Dr. Narayanan N.K, Endocrinologist, Apollo Hospitals, Greams Road Speaks about ways to manage diabetes for Life
Diabetes is a growing epidemic throughout the world and India is fast becoming the diabetes capital of the world. There are currently approximately 7 crore people with diabetes in India and it is estimated that by 2030 this will increase to 10 crores.
Diabetes is a state of elevated blood glucose. Insulin, a hormone that is secreted from an abdominal organ called pancreas, controls the blood glucose levels. Diabetes is due to either a complete lack of insulin in the body (type 1 diabetes) or inadequate insulin production and inefficient insulin action (type 2 diabetes). The risk factors for developing type 2 diabetes are both genetic and environmental: family history of diabetes, sedentary life style, obesity and excessive carbohydrate consumption.
The symptoms due to either type of diabetes include tiredness, increased thirst, increased frequency of urination, increased hunger, unexplained weight loss, blurred vision and slow-healing wounds. Normalising blood glucose levels alleviates the symptoms mentioned above, but more importantly it also helps to decrease/ avoid complications due to diabetes. Uncontrolled blood glucose levels can affect several organs, most common of which are kidneys, eyes, nerves, heart and brain.
Treatment of diabetes involves three components, namely dietary modifications, adequate physical activity and medications all of which are equally important. The general principles of dietary modifications are applicable to most patients with diabetes, although certain recommendations could be individualistic. People with diabetes are advised to maintain a well-balanced meal with about 60% carbohydrates, 20% proteins and 20% fat. They are advised to avoid sweets, sugars, jaggery, refined starch, deep fried foods and high-fat foods. They should reduce animal fat and saturated fat intake. Adopting healthy cooking habits like grilling, microwaving and steaming rather than deep frying would be highly advantageous. They can have unlimited amounts of vegetables. Among the fruits, apple, pears, guava, orange and papaya are the ones with have the least impact on glucose levels. The importance of adequate physical activity cannot be over-emphasised. People should not rely solely on house-hold work for their physical activity. Physical activity could include walking, jogging, swimming and playing games. Medications include tablets and insulin injections.Technology has revolutionised the way in which insulin is delivered – smaller needles, insulin pens, insulin pumps – all of which have made life easier for people with diabetes.
Periodic monitoring of blood glucose levels to ensure good control and periodic examination (eg. annually) for possible complications of diabetes can avoid complications of diabetes and thereby would improve the quality of life for people with diabetes. Preventing diabetes and minimising the complications in people who already have diabetes will not only improve the health of our people, but also our country’s economy.
DIET AND LIFESTYLE MODIFICATIONS FOR PEOPLE WITH DIABETES
The food you eat on a daily basis plays an important role in managing your diabetes.
Focus on eating only as much as your body needs.
Limit foods that are high in sugar and fat. Remember that carbohydrates turn into sugar, so watch your carbohydrate intake.
Highly processed foods (junk foods) and refined carbohydrates are high in sugar.
Always try to take a mixed meal containing carbohydrate, protein, fat and fibre with each meal.
Aim to eat at least five portions of fruit and vegetables per day.
Try to combine several different vegetables or fruits of different colours to get the different vitamins and minerals.
Try to avoid the more sugary (high glycaemic index) tropical fruits like bananas, oranges or pineapples. Instead, eat lower glycaemic index fruits like blueberries, strawberries or raspberries.
Choose semi-skimmed or skimmed milk rather than full-fat milk.
Take adequate protein (eg. egg, pulses, lentils, beans, nuts, etc)
Get at least 30 minutes per day of brisk physical activity every day. Aerobic exercises like walking, jogging are quite useful.
Lose excess weight: weight loss in people who are over-weight or obese will help to bring down the sugar, blood pressure and cholesterol level.
Diabetes and smoking are bad combinations. Both increase the risk of several complications like stroke, kidney disease, heart disease, etc,. Therefore it is all the more important for people with diabetes to stop smoking.
People who drink alcohol need to be aware that alcohol can make the sugar levels go low or high.
And lastly, regular check-ups and monitoring are vital to prevent complications – sugar levels once in 3 months and kidney blood tests, urine test and eye examination at least once in a year are important.