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You can get Diabetes of HbA1C 10.4 at 20 years if you have a family history of diabetes.


Name: Vaishnavi

Age: 20 yrs old

BMI: 37 (obese)

Case history: When Vaishnavi’s mother approached us, she was very worried about her daughter’s health. Her daughter was a plump child at a young age. Earlier she wasn’t very worried as the whole family had obesity and for them, it seemed normal. Obesity in the family did not cause any major health problems till the 40s. Vaishnavi gained weight progressively with time and the Covid scenario made her gain even more weight. Her growing lethargy, fatigue, dullness while studying and delayed periods for the past several months were severely impacting her college grades and made them visit a doctor.

Diagnosis: Blood reports, diet and lifestyle analysis. A routine blood test indicated that Vaishnavi was severely diabetic with an HbA1C of 10.4 and fasting blood glucose at 184 mg/dl. All her lipid parameters were above the range and her liver function test indicated that she was progressing towards grade 2 fatty liver.

Approach by the best diabetes nutritionist: We started our program by educating her on the concept of metabolic flexibility. The food we eat is an energy source for our body and we should eat well, however, we have our body fat which is also a very important energy source. When our body transitions seamlessly between the energy from the food we eat and our body fat, we will be energetic through the day, semi-burned fat that fills the fat cells is released from the cells and enables the body to go into a metabolic flexibility zone and therefore fat burning. When we observed her dietary recall, the food that she ate shifted her body into a fat accumulation phase and her body was not shifting to fat-burning mode which further caused her lots of hunger. Her eating pattern was totally disrupted, she had a habit of eating too fast and too frequently around 8-9 meals a day. Her energy levels were low and she would snack to give her some energy when her energy would dip again, she would snack again and the cycle would go on resulting in frequent eating and snacking throughout the day. Her imbalanced meals were the reason that caused frequent hunger pangs throughout the day. So, we started with balanced meals that would aid in metabolic flexibility and reduced the number of meals from 9 to 5. We included complex and cell wall intact carbs, efficient sources of protein and healthy fats in her meals. As her body started to move towards the fat-burning zone, she started feeling less hungry, more energetic and more active throughout the day. We gradually gave her larger but fewer meals keeping the calories intact to support her growth functions as a young adult. We increased the calories in her meal plans to keep her satiated for hours. We shifted her body from carb-burning to a fat-burning body therefore, we gave her snacks like nuts, fruits etc. in between the meals in case she felt hungry and also gradually included her pleasure foods to ensure she did not feel deprived and enjoyed her lifestyle changes.

As she is a college-going student, we gave her a plan that matched her daily routine. We also provided her with lists of on-the-go foods that she could have in between classes and lunch breaks in case of hunger pangs. We asked her to perform physical activity on a daily basis in order to help her with weight management and also in the reversal of her diabetes condition.

Result: In just one month, her fasting blood sugar levels dropped down to between 100-120 mg/dl and she had to take only one medication to control her sugar levels. In 3 months, her HbA1c levels dropped down from 10% to 6% and were not on any diabetic medication. She also lost 6 kilos in just 45 days. In 6 months her HbA1C reduced to 5.4 and she lost 15 kgs. She was able to sustain her weight lost even though she had an ankle injury during one of her vacations which did not allow her to exercise at all and in fact made her very sedentary. She got her energy levels back to normal and was able to sustain her reduced blood sugar levels and weight while enjoying her pleasure foods, enjoying her socialising with friends It’s been over a year now, and she has been able to sustain her weight loss, she continues to be at a 5.4 HbA1C without medications and enjoys her pleasure meals as well.

Deepika Chalasani is a Clinical Nutritionist, Mind and Body Transformation Coach and co-founder of Fit4Life India, an integrated nutrition and wellness organization for Indians that provides complete solutions, addressing health and wellness challenges of individuals by working on their overall well-being. Deepika, best nutritionist in Hyderabad for weight loss and online dietician can be contacted via email or Mobile +91 9491011202

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