Your prediabetic patient needs to change how they eat, sleep, move and handle stress. You have fifteen minutes and a full waiting room. I have the time you don't — and I don't go anywhere near your clinical decisions.
Nobody reading this needs to be told that lifestyle drives metabolic disease. The problem was never the knowledge, or the prescription. It's that "lose weight, eat better, sleep more, reduce stress" is a destination handed to someone with no map, no route, and nobody walking alongside them.
The clinical decision is sound. Nothing on this page suggests otherwise.
Cut the sugar, walk daily, sleep earlier, manage the stress. All correct. All unactionable at that level of detail.
They don't know what to eat at 9pm after a twelve-hour day, or which of the six things to start with. So they start none of them.
Or they've drifted the wrong way. The dose goes up, and the conversation repeats.
Occasionally that's what it is. Far more often, it's simply that nobody had the hours to show them how.
That's the part I'd like to take off your hands.
None of the rest of it.
A full lifestyle history, then a specific, sequenced protocol the patient can actually run on a working weekday. Sequenced matters: patients given six changes at once reliably do none.
Composition, portion, and above all timing — built around what's actually cooked in their kitchen, not an imported plan.
Duration, consistency and what's breaking it. Usually the first domino, given its effect on glycaemic control and appetite regulation.
Dosed to current capacity and comorbidity. Breaking up sedentary time and post-meal walking, before any talk of a gym.
Symptom pattern, meal spacing, fibre and tolerance — introduced at a pace the patient can sustain.
The stress load that quietly undoes the other four. Practical, daily, and referred onward the moment it needs a professional.
You're being asked to put your name near someone else's work. So here is exactly where mine stops — in writing, before you ask.
If a patient asks me a clinical question,
the answer is always “ask your doctor.”
What your patient actually eats and when, how they really sleep, what they move, their stress load — written up properly. Often more candid than what's said in a consulting room.
What's been changed, what's holding, what isn't. Timed so you have it before their next review rather than after.
Red flags, new symptoms or anything outside my scope come back to you the same day. You'll hear it from me before you hear it from them.
Plainly: these come by email, written by me. There is no portal, no login and nothing for your staff to learn — and I'd rather say that than dress up a document as a platform. If a doctor-facing view is ever worth building, it'll be because referring doctors asked for it.
No forms, no referral letter, no portal. Telling the patient to get in touch is enough — though anything you want me to know is welcome.
Thirty minutes. If lifestyle work isn't what they need, or something needs you first, I tell them so and send them back. I'd rather decline a referral than mishandle one.
They work with me on the five pillars. You get the intake summary and progress notes, and every clinical decision stays entirely yours.
I'm Akash Malviya. I'm not a doctor and I hold no medical degree — you'd have found that out eventually, so you should have it from me first. What I have is nine years of study in metabolic and lifestyle health, a method I've thought hard about, and a practice that is deliberately still small.
Being early is the honest pitch here. I'm working with a small first group of patients, which means each one gets considerably more of my attention than they would from an established practice — and it means I have every reason to handle your referral carefully. My scope discipline above isn't marketing. It's the only basis on which a coach without a medical degree should be anywhere near your patients.
The fastest way to judge whether this is any good: refer one patient and watch what comes back.
The one you've had the same conversation with three reviews running. Send them my way and see what comes back before you send a second.
Talk to me about referrals →Or email hello@sankalphealth.in — happy to answer questions before you refer anyone.