'In diabetes remission, you go below a 6.5 HbA1c without medication.'
'And this happens only when you lose 10 to 15 per cent of your body weight with a good amount of lifestyle and dietary changes, exercise and sometimes medication.'
'You have to be able to sustain your HBA1C below 6.5 for at least a year without medication to say that the patient is in remission.'
Diabetes is not about sugar.
Diabetes reversal is a myth.
Cutting down sugar and carbs may not necessarily help you reduce your blood sugar.
Shocked? Surprised?
"Most people think that eating sweets will give you diabetes; this is a complete myth," says Dr Rajiv Kovil, head of diabetology, Zandra Healthcare.
"The fat deposits in your organs is the real cause of diabetes; it has nothing to do with your sugar intake," he tells Divya Nair/Rediff.
On World Diabetes Day, Dr Kovil discusses the myths surrounding diabetes, why India is seeing a surge in cases and what truly works when it comes to prevention and management of the lifestyle disease that is affecting millions across the country.
"In diabetes, several functions including cardiovascular, renal, metabolic, liver and peripheral vascular is involved. So it needs to be given that kind of importance," he says.
What is the biggest lie you have heard about diabetes treatment in India?
That all kinds of diabetes are reversible!
In reality, the whole idea about reversing is what we call remission. There is nothing like diabetes reversal. This word -- diabetes reversal -- doesn't exist in medical literature. The correct medical term is remission.
The idea is to lose up to 10 to 15 per cent of your body weight so you can put these patients into remission. Your HbA1C should be below 6.5 without medication.
But some smart engineer or social media influencer has converted remission into reversal.
Because of this misleading marketing campaign about diabetes reversal, I've had patients who are on dialysis and on a diabetic diet saying that we would like to reverse our diabetes now.
This myth needs to be corrected.
In diabetes remission, you go below a 6.5 HbA1c without medication. And this happens only when you lose 10 to 15 per cent of your body weight with a good amount of lifestyle and dietary changes, exercise and sometimes medication.
You have to be able to sustain your HBA1C below 6.5 for at least a year without medication to say that the patient is in remission.
A lot of people believe that cutting down sugar and sweets will help manage your diabetes. What would you like to tell them?
Most people think that eating sweets will give you diabetes which is a complete myth.
What people don't realise is that diabetes is a multi-factorial, multi-hormonal, multi-genetic health issue triggered by poor lifestyle.
The fat deposits in your organs is the real cause of diabetes; it has nothing to do with your sugar intake.
Obviously an energy-dense, high calorie intake will deposit more fat. But it doesn't mean that if you have little or no sugar, you will not get diabetes.
Can diabetes caused due to a poor diet or eating habits be controlled with medication?
It's a myth that if you have eaten wrong, you can compensate by taking extra medication.
This may work with people who have Type 1 diabetes or somebody who's very well trained with Type 2 diabetes on insulin. But it can go horribly wrong if patients on oral drugs try to do that without knowing what the doses are. This should never be encouraged.
Apart from this, a lot of people often think that insulin injections are to be taken throughout your life which is also not true.
On several occasions we give insulin as an intermittent therapy to tide over a problem.
If a diabetic patient is battling an infection, undergoing surgery or is admitted for some reason, insulin is provided. But once the problem is taken care of, insulin is out.
Another misconception people have is that diabetes is only about blood sugar and if that is normal, everything else is normal.
You have to understand that diabetes is a cluster of metabolic disorders where blood pressure, cholesterol, obesity, kidney and blood circulation to the liver are involved.
Most people in India believe that including certain food in their daily diet will help them fight diabetes. Can you help verify the claims and suggest if and how the following foods can help reduce blood sugar?
Karela or Bittergourd
Karela only increases the fibre content and any fibre increase will reduce the absorption of glucose and reduce the glycaemic index of other foods. It does not have any direct effect on your blood sugar level.
Methi or fenugreek seeds
Again, it works on the same principle that it increases in size; the bulk of what you have consumed further increases in your stomach. Basically, with methi, your fibre content increases and absorption of glucose goes down.
Paneer Phool
There is no data on it. I think it's absolutely rubbish.
Black jamun seed powder
There is no proven or scientifically verified data on this at all.
Boiled neem leaves water
Neem leaves have been used to treat a variety of skin conditions where they have shown some benefit but internalising neem water has shown no benefit in reducing blood sugar or diabetes.
Millets are the new superfood for diabetics. Do you think replacing traditional grains with millets will help manage diabetes?
A lot of people today, especially in urban India, are looking at millets as the ultimate food for people with diabetes.
I'd like to tell them it's not about the food, it's always about the portion you consume. It's not the carbs, it's the type of carbs and how you consume it that matters.
If you eat millets, it has slightly higher fibre. But if the portion size increases, the overall glycaemic load increases so choosing millets as the ultimate food is not going to help.
India is often called the diabetes capital of the world. What do you think has encouraged this trend?
Technically speaking, we do not have comprehensive countrywide survey data on diabetes. The closest we have is the ICMR (Indian Council of Medical Research) data, which is a random pick of certain sections from each state, which says it's 100 million.
There was a Lancet publication last year which said the ICMR data may not actually be true and that India may be looking at 225 million people with diabetes which, according to me, is a big number.
And we would likely have an equivalent number of pre-diabetics as well.
Where do you think India maybe going wrong? What according to you is encouraging this unhealthy trend?
The trend is purely driven by a lack of health literacy in India.
People are not able to identify good, nutritious food. Nutrition is not taught as a subject in school. There is wrong food labelling.
If a person wants to eat healthy food outside, there is no way s/he can source healthy food.
Next, s/he has to buy healthy food which is not so affordable. For example, the cost of a vada pav in Mumbai is Rs 20 and the cost of three apples may be Rs 150 which is so unfair.
We have to be able to curb the wrong foods.
Unhealthy, ultra-processed food should be taxed more and healthy food should be made affordable and accessible.
A large majority of our middle class and lower middle class who are getting affected by diabetes are not able to afford healthy food on a daily basis. And that is where basic problem lies -- you are not able to procure healthy food outside and it is comparatively more expensive.
Even on food labels, the advertisement says low carb, high fibre when there's actually nothing in it.
Children have to be taught nutrition in schools; they have to be taught how to interpret food labelling. These little changes will go a long way in addressing India's nutrition gap.
What are some of the simple ways in which we can prevent diabetes in our homes from an early age?
Culturally, we should stop gifting each other sweets because whether it's a birthday, anniversary, a celebration or any festival, there's an exchange of sweets.
Even in places of worship, whether it's a mosque, a temple or a church, the prasad is always something sweet. These are places that have a lot of influence so they should encourage people to have healthy eating behaviour. The prasad too should be something healthy.
Similarly, the traditional belief that you should exercise only when you have a problem should go. Exercise is not an integral part of our lifestyle in India.
The workplace timings should not go not go up to 9 pm and 11 pm in the evenings. There should be equal working hours and relaxing hours. There should be a way to link your performance not just to sales or academics but also to your health.
There should be wider insurance cover for people with disorders, especially diabetes.
Right now we are looking at an obesity epidemic in India. We are looking at 350 million people with obesity and we need to reduce this number because obesity is driving all these disorders -- whether it's diabetes, blood pressure, cholesterol and there are 14 different types of cancers as well.
We need to make food choices healthy.
We need to encourage people to lose weight and have a national movement for people to become healthy like we had the Fit India movement. The idea needs to be absorbed by people across India. Only then will it have a positive outcome.
Disclaimer: All content and media herein is written and published online for informational purposes only. It is not a substitute for professional medical advice. It should not be relied on as your only source for advice.
Please always seek the guidance of your doctor or a qualified health professional with any questions you may have regarding your health or a medical condition. Do not ever disregard the advice of a medical professional, or delay in seeking it because of something you have read herein.
If you believe you may have a medical or mental health emergency, please call your doctor, go to the nearest hospital, or call emergency services or emergency helplines immediately. If you choose to rely on any information provided herein, you do so solely at your own risk.
Opinions expressed herein cannot necessarily provide advice to fit the exact specifics of the issues of the person requesting advice.
© 2025