| UNDERSTANDING DIABETES |
Diabetes is a lifetime disorder. However, it is possible to lead a quality life despite this condition. All it takes is knowledge, care and discipline.
Nutrition is an important aspect in the management of this disorder, so let us begin by understanding what happens to the food that we eat. Carbohydrates constitute about 60% of food that we consume and these, on digestion are directly converted into glucose, which then enters the blood stream. This glucose provides energy for cellular function, but only when it enters the cells of our body.
It is the insulin produced by the pancreas that helps glucose to enter the cells. Without insulin glucose can not enter the cells, with the result, high levels of sugar remain in the blood stream, but can not provide energy to the cells which need it. When high blood glucose exists with low insulin or defective insulin function, the condition is called diabetes. |
| You are at a higher risk: |
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If you have family history of diabetes in the family |
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If you have had diabetes in an earlier pregnancy |
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If you are obese |
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If you have given birth to an overweight baby |
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If you are 40+ |
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If you have had multiple pregnancies |
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If you have too many refined foods in your diet |
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If you have infections that do not heal |
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If you are not physically active |
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If you suffer from emotional stress |
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| Types of blood sugar abnormalities: |
| Hypoglycaemia: when the blood sugar is too little, less than 50 mg/dl. There may be other conditions leading to hypoglycaemia but the commonest remains inappropriate management of diabetes. |
| Hyperglycaemia: |
| when there is too much sugar in the blood. |
| Type I Diabetes: |
| develops usually in early childhood and the affected person is totally dependant on taking insulin from external sources. Nearly 2% diabetics in India have Juvenile Diabetes. |
| Type II Diabetes: |
| is the commonest type, which usually develops around middle age.
Onset takes few years to be detected, though damage to the vital organs already sets in. More than 95% diabetics are with Type II diabetes, also known as non-insulin dependant diabetes. It is important to diagnose the condition as early as possible to save damage from happening |
| Symptoms of Type II Diabetes |
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Frequent urination |
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Excessive hunger |
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Excessive thirst |
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Fatigue |
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Unexplained weight loss |
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Overweight (when waist measurement is more than half your height) |
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Blurred vision |
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Sores that don’t heal |
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Numbness or tingling in feet |
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Sexual dysfunction |
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Vaginal infection, and itching in vulva, & infection of penis |
If you experience any of the above, consult your doctor immediately. However, very often, there may not be any symptoms and diabetes may be diagnosed by routine testing or while investigating another disease. |
| Symptoms of Hypoglycaemia |
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Excessive hunger |
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Excessive sweating and anxiety |
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Weakness |
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Palpitation and trembling |
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Headache |
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Irritability/ confusion |
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Sleepiness |
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Fainting/ loss of consciousness |
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Abnormal behaviour |
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| The risks associated with uncontrolled diabetes |
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Blood pressure may go up |
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Risk of brain stroke is doubled |
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Risk of heart attack increases 3-4 times |
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Risk of kidney failure goes up by 17 times |
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Injury to feet can lead to uncontrolled infection and amputation |
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Loss of sensation in limbs can lead to nerve damage |
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| Treatment and control |
Diabetes should be timely detected and managed, as it may otherwise lead to permanent damage of vital body organs. Treatment will depend on the type of diabetes, your age and health condition, weight, physical activity pattern, etc.
There is a big importance of eating a well balanced diet, regular exercise, blood sugar monitoring and timely intake of prescribed medicine. |
| Preventing Diabetes |
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Keep a watch on your weight and waist line |
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Take a healthy diet of more vegetables, fruits, cereals, and pulses |
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Avoid fat, refined and processed foods, red meat and high calorie sweets |
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Avoid or reduce intake of alcohol |
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Exercise regularly |
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Avoid physical and mental stress |
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Do regular medical check ups |
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Stop smoking, gutka, pan or tobacco in any form; |
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Check your blood glucose at least once a week |
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Check your HbA1c ever 3 months |
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Check your blood pressure every month |
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Check your urine micro albuminuria once a year |
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Check your eyes for retinopathy |
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Check your lipid profile every six months |
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Make exercise an every day routine |
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Meditate for peaceful and stress free existence. |
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| Diabetic Diet |
| A good diet plan should help you control blood sugar, weight and cholesterol. You should try to eat a diet, which is low in refined carbohydrates and high in fiber and complex carbohydrates. A high intake of fiber is associated with a reduced risk of diabetes; in patients with diabetes, it is associated with improved glycaemia control and decreased blood lipids. Fiber and mineral rich fruits and vegetables are very important and you should take at least 2-3 servings per day. Whole grains and pulses should be 6-8 servings per day, milk and milk products should be low fat with a minimum of 1-3 servings, and fat and oil rich foods should be totally avoided. |
| Some great health foods: Best bets for eating well
These 10 health foods are some of the healthiest because they meet at least three of the following criteria: |
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Are a good or excellent source of fiber, vitamins, minerals and other nutrients |
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Are high in phytonutrients and antioxidant compounds, such as vitamins A and E and beta carotene |
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May help reduce the risk of heart disease and other health conditions |
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Are low in calorie density, meaning you get a larger portion size with a fewer number of calories |
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Are readily available |
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Apples
Apples are an excellent source of pectin, a soluble fiber that can lower blood cholesterol and glucose levels. Fresh apples are also good sources of the vitamin C — an antioxidant that protects your body's cells from damage. keeps your capillaries and blood vessels healthy, and aids in the absorption of iron and folate. |
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Almonds
These tear-shaped nuts are packed with nutrients — fiber, riboflavin, magnesium, iron and calcium. In fact, almonds have more calcium than any other nut — 70 milligrams (mg) in 23 almonds. And one serving of almonds provides half of your body's Recommended Dietary Allowance (RDA) of vitamin E.
Like all nuts, almonds provide one of the best plant sources of protein. And they're good for your heart. Most of the fat in almonds is monounsaturated fat — a healthier type of fat that may help lower blood cholesterol levels. |
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Blueberries
Blueberries are a rich source of plant compounds (phytonutrients). These blueberries may help prevent urinary tract infections. Blueberries may also improve short-term memory and promote healthy aging.
Blueberries are also a low-calorie source of fiber and vitamin C — 1 cup of fresh blueberries has 83 calories, 3.5 grams of fiber and 14 mg of vitamin C. |
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Broccoli
Besides being a good source of calcium, potassium, folate and fiber, broccoli contains phytonutrients — a group of compounds that may help prevent chronic diseases, such as heart disease, diabetes and some cancers. Broccoli is also a good source of vitamins A and C — antioxidants that protect your body's cells from damage. |
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Red beans
Red beans — including small red beans and dark red kidney beans — are good sources of iron, magnesium, phosphorus, potassium, copper and thiamin. They're also an excellent low-fat, low-calorie source of protein and dietary fiber. Red beans also contain phytonutrients that may help prevent chronic diseases such as cardiovascular disease and cancer. |
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Salmon
Salmon is an excellent source of omega-3 fatty acids — a type of fat that makes your blood less likely to form clots that may cause heart attacks. Omega-3s may also protect against irregular heartbeats that may cause sudden cardiac death, decrease triglyceride levels, decrease the growth of artery-clogging plaques, lower blood pressure and reduce the risk of stroke.In addition to being an excellent source of omega-3s, salmon is low in saturated fat and cholesterol and is a good source of protein. |
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Spinach
Why eat spinach? Spinach is high in vitamins A and C and folate. It's also a good source of riboflavin, vitamin B-6, calcium, iron and magnesium. The plant compounds in spinach may boost your immune system and may help keep your hair and skin healthy. |
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Vegetable juice
Why drink vegetable juice? Vegetable juice has most of the vitamins, minerals and other nutrients found in the original vegetables and is an easy way to include vegetables in your diet. Tomato juice and vegetable juices, which include tomatoes, are good sources of lycopene, an antioxidant which may reduce the risk of heart attack, prostate cancer and possibly other types of cancer. Some vegetable and tomato juices are very high in sodium, so be sure to select the low-sodium varieties. |
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Wheat germ
Why eat wheat germ? At the center of a grain of wheat is the wheat germ — the part of the seed that's responsible for the development and growth of the new plant sprout. Though only a small part of the wheat seed, the germ is a highly concentrated source of nutrients, vitamin B,vitamin E, folate, magnesium, phosphorus, potassium, iron and zinc. The germ also contains protein, fiber and some fat. |
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| 1.Fruit recommendation for diabetics have fresh fruit instead of fruit juice include beta carotene rich fruits like papaya diabetics must have less of grapes, chikoos, mango, and banana. |
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| 2.Fat intake should be from monounsaturated oils like – Canola, Olive, and Rapeseed. Groundnut, Soybean, and Corn oil can be used. Polyunsaturated oils like Safflower, Sunflower, or Cottonseed should be used in limited quantities. |
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| 3. Fasting is not recommended as it changes the body metabolism |
Effect of diabetes on eyes
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There can be an early development of cataract or cloudiness on the lens of the eye. |
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There is an increased risk of glaucoma or increase in pressure within the eye. |
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Damage to the small blood vessels in the eye, leading to retinopathy – uncontrolled diabetes can cause permanent damage to the small vessels supplying oxygen to the back of the eye leading to retinopathy |
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| Make the connection, make a difference |
| Understanding the strong link between diabetes and cardiovascular disease is an important step in preventing life-threatening complications. So talk to your health care team about your risk factors and how you can change them, and about getting periodic assessments to see if you're meeting your goals. |
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Dr. Pratima Rajan MD, MPH
Consultant & Head of Preventive Cardiology
and Cardiac Rehabilitation.
IInd Floor, Room No. 224
Jaslok Hospital & Research Center
Tel: 66573342 |
