tDNA: A New Age, Culturally Relevant Diet Plan for People with Diabetes

·       With 77 million diabetics in the country, India harbors the second highest diabetes burden in the world. This is expected to rise to over 134 million by 2045

·       Diabetes boom is mainly fueled by the increasing prevalence of obesity and unhealthy lifestyles, making lifestyle management (LSM) essential to managing diabetes

·       Transcultural Diabetes Nutrition Algorithm (tDNA) is a tool to facilitate the delivery of nutrition therapy to patients with Type 2 diabetes (T2D) and prediabetes in a variety of cultures and geographic locations

 

March 20, 2023, Hyderabad: Diabetes is a major health concern around the world – especially in developing economies, like India where more than 77 million people are diabetic. Data shows that this number is set to rise to 135 million by 2045.[i] In fact, according to ICMR (Indian Council of Medical Research) guidelines 2022, the past three decades has witnessed a 150% increase in the number of people with diabetes in the country. Despite the high prevalence and associated burden, diabetes, along with other non-communicable diseases (NCDs), remain neglected.

The dramatic rise of diabetes prevalence can largely be attributed to the rapid changes in demographic, socioeconomic, and nutritional factors. Coupled with this, a predominantly sedentary lifestyle has led to an increase in obesity and other diet-related noncommunicable diseases. Speaking on how to manage the condition, Dr. Irfan Shaikh, Head of Medical Affairs at Abbott’s Nutrition business says, “Diabetes is a chronic condition that needs attention. If left undiagnosed, over time, increased glucose levels can cause serious health problems, such as heart disease, vision loss, and kidney disorders. Early interventions such as lifestyle management plays a crucial role in managing diabetes. Understanding the role of nutrition such as that of diabetic specific nutrition supplements (DSNS) and physical activity on glucose levels is essential for the optimal management of the condition. Abbott, through various initiatives, is committed to raise awareness highlighting the need for right nutrition for managing the condition.”

 

Emphasizing on the importance of nutrition for diabetics, Transcultural Diabetes Nutrition Algorithm (tDNA) is a new-age tool introduced to aid in providing nutrition therapy to people with Type 2 Diabetes (T2D) and prediabetes in diverse cultural and geographical settings. tDNA targets interventions for prediabetes and T2D, considering variations in cultural practices and comorbidities, and addressing interventions at all levels where current clinical practice guidelines for diabetes may not be portable to diverse cultures.

 

With the launch of tDNA, the objective is to increase awareness on the benefits of nutritional interventions for people with diabetes, encourage healthy eating practices that accommodate regional differences in lifestyles, foods, and cultures, and enhance the implementation of existing clinical practice guidelines (CPGs).

 

Dr. Osama Hamdy, Medical Director, Obesity Clinical Program, Director of Inpatient Diabetes Program at Joslin Diabetes Center says, “It is generally observed amongst diabetics that when they are shifted to healthy diets, it often means dropping decades of acquired eating habits thus, leading to a poor adherence rate as low as 38%. Hence, the transcultural Diabetes Nutrition Algorithm (tDNA) is a therapeutic tool intended to foster implementation of lifestyle recommendations and to improve disease-related outcomes in prediabetes and T2D patients ensuring nutritional interventions through a structured lifestyle intervention which can help improve a patient’s eating self-efficacy, maintain weight loss and glycemic control.”

 

Adding further, Dr. Irfan Shaikh says, “Indian diet varies from region to region and is usually heavy in carbohydrates & fats or both. Within India, inter-regional disparities in burden of type 2 diabetes are expected because of varying lifestyles and demographic patterns. According to a recent data, the prevalence of diabetes in Telangana state has been estimated at 16.6%, which is higher than cities, such as Mumbai (7.5%), Chennai (13.5%), and Bangalore (11.7%). Hence, an Indian customized tDNA will provide guidance to physicians in the management of the condition for prediabetes and T2D in a much more structured, systematic, and effective way thereby increasing adherence.”

 

Today, the prevalence of diabetes differs not only across the rural-urban divide within the country but also across the states. This is because different states are at different stages of demographic transition. Hence, higher burden of diabetes calls for a more stringent and practical approach involving both the treating physicians and the people with diabetes to be aware on how dietary compliance can have a beneficial impact. tDNA with its structured and pragmatic approach will help to serve this purpose. Efforts for an Asian Indian tDNA customization will reflect various physiologic, nutritional, epidemiologic, pathologic, and anthropometric factors as well as nutritional and cultural factors.

 

 

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