Consultant Diabetologist DIA HAPPY CLINIC Ahmedabad, Gujarat, India
Objective: To investigate the real-world effectiveness of Dia Happy’s Personalised Nutrition and Lifestyle Program using Dia Happy Food Kit on the high glycated haemoglobin (HbA1c) levels of Type 2 diabetes patients in India.This paper is also an attempt to study the compliance and palatability of these foods amongst the patients.
Methods: This is a retrospective observational study of 35 Type 2 Diabetes patients enrolled in Dia Happy Personalised Nutrition and Lifestyle program between September 2022 to November 2022. The key inclusion criteria was patients with HbA1c between 7 % and 9 % in the age group of 21 to 60 years of age. The key exclusion criteria were patients with advanced renal, cardiac, or liver dysfunction, pregnancy or planning pregnancy and history of ketoacidosis.
The intervention was personalized nutrition and active lifestyle for 3 months. Personalised nutrition was focused on low carbohydrate diet with the help of Dia Happy Food Kit. The food kit included seeds based products like flour to make Indian flat bread, biscuits and savoury snacks. Patients were advised to avoid regularly consumed high-carbohydrate food categories such as grains, sugars, and high-carbohydrate fruits. No restrictions were made on the intake of non starchy vegetables, sources of lean protein, berries, sprouts and dairy.
The patients were asked to continue the medications they were already taking. As the patient’s blood glucose levels gradually improved with change in diet and lifestyle, medicines doses were down titrated by the doctor. Insulin and sulphonylureas were the first groups of medications to be reduced and stopped.
Patients were also put on Abbott Libre Pro Flash Glucose Monitoring System to study the variability of glucose levels in response to different foods for 14 days. Dia Happy Health’s coach constantly provided remote support to resolve queries and doubts through phones and chats. The patients were advised to include a mix of cardio and strength training exercises for 45 minutes thrice a week.
Results: The study showed an average 2.3% drop in HbA1c levels in participants at the end of 3 months. 2 patients dropped out before completion of 3 months. 29 patients i.e 87.8% achieved an HbA1c of less than 6.5% in 3 months and 31 patients (93.3%) achieved an HbA1c less than 7%.
The patients scored Dia Happy Food Kit’s products on a scale of 1 to 10 (10 being best) for palatability. Flour and sweet cookies were rated as 8.5, savoury cookies as 7.5 and savoury snacks as 8.
Discussion/Conclusion: India has the second largest population of individuals with Diabetes. The traditional Indian diet is heavily dependent on carbohydrates with 65% of total calories coming from carbohydrates. Wheat in the form of Indian flat bread forms a major portion of all meals. This pattern of eating high carbohydrate diet acts as a major obstacle to diabetes control.
The improvement in HbA1c in this study demonstrates that the Personalised Nutrition and Lifestyle Program using Dia Happy Food Kit is an effective way to manage T2DM. Replacing grain-based flour with seed-based flour allows the patient to stick to their traditional pattern of eating and still cut down carbohydrates. This further improves patients’ compliance.