Living With Chronic Conditions · 6 min read
Living with diabetes in a Thane household — the realistic version.
Most diabetes advice is written for somebody else's kitchen. This is for a real Indian household, with real chai, real chapatis, and real festivals.
By Dr. Pratik Chhajed, MD · Updated for monsoon season
Most diabetes advice in books is written for kitchens that don't exist in Thane. The pamphlet says "avoid white rice and chapatis." The patient nods politely and goes home to a household where chapatis are dinner six nights a week. We have to do better than that.
What "control" actually means
Most patients arrive checking their fasting sugar every morning, on a finger-prick monitor that might be calibrated, or might not. The fasting number matters, but it is not the number that decides whether your eyes, kidneys, and nerves stay healthy over the next twenty years.
The number that does is HbA1c — your three-month average sugar. We want it under 7.0% for most adults, sometimes a touch tighter, sometimes a touch looser depending on age and other conditions. One blood test, every three months, tells us more than ninety finger-pricks.
If your fasting is good but your HbA1c is rising, your sugar is doing something at lunch or dinner that you're not seeing.
The chapati conversation
Yes, you can eat chapatis. Yes, even with diabetes. The number that matters is how many, and what's on the plate beside them.
- Two chapatis at a meal, not four. Smaller, thinner, made with whole wheat or a multigrain blend (jowar, bajra, ragi mixed in).
- Half the plate is vegetable — the green sabzi, a salad, even a katori of dal counts.
- Protein every meal — paneer, dal, eggs, chicken, fish. This is the single most-skipped diabetes intervention in Indian households.
Chai, sugar, and four practical compromises
I am not going to ask you to stop drinking chai. I drink chai. What I will ask:
- One spoon of sugar instead of two — and after a month, half a spoon.
- Two cups a day, not five. The volume is the problem more than the sweetness.
- No biscuit with the chai. The biscuit is doing more damage than the chai.
- If you must, switch to stevia or a non-nutritive sweetener for one of the cups.
Walking after meals
Of every diabetes intervention I have ever recommended, this is the one that produces the most consistent benefit for the least effort. A 15-minute walk after dinner. Not a power walk. Just a steady walk around the building, the lobby, the terrace, anywhere.
Post-meal walking blunts the sugar spike. Patients who do it consistently see their HbA1c drop by half a percentage point or more over six months — comparable to adding a medication.
Diwali, Ganpati, Eid — diabetes does not get a holiday, but it does get an honest conversation. Pick the two or three meals that matter to you most. Eat what you want, in normal portions, at those meals. Walk afterwards. The other meals stay disciplined. This works far better than a four-day denial followed by a guilt-driven binge.
When to call me
If your fasting sugars start trending above 150 for a week, if you're losing weight without trying, if you have new tingling in feet or unusual thirst — please don't wait three months. WhatsApp me with the readings, we'll adjust.
Diabetes management is a long conversation, not a single prescription. If yours feels stuck, let's talk.
If this sounds like you, book a slot.
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