3. Watch Your Evenings

  • Avoid caffeine or nicotine 6 hours before bedtime.
  • Minimize alcohol—it disrupts deep sleep and can destabilize blood sugar.
  • Avoid heavy dinners or high-carb snacks late at night.

4. Balance Blood Sugar Before Sleep

  • Eat a light, protein-rich snack (like Greek yogurt or nuts) if prone to nighttime lows.
  • Check your blood sugar before bed if needed, especially if you’re on insulin.

5. Stay Active During the Day

Regular exercise can improve sleep quality, reduce stress, and support glucose control. Just avoid vigorous workouts 2–3 hours before bedtime.

6. Address Underlying Problems

If you suspect sleep apnea, restless legs, or nighttime hypoglycemia, speak with your doctor. Treatment can dramatically improve sleep, energy, and metabolic health.

A Practical Night Routine for People with Diabetes

Here’s a simple framework to wind down at night:

  • One hour before bed: Turn off electronics, dim lights.
  • 30 minutes before bed: Light stretching, reading, journaling, or meditation.
  • At bedtime: Keep water nearby, make sure blood sugar is stable, and set the environment for comfort.

Final Thoughts

Sleep is not just about feeling rested—it’s an essential pillar of diabetes care. By balancing blood sugar and prioritizing rest, you not only improve day-to-day energy but also prevent long-term complications of diabetes.

 Dr. Praveen Kumar N S

MBBS, MD (Gen. Med.), DNB (Endocrinology)
Consultant Endocrinologist & Diabetologist
Dr. Praveen's Endocrine Centre
Mysuru, Karnataka. 570009.



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Diabetes-Friendly Foods: Healthy Eating for Blood Sugar Control

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Diabetes-Friendly Foods: Healthy Eating for Blood Sugar Control

Managing diabetes in India comes with unique challenges and opportunities due to our diverse cuisine, cultural habits, and food availability. A well-planned diet that aligns with traditional Indian flavors yet supports blood sugar control is essential for living well with diabetes.

Why Food Choices Matter in Indian Diabetes Care

India has one of the highest numbers of people living with diabetes globally. Many Indian diets are rich in carbohydrates, often from white rice, breads, and sweets, which can cause rapid blood sugar spikes. However, Indian cuisine also offers many naturally diabetes-friendly ingredients that help stabilize blood sugar when chosen wisely.

Core Principles for Diabetes-Friendly Eating in India

  • Prefer whole grains over refined grains
  • Include plenty of fiber-rich vegetables and legumes
  • Opt for lean proteins from vegetarian or non-vegetarian sources
  • Incorporate healthy fats from nuts, seeds, and oils
  • Practice portion control, especially with carbohydrate-rich foods

Diabetes-Friendly Indian Foods to Include

Whole Grains and Millets

Switching to whole grains is a cornerstone for blood sugar management. Instead of white rice or refined wheat flour, consider:

  • Brown rice or red rice varieties
  • Millets such as ragi (finger millet), jowar (sorghum), bajra (pearl millet), foxtail millet, and barnyard millet
  • Whole wheat or multi-grain chapatis instead of refined flour ones
  • Oats and cracked wheat (dalia) for breakfast

These grains have a lower glycemic index and more fiber, which slows down sugar absorption.

Lentils and Legumes

These are staples of Indian meals and excellent sources of protein and fiber:

  • Moong dal, masoor dal, toor dal, chana dal
  • Chickpeas (chole), kidney beans (rajma), black gram (urad dal)
  • Sprouted lentils enhance nutrient bioavailability and aid digestion

Vegetables and Leafy Greens

Fresh vegetables are a vital part of Indian meals and provide essential vitamins, minerals, and fiber:

  • Bitter gourd (karela), which may help reduce blood sugar
  • Bottle gourd (lauki), ridge gourd (torai), and snake gourd (chichinda)
  • Spinach, fenugreek leaves (methi), amaranth leaves (chaulai), and other greens
  • Cauliflower, cabbage, carrots, tomatoes, and bell peppers

Choose seasonal, locally available vegetables to keep meals fresh and nutritious.

Lean Proteins

Protein helps keep blood sugar steady and supports muscle health:

  • Paneer (in moderation, preferably homemade or low-fat)
  • Low-fat dairy such as curd and buttermilk
  • Eggs, chicken, fish, and lean meats for non-vegetarians
  • Tofu and soy-based options for vegetarians

Healthy Fats

Use healthy fats while cooking and garnishing:

  • Mustard oil, groundnut oil, and olive oil in moderation
  • Nuts like almonds, walnuts, and pistachios
  • Seeds like flaxseeds, chia seeds, and pumpkin seeds

Foods to Limit or Avoid in the Indian Context

  • White polished rice and maida-based products like white bread, puris, and parathas made with refined flour
  • Deep-fried snacks such as samosas, pakoras, and bhujia
  • Sweetened beverages, traditional sweets like jalebi, gulab jamun, and sugary desserts
  • Excessive use of ghee and butter
  • Store-bought pickles and chutneys high in salt and sugar

Tips for Managing Indian Meals with Diabetes

  • Moderate portion sizes of rice and breads; fill half your plate with vegetables.
  • Soak and sprout lentils and beans to increase nutrient absorption.
  • Use traditional spices like turmeric, cinnamon, fenugreek, and coriander, which may improve blood sugar metabolism.
  • Eat slow-cooked foods like dals and khichdi to improve digestion and glycemic response.
  • Avoid eating late-night heavy meals; aim for your last meal at least 2-3 hours before bedtime.

Final Words

Adopting a diabetes-friendly diet in India doesn’t mean giving up the joy of flavorful food. By making informed choices—embracing whole grains, fresh vegetables, healthy fats, and balanced proteins—you can enjoy meals that keep your blood sugar steady and your taste buds satisfied. Small, consistent changes to your traditional eating habits will bring great benefits to your diabetes management journey.

 

Prof(Dr)Tirthankar Mukherjee

MBBS, MD (Internal Medicine), DNB ( Internal Medicine) , 
MRCP ( UK) , MRCP ( Edinburgh), MRCEM ( London), FRCP (Edinburgh)
Member of National Academy of Medical Sciences New Delhi( MNAMS)
Professor & Senior Consultant KIMS Bengaluru.

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Prediabetes in India: The Silent Epidemic Affecting 136 Million Lives

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Prediabetes in India: The Silent Epidemic Affecting 136 Million Lives

Prediabetes is emerging as one of the most pressing health concerns in India. With a rapidly rising number of affected individuals and significant differences across regions, understanding the scope, risks, and solutions for prediabetes has never been more critical.

What Is Prediabetes?

Prediabetes is a condition in which blood sugar levels are elevated, but not high enough to qualify as diabetes. It serves as a crucial warning sign — without intervention, there’s a high risk that these levels will progress to type 2 diabetes, as well as related complications such as heart disease and stroke.

Alarming Numbers: The Scale of the Problem

  • Estimated cases in 2024: Approximately 136 million Indians have prediabetes, compared to 101 million diagnosed with diabetes. This means more than 1 in 10 people are living in the prediabetic stage.
  • Urban vs. Rural: The prevalence is nearly identical in urban (15.4%) and rural (15.2%) communities, showing that lifestyle diseases are no longer confined to cities.
  • Large-scale study results: A nationwide HbA1c study of almost 2 million adults found that 22.25% were classified as prediabetic, with 27.18% labeled as diabetic — highlighting both the magnitude and urgency of the issue.
  • Regional differences: States like Odisha report the highest rates, while Jammu & Kashmir shows the lowest, underscoring the impact of local factors such as diet, lifestyle, and socioeconomic conditions.

Why Is Prediabetes on the Rise?

Key Contributing Factors

  • Diet and Lifestyle: A shift towards unhealthier diets, reduced physical activity, and increased consumption of processed foods is fueling the epidemic.
  • Screening and Detection: Increased diagnostic screening has led to the identification of many previously undiagnosed cases.
  • Socioeconomic disparities: Lower-income groups in some regions show marginally higher rates, potentially due to less access to preventive healthcare and healthy choices.

The Hidden Risks of Prediabetes

Often, prediabetes presents no symptoms. Despite this, it carries a heavy burden:

  • Progression: Indians, on average, progress from prediabetes to diabetes faster than other populations. Without timely intervention, millions could develop full-blown diabetes in the next few years.
  • Complications: Even prediabetic blood sugar levels elevate the risk of cardiovascular diseases, kidney issues, nerve damage, and vision problems.

Preventing and Managing Prediabetes

Screening and Early Detection

Most cases are only found via systematic screening — making regular blood sugar checks vital, especially for those with family history or risk factors.

Intervention Strategies

  • Lifestyle changes: Modifying diet, increasing physical activity, and managing weight have proven effective in preventing progression.
  • Medical management: Some may benefit from medications to reduce blood sugar, but lifestyle is the cornerstone of prevention.
  • Public awareness: Governments and healthcare organizations must prioritize education and affordable screening.

Can Prediabetes Be Reversed?

Yes. With timely and committed lifestyle interventions, prediabetes can often be reversed or controlled, preventing or delaying the onset of diabetes.

Key Takeaways

  • Prediabetes affects over 136 million people in India and is rising sharply.
  • Urban and rural rates are almost identical, indicating a nationwide challenge.
  • Early detection and intervention can prevent progression to diabetes and reduce risk of complications.
  • Regional programs and targeted awareness are urgently needed to address disparities and make a difference.

India stands at a pivotal point in the fight against diabetes, with prediabetes offering an opportunity to curb the epidemic before it worsens. Awareness, screening, and lifestyle modifications can make all the difference — for individuals, families, and the nation as a whole. If you want to learn more about symptoms, screening methods, or management strategies for prediabetes in India, ask for expert guidance today!

Dr Aravinda J

MD,MRCP(London),Triple FRCP(Edinburgh, London, Glasgow) National RSSDI Executive Committee Member President RSSDI Karnataka chapter ( 2018-19 ) Chairman and Chief Diabetologist Dr Aravind's Diabetes Centre Basaveshwara Nagar, Bengaluru.

 

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How Sugar Intake Leads to Weight Gain, Visceral Fat, and Raises Diabetes Risk

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How Sugar Intake Leads to Weight Gain, Visceral Fat, and Raises Diabetes Risk

Understanding the complex relationship between sugar, body fat, and diabetes is crucial for anyone interested in improving their long-term health. While most of us know that too much sugar isn’t good, the specific ways it impacts our bodies—especially through the buildup of visceral fat—are less widely discussed. Let’s break down how high sugar consumption can quietly set off a chain reaction inside your body, ultimately raising your risk of type 2 diabetes.

Sugar: More Than Just Empty Calories

Sugar, especially when added to processed foods and drinks, delivers a hefty dose of calories with little nutritional value. These "empty calories" quickly add up, often leading us to consume far more energy than our bodies actually need. Unlike protein or fiber-rich foods, sugary items often do little to satisfy hunger, making it even easier to overeat.

Excessive sugar intake can also disrupt important metabolic hormones. For example, it can boost insulin levels and, over time, drive our bodies to become less sensitive to this crucial hormone. Sugar intake is also linked to leptin resistance, a phenomenon that can interfere with our natural appetite control. Together, these changes make it easier to gain weight, especially around the belly.

The Role of Visceral Fat: More Dangerous 

Not all fat is created equal. While we often worry about what we see in the mirror, the real concern is the fat we can’t see—visceral fat. This type of fat accumulates deep inside the abdomen, surrounding vital organs like the liver and pancreas. Research consistently shows that diets high in added sugar increase the risk of developing this harmful visceral fat.

Why is visceral fat a problem? Unlike the fat that sits just under the skin (subcutaneous fat), visceral fat is much more active metabolically. It releases high levels of free fatty acids and inflammatory molecules, which travel throughout the body. These chemicals make it harder for your muscles and liver to respond to insulin, leading to a condition called insulin resistance.

Insulin resistance means your body needs to pump out more and more insulin to keep blood sugar stable. Over time, this extra effort can wear out your insulin-producing cells—and that’s when blood sugar starts to rise, opening the door to type 2 diabetes.

Visceral Fat and Chronic Inflammation: A Double Threat

As visceral fat stores grow, they also become a hub for inflammation. They release pro-inflammatory cytokines that disrupt insulin’s normal workings even further. This chronic, low-grade inflammation not only affects how your body uses sugar but can raise your risk for other chronic diseases as well.

Among all the ways we measure health—weight, BMI, or even the amount of fat just under our skin—visceral fat stands out as the strongest predictor of future diabetes risk. That’s why reducing visceral fat, by cutting back on sugar and adopting a healthier lifestyle, can significantly improve insulin sensitivity and lower your risk of type 2 diabetes.

What Can You Do?

The good news is that visceral fat responds well to lifestyle changes. Reducing your intake of added sugars and sugary drinks, eating a balanced diet, and staying physically active can not only help prevent new fat from forming but also shrink existing visceral fat stores.

In Summary

While sugar itself doesn’t “cause” diabetes directly, its powerful role in promoting weight gain—especially the accumulation of visceral fat—sets the stage for insulin resistance and, ultimately, type 2 diabetes. By understanding these connections, you can make informed choices to protect your health for years to come.

Dr Suman R

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Diabetes in Pregnancy: What Every Indian Woman Should Know

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Diabetes in Pregnancy: What Every Indian Woman Should Know

In India, where diabetes is rising steadily—especially among women of childbearing age—understanding how diabetes impacts pregnancy is crucial. Whether you're planning a pregnancy or are already expecting, managing diabetes carefully can ensure a healthy future for both mother and child.

This blog explains what diabetes during pregnancy means, why it matters, and how to manage it from an Indian perspective—based on the latest global recommendations by the American Diabetes Association (2025 guidelines).

Why Is Diabetes During Pregnancy a Concern?

Diabetes in pregnancy can be of three types:

  1. Type 1 Diabetes – insulin-dependent diabetes present before pregnancy.
  2. Type 2 Diabetes – often linked to obesity or lifestyle factors, also present before pregnancy.
  3. Gestational Diabetes Mellitus (GDM) – diabetes first diagnosed during pregnancy.

In India, GDM is especially common, affecting 10–14% of pregnant women, and is often missed unless actively screened.

Poorly controlled blood sugar levels during pregnancy can increase risks such as:

  • Miscarriage
  • Birth defects
  • Premature delivery
  • High birth weight (macrosomia)
  • Preeclampsia (high blood pressure in pregnancy)
  • Stillbirth
  • Long-term risk of diabetes in the child

Planning Ahead: Preconception Care

For women with existing diabetes, planning the pregnancy is absolutely essential.

✅ Start preconception counseling early—ideally from puberty if you have diabetes.
✅ Aim for HbA1c <6.5% before getting pregnant.
✅ Use effective contraception until your sugar levels, weight, and overall health are well-managed.
✅ Get screened for diabetic complications—especially retinopathy, kidney health, and thyroid function.

Note: Women with a history of gestational diabetes should get screened for type 2 diabetes before planning their next pregnancy.

Healthy Diet and Exercise: The First Line of Defense

For all Indian women, whether diabetic or at risk of GDM:

🥗 Eat a balanced diet rich in whole grains, legumes, vegetables, fruits, seeds, and lean proteins.
⛔ Avoid crash diets, keto diets, or excess fat intake—especially in pregnancy.
🚶‍♀️ 150 minutes of moderate activity per week (e.g., brisk walking) is recommended—even during pregnancy.
⚖️ Manage weight wisely. Even 5% weight loss before pregnancy can reduce GDM recurrence risk in overweight women.

Monitoring Sugar Levels: What Are the Targets?

Blood sugar goals during pregnancy differ from the non-pregnant state:

Time of Measurement

Target Range (mg/dL)

Fasting

< 95

1-hour post-meal

< 140

2-hour post-meal

< 120

Regular self-monitoring with a glucometer is essential. In many cases, your doctor may recommend a continuous glucose monitor (CGM), especially if you have type 1 diabetes.

Medication During Pregnancy: What’s Safe?

  • Insulin is the preferred and safest treatment for type 1, type 2, and GDM.
  • Oral medicines like metformin and glyburide are not recommended as first-line during pregnancy due to potential risks to the baby.
  • If you're on medications like statins or ACE inhibitors, speak with your doctor well before planning pregnancy—they may need to be stopped.

Delivery and Postpartum Care

After delivery:

  • Insulin requirements often drop suddenly—especially for those with type 1 diabetes.
  • Breastfeeding is encouraged as it helps reduce long-term risk of diabetes in both mother and baby.
  • Women with GDM should be retested 4–12 weeks postpartum using an oral glucose tolerance test (OGTT)—not just HbA1c.
  • Even if sugars are normal, continue getting tested every 1–3 years lifelong, as 50–60% of GDM mothers develop type 2 diabetes later.

Key Takeaways for Indian Women

  • Don’t wait till pregnancy to start diabetes care. Start planning early.
  • Work with an expert team—your endocrinologist, obstetrician, dietitian, and diabetes educator.
  • Regular screening and prevention of GDM can improve lifelong health outcomes.
  • Lifestyle changes—diet, exercise, weight management, and avoiding unplanned pregnancies—are powerful tools in diabetes care.
  • Know your rights—demand postpartum diabetes screening and continued education.

Final Words

Pregnancy is a time of joy and hope. But with diabetes, it also becomes a time of vigilance and preparation. The good news? With the right guidance and timely care, most women with diabetes have healthy pregnancies and healthy babies.

Dr Aravinda J

MD,MRCP(London),Triple FRCP(Edinburgh, London, Glasgow) National RSSDI Executive Committee Member President RSSDI Karnataka chapter ( 2018-19 ) Chairman and Chief Diabetologist Dr Aravind's Diabetes Centre Basaveshwara Nagar, Bengaluru.

 

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