This interview is with Dr. Gagandeep Singh, Founder, Redial Clinic.
For readers meeting you for the first time, how do you describe your work in drug-free diabetes and hypertension reversal in New Delhi?
I run Redial Clinic in New Delhi, where we specialize in metabolic reversal—helping patients with Type 2 diabetes, hypertension, and obesity actually reverse their conditions rather than just managing them indefinitely.
The conventional model tells patients they have a progressive, lifelong disease requiring escalating medications. My clinical experience with hundreds of patients tells a different story. When we address the root causes—insulin resistance, a sedentary lifestyle, poor nutrition, and metabolic dysfunction—many patients can achieve complete remission and safely discontinue their medications.
What distinguishes our approach is the Triangle Model: a coordinated intervention where the physician, nutritionist, and fitness trainer work together as an integrated team. The doctor handles medical supervision and medication management. The nutritionist designs sustainable eating patterns adapted to the patient’s lifestyle and culture. The trainer builds movement protocols appropriate to the patient’s fitness level and physical limitations. These three specialists communicate constantly, adjusting each element based on what the others observe.
This isn’t a diet program or an exercise program—it’s comprehensive metabolic rehabilitation. We measure success not by how well we control numbers with drugs but by how many medications we can safely eliminate while improving those numbers.
Urban society presents unique challenges: sedentary desk jobs, a carb-heavy food culture, pollution, and family meal dynamics that resist individual changes. We’ve developed protocols specifically adapted to these realities.
What key moments or influences shifted you from conventional disease management to building a lifestyle-first, deprescribing care model?
My shift toward a lifestyle-first, deprescribing model wasn’t one dramatic epiphany; it was a series of moments that quietly built a very loud truth. It involved three conditions I now specialize in reversing: diabetes, hypertension, and obesity.
First, the personal side. I grew up with childhood obesity, and that experience leaves a lasting imprint. When you’re young and carrying more weight than your frame is ready for, you learn two things early:
- Biology and behavior are far more intertwined than most people realize, and…
- The world has no shortage of unsolicited “advice.”
That internal battle with weight, energy, cravings, and self-esteem gave me a lived understanding of metabolic dysfunction long before I studied it professionally. It also gave me a stubborn belief that people deserve more than lifelong management—they deserve a pathway back to health.
Then came the professional side. In clinical practice, I noticed a pattern that every physician quietly recognizes: despite guideline-driven care, most patients with diabetes, hypertension, and obesity weren’t actually improving. Their numbers were being controlled, not corrected. Every year meant a higher dose, an additional medication, or another step toward insulin. Patients were following instructions, but the diseases kept marching forward.
The real shift happened when I realized that these conditions are not “pill deficits”—they are metabolic dysfunctions with behavioral, nutritional, hormonal, and lifestyle roots. If the root is lifestyle-driven, the solution has to be lifestyle-first.
That insight pushed me to rebuild my practice around metabolic assessment, nutrition science, behavior change, structured coaching, and careful, data-driven deprescribing. When patients reclaim insulin sensitivity, reduce inflammation, normalize blood pressure, and lose weight sustainably, medications naturally step out of the picture—not because we force them out, but because the body no longer needs the biochemical crutches.
In essence, my personal struggle gave me empathy, my clinical experiences gave me clarity, and together they led me to create a care model that doesn’t just manage diabetes, hypertension, and obesity—it helps people reverse them by fundamentally restoring their metabolic health.
When a new patient enrolls, what do the first 30 days look like in your program—from baseline assessments and safety protocols to the single behavior change you start with?
Week 1: Comprehensive Assessment
All three team members conduct independent evaluations. I perform a detailed medical assessment, which includes metabolic panels, insulin resistance markers, inflammatory indicators, medication review, and complication screening. The nutritionist completes a thorough dietary audit, covering eating patterns, food preferences, cooking capabilities, family dynamics, and cultural considerations. The trainer assesses physical capacity, mobility limitations, current activity levels, and exercise history.
We then convene as a team to build an integrated picture. A patient’s medical status informs which nutrition and exercise interventions are safe. Their dietary patterns reveal why previous exercise attempts failed, and their physical limitations shape which dietary compliance strategies will work.
Safety protocols are established, including medication adjustments that must precede lifestyle changes, monitoring schedules, and clear communication channels for concerning symptoms.
Weeks 2-3: Coordinated Single-Focus Changes
This is where programs typically fail—by overwhelming patients with simultaneous demands. Instead, each team member introduces one foundational change in their domain, coordinated so that they reinforce rather than compete.
The nutritionist might focus solely on meal timing. The trainer introduces daily walking—nothing more. I adjust medications to accommodate these changes safely. One change per domain, all supporting each other.
Week 4: Assessment and Progression
The team reviews two weeks of data together. What’s working? What’s creating friction? We adjust based on real feedback, not theoretical protocols. The patient leaves week four with established foundations and a clear roadmap for intensification. While four weeks may not yield dramatic results, they indicate to the patient that they are finally moving in the right direction.
During rapid improvement, medications can become too strong; what rules of thumb guide your safe tapering of diabetes and blood-pressure drugs, and which warning signs make you pause?
The fundamental principle: lifestyle improvements can make existing medications dangerous. Blood pressure that required medication at baseline may drop too low when diet and exercise take effect. Diabetes drugs dosed for previous eating patterns can cause problems when those patterns change.
This is precisely why the Triangle Model matters. When our nutritionist implements dietary changes or our trainer increases exercise intensity, I’m immediately informed. Medication adjustments happen proactively, not reactively after problems emerge.
General Tapering Principles:
- We reduce medications that carry the highest risk with lifestyle changes first. The sequence depends on each patient’s specific regimen and how they’re responding to interventions.
- We taper gradually—typically reducing rather than eliminating—and observe for two weeks before making further changes.
Frequent home monitoring during active tapering is non-negotiable. Patients track their numbers and report to the team. Any concerning patterns trigger an immediate review.
Warning Signs That Pause Everything:
- Symptoms suggesting medications have become too strong—dizziness, excessive fatigue, shakiness.
- Rapid changes in glucose or blood pressure readings in either direction.
- Patient stress, illness, or poor sleep—not the time to push protocols.
- Inconsistent monitoring or missed check-ins—we can’t adjust what we can’t track.
- Any emergency symptoms requiring immediate medical attention.
The principle: we can always slow down. Our nutritionist and trainer adjust their progressions when I need to stabilize medications. Aggressive reversal that causes medical emergencies isn’t reversal—it’s negligence. The team approach lets us modulate all three interventions in response to what we’re seeing.
Working within Delhi’s food culture and schedules, how do you adapt meal plans and preparation techniques so patients can adhere (for example, handling rice/roti, eating out, and family meals)?
This is where our nutritionist’s expertise becomes invaluable. I can prescribe “reduce carbohydrates,” but translating that into practical strategies for a Delhi household requires specialized skill.
Strategic Low-Carb Within Indian Context:
Make no mistake—our approach is fundamentally low-carbohydrate. The evidence for carbohydrate reduction in diabetes reversal is overwhelming. However, we’ve learned that demanding complete elimination of cultural staples creates resistance that undermines long-term adherence.
Our nutritionist implements strategic carbohydrate reduction: significantly smaller portions, deliberate timing, and progressive reduction as patients adapt. Rice and roti aren’t encouraged—they’re strategically minimized. When carbohydrates do appear, they’re shifted to earlier meals when insulin sensitivity is higher, paired with protein and fiber to blunt glucose response, and strictly portion-controlled.
The evening meal transformation is non-negotiable: dinner becomes protein, vegetables, and healthy fats with no starchy carbohydrates. This single change—protein without rice or roti—produces remarkable metabolic improvements. Over time, many patients naturally reduce carbohydrates further as they experience the benefits and lose their dependence on these foods.
Eating Out and Social Situations:
Delhi’s social life revolves around food. Our nutritionist prepares patients for specific scenarios: restaurant strategies, wedding season navigation, and office lunch options. The trainer reinforces this—extra activity before or after indulgent events.
Family Meal Dynamics:
This is often the hardest challenge. Our nutritionist frequently involves family members—explaining the reasoning, not just the rules. When families understand that reversal depends on significant carbohydrate reduction, they typically support it.
Practical solutions include the same protein and vegetable dishes for everyone; only the patient skips or minimizes the carbohydrate portion. This maintains family dining without creating isolation.
Movement Integration:
Our trainer works within the same constraints—designing activity that fits Delhi’s pollution, heat, and work schedules. Sometimes that’s early morning walks, sometimes gym sessions, and sometimes home-based routines. The exercise prescription adapts to the same lifestyle realities the nutrition plan addresses.
In your real-world data, which fasting patterns or carbohydrate strategies consistently deliver the best A1c and blood-pressure improvements, and for whom do they not work?
The patients who achieve the best outcomes share common characteristics: they engage fully with all three team members, not just one or two. Diet alone produces moderate results. Exercise alone produces moderate results. The combination, coordinated by medical supervision, produces reversal.
Typically, we see HbA1c reductions of 1.5-2.5% over 3-4 months in compliant patients. Blood pressure reductions of 10-15 mmHg systolic are common. These improvements allow significant medication reduction or elimination.
The specific protocols vary by patient—our nutritionist might emphasize time-restricted eating for one person and portion control for another. Our trainer might focus on strength training for someone with joint issues and walking for someone else. What’s consistent is the coordinated approach and sustained follow-up.
We routinely work with Type 2 diabetics on insulin—these patients often see the most dramatic improvements as we’re able to reduce and sometimes eliminate insulin dependency through intensive lifestyle intervention. We also work extensively with gestational diabetes patients, where timely intervention protects both mother and baby while often preventing progression to Type 2 diabetes postpartum.
Patients who plateau on initial interventions often respond to intensification—extended fasting periods, more structured exercise progression, or addressing factors like sleep and stress that we hadn’t fully optimized.
Who It Doesn’t Work For:
- Patients who engage with only one aspect—diet without exercise, or exercise while ignoring nutritional guidance.
- Those who cannot commit to regular monitoring and team communication.
- Patients with Type 1 diabetes—fundamentally different pathophysiology requiring different approaches.
- Those with active eating disorders where structured dietary intervention could cause harm.
- Patients with significant psychological barriers to lifestyle change—this requires addressing those barriers first.
Not every patient is a reversal candidate, and recognizing this early prevents frustration for everyone.
Beyond HbA1c, which biomarkers and clinical endpoints do you track weekly and monthly to confirm durable reversal rather than short-term compensation?
We monitor approximately 50 data points across our team, creating a comprehensive picture of metabolic health that goes far beyond standard diabetic care.
Weekly Monitoring:
Each team member tracks domain-specific indicators continuously. We use CGMs (continuous glucose monitors) for real-time glucose tracking—this reveals patterns that finger-prick testing misses: overnight trends, post-meal spikes, glucose variability, and response to specific foods or activities.
Our nutritionist tracks dietary adherence, meal timing, and portion compliance. Our trainer monitors activity metrics—steps, heart rate, exercise completion, and strength progression. We also measure waist circumference and body weight weekly to track physical changes.
Subjective markers matter equally: energy levels, sleep quality, hunger patterns, and exercise recovery. These soft indicators often signal improvement before lab values change or warn us of problems before they become crises.
Monthly Lab Assessment:
We check HbA1c monthly during active intervention—more frequently than the standard quarterly testing. This allows us to see trajectory and adjust protocols in real-time rather than discovering three months later that something wasn’t working.
Quarterly Comprehensive Panels:
Every three months, we conduct complete metabolic blood work and body composition analysis to understand deeper progress:
- Cardiac risk profile: Including ApoB, which gives us a more accurate picture of atherogenic particle burden than standard LDL cholesterol.
- Inflammatory markers: HsCRP to assess systemic inflammation, which should decline as metabolic health improves.
- Insulin resistance assessment: Fasting insulin and HOMA-IR calculation—these reveal metabolic improvement before glucose fully normalizes.
- Body composition analysis: Understanding fat loss versus muscle preservation, visceral fat reduction, and metabolic rate changes.
What Confirms Durable Reversal:
Sustained HbA1c in the normal range off medications, normalized HOMA-IR, improved inflammatory markers, favorable ApoB levels, and healthy body composition—maintained over six-plus months with basic lifestyle maintenance rather than intensive intervention.
The team approach helps here: our trainer confirms the patient maintains activity independently, and our nutritionist confirms that eating patterns are sustainable without constant guidance. Durable reversal means the patient has internalized the changes, not that they’re white-knuckling through a temporary program.
When progress stalls despite reported adherence, what is your step-by-step troubleshooting approach—from verifying data to adjusting nutrition, sleep, stress, or training?
Step 1: Team Data Review
All three of us examine our respective data streams. Is the plateau real, or is the patient focused on one metric while others improve? Someone might plateau on weight while body composition improves—losing fat and gaining muscle. The trainer’s measurements and the nutritionist’s observations help clarify.
I verify monitoring accuracy—are readings reliable? Is timing consistent? Measurement errors create false plateaus.
Step 2: Cross-Domain Audit
Each team member independently assesses true adherence in their domain.
- Our nutritionist digs into actual eating patterns—detailed food diaries, photos, and honest conversations about exceptions. Hidden snacking, liquid calories, portion creep, and weekend deviations often explain stalls.
- Our trainer examines exercise reality—actual completion versus planned sessions, intensity levels, and recovery quality.
- I review medication compliance and any new factors—other prescriptions, supplements, and health changes.
Most plateaus resolve when we identify gaps that the patient hadn’t recognized or reported.
Step 3: Assess Sleep and Stress
This is massively underappreciated. Poor sleep significantly impairs insulin sensitivity. Chronic stress elevates cortisol regardless of a perfect diet and exercise. Our trainer often identifies this first—patients whose recovery and performance decline despite good effort.
If sleep and stress emerge as factors, we address them before intensifying other interventions.
Step 4: Coordinated Intensification
If adherence is verified and sleep/stress are addressed, the team coordinates next steps. Perhaps the nutritionist extends fasting windows while the trainer maintains current exercise. Or the trainer adds strength training while nutrition holds steady. We change one variable at a time so we know what’s working.
Step 5: Medical Investigation
Persistent plateaus warrant looking for underlying factors: thyroid dysfunction, undiagnosed sleep apnea, medication effects, or simply biological resistance requiring patience rather than protocol changes.
After deprescribing and achieving remission, what follow-up cadence and maintenance habits have proven most reliable for preventing relapse over the next 2–3 years?
Follow-up Cadence:
Months 1-6 post-remission: Monthly team check-ins. This is the highest-risk period for relapse. The nutritionist monitors for dietary drift. The trainer watches for exercise drop-off. I track metabolic markers. Any concerning trend is addressed immediately across all three domains.
Months 6-12: Bi-monthly appointments if stability holds. Quarterly lab testing continues.
Years 1-3: Quarterly check-ins at a minimum, with labs every six months. Patients can contact any team member anytime if they notice concerning changes.
Maintenance Habits That Prevent Relapse:
Patients who maintain remission long-term share common practices across all three domains:
- Nutritional habits: They maintain structured eating patterns that suit their metabolism. They have developed sustainable approaches to social eating and family meals.
- Movement habits: Consistent activity remains integrated into their lives—regular walking, movement throughout the day, and some form of structured training. Our trainer helps patients transition from prescribed exercise to self-directed maintenance.
- Medical vigilance: Regular self-monitoring—weekly weight checks and occasional glucose readings. They catch drift early before it becomes reversal. They maintain scheduled check-ins even when feeling fine.
- Lifestyle foundations: Sleep is prioritized. Stress management practices continue. These aren’t “extras”—they’re essential maintenance.
Warning Signs We Watch For:
- Weight regain exceeding 5% of the lowest achieved weight
- Glucose readings trending upward
- Exercise consistency declining
- Abnormalities in lab reports
The key insight: remission requires ongoing maintenance, not temporary effort. Patients who view lifestyle changes as permanent—not a “program” they completed—maintain their results.
Thanks for sharing your knowledge and expertise. Is there anything else you'd like to add?
What I want readers to understand is that metabolic reversal isn’t alternative medicine or a fad diet—it’s comprehensive lifestyle rehabilitation delivered by a coordinated medical team.
Type 2 diabetes and hypertension, in most cases, are lifestyle conditions. The conventional model addresses symptoms while ignoring root causes. We’re taught to accept progressive decline as inevitable when it’s actually optional for many patients.
The Triangle Model exists because isolated interventions fail. A doctor alone can’t design proper nutrition. A nutritionist alone can’t adjust medications safely. A trainer alone can’t account for metabolic limitations. When all three work together, communicating constantly and adjusting in coordination, we achieve outcomes that none of us could produce independently.
I’m not anti-medication. Medications save lives, and some patients will always need them. But the current default—lifelong escalating drugs with no discussion of reversal—fails patients who could do better. Every diabetic deserves to know that remission is possible.
The work isn’t glamorous. There’s no proprietary secret or expensive supplement. It’s coordinated nutrition, progressive movement, medical supervision, sleep, and stress management. The “secret” is teamwork and sustained accountability—helping patients through difficult weeks until new habits become automatic.
If you’re a patient reading this: question the narrative of inevitable decline. If you’re a healthcare provider: consider what coordinated team-based care might achieve compared to isolated prescriptions.
Reversal is a scientific reality. Embrace it and live free, healthy, and optimized. Never accept just being disease-free as a goal; rather, strive to be the healthiest version of yourself that you can be.