Diabetes

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Diabetes also known as Diabetes Mellitus, is a condition where the blood sugar or blood glucose levels in the blood are too high. It is a non communicable disease and is caused by various factors which may be either genetic, an autoimmune condition, sedentary lifestyle, being overweight, unhealthy eating habits, tobacco use, stress, etc.

It can cause, among other conditions, damage to the heart, blood vessels,  eyes, kidneys and nerves.

In order to understand diabetes, it is important to understand what is blood sugar and insulin and the role it plays in the body.

Blood sugar and Insulin:

When we eat food containing carbs, it is broken down into glucose in the stomach and other parts of the digestive system. Glucose is what gives our body energy to function on a day to day basis. Glucose then moves into the bloodstream and when the body detects any rise in the blood glucose levels, the glands underneath the stomach, called pancreas, releases a hormone called insulin.

Insulin acts like a key to help unlock the cells and let the blood sugar move  into the cells, thus facilitating the process of giving the body energy from what we eat and in helping to lower the glucose levels in the blood. When sugar moves out of the blood and into the cells, the amount of sugar in the blood goes down.

Excess glucose that is not required by the body for energy at that point of time, gets stored in the liver as glycogen or, with the help of insulin, converted into fatty acids, circulated to other parts of the body and stored as fat in the adipose tissue.

The body does not like the blood glucose levels to spike and functions optimally, only when the blood glucose is at an optimum level. Normally, the body is programmed to balance out the glucose and insulin levels, which is achieved by food intake, pancreas and the liver, provided the 3 are working in harmony.

In people who are pre diabetic or already diabetic this harmony is disturbed. The condition is caused either because of a deficiency of insulin in the body or because the insulin in the body cannot function as well as it should, leading to a rise in the blood sugar levels. Without insulin, cells will be unable to use glucose as fuel and they will start malfunctioning.

There are many types of diabetes, but the 2 most common ones are:

1. Type 2 Diabetes (T2D): This type of diabetes is seen most often in middle-aged and older people. T2D is the most common type of diabetes and accounts to 80% of all diabetics. Causes are typically weight gain, a sedentary lifestyle, faulty dietary habits and even stress. In this type of diabetes the insulin is not properly regulated. The cells of the body become insulin resistant. When the cells become insulin resistant, it requires higher than normal levels of  insulin to move the sugar into the cells. Difficulty to do so, leads to too much sugar being retained in the blood. Over time, if the cells require more and more insulin, the pancreas get stressed out and may begin to fail.

Genetic factors do predispose susceptibility to the disease but lifestyle plays a major role in T2D. It can definitely be prevented. If you are genetically susceptible to T2D, but if you take good care of your body, you may not develop diabetes at all. If not prevented, it can be delayed or kept well under control with proper lifestyle changes. This includes following a proper diet, exercising regularly and regular visits to the doctor. A T2D management of the disease includes weight loss and a low carb diet.(For guidelines on Low GI Carbs, click here) Replacing sugar or refined carbs with foods that have less of an effect on blood sugar may help reduce your risk of T2D.

2. Type 1 Diabetes (T1D): In this type of diabetes the body is incapable of making the insulin hormone because of an autoimmune response whereby the insulin producing cells in the pancreas have been destroyed. Unfortunately, the reason why this happens is not clear. Underlying genetic disposition may also be a T1D. While a person can prevent Type 2 Diabetes by avoiding a sugar-rich diet and inactive lifestyle, preventing Type 1 Diabetes is not possible. This kind of diabetes are most often found in childhood or under the 40’s age group. It  accounts for 10% of all the cases. In people suffering from T1D, the carbs are broken down to glucose as normal and the glucose moves through the bloodstream. Normally, the body would detect the blood glucose and the pancreas would release the insulin hormone, to let the glucose into the cells in the body, thereby reducing the blood glucose levels. However, in Type 1 Diabetics, the glucose is unable to get into the cells because of the absence of insulin or insufficient insulin production.

Consequently, the blood glucose levels keep rising. The body tries hard to get rid of the blood glucose and in this attempt, gets rid of it through the kidneys to lower the blood glucose levels. This is the reason that people with T1D frequent the toilet. T1D is normally managed with insulin injections and therefore Type 1 diabetics are are always insulin dependant.

Blood Parameters for Diabetes:

Blood Normal Pre- Diabetes Diabetes
Glucose Fasting 70-100 101-126 >126
Postprandial

(2 hrs post lunch)

70-140 140-200 >200

Tests to Detect Diabetes:

  1. Fasting blood sugar test 
  2. Glycated Hemoglobin (HbA1c) test is highly recommended as it tells you your average level of blood sugar over the past 2 to 3 months. It is a common blood test used to diagnose type 1 and type 2 diabetes and to monitor how well you are managing your diabetes. (For reference click here)

Nutritional Guidelines for Controlling Blood Sugar/Diabetes:

Do’s

  • Do include only Low to Moderate Glycemic Index and High Fiber Carbs such as:

      -All green veggies.

     -Fruits like apples, pears, guavas, oranges, papaya

   -Cereals like Oats, jowar/sorghum, bajra/ pearl millet, ragi/finger millet, buckwheat, quinoa

  • Do include -pulses & sprouts in daily meal.
  • Include only- skim milk & skim milk products like curds/yogurt & paneer/cottage cheese.
  • Do use olive oil or canola oil instead of vegetable oils.(For reference click here)
  • Do use garlic as it is beneficial in lowering cholesterol.(For reference click here)
  • Do consume proteins with a good biological value such as egg whites, low fat chicken, fish, paneer/cottage cheese from skim milk, etc.
  • Do ensure good water intake that is well distributed throughout the day.
  • Do take 1 tsp fenugreek(methi) soaked overnight & add vinegar to foods. (For reference click here)
  • Do indulge in favourite treats occasionally, but keep the portion size small.
  • Do carry dry fruits to be had if there is a dip in the sugar levels or any dizziness.
  • Do read nutritional labels and ingredient list before buying  packaged foods to check for fat content and amount of added sugars.
  • Do include exercise as part of your daily routine.
  • Do ensure regular doctors examination & sugar level check periodically.

Don’ts

  • Do not consume refined foods and foods with very high glycemic index (which spike your insulin levels), such as :

     -High starch vegetables like potatoes, yam, tapioca

     -Fruits like bananas, mangoes, grapes

     -Cereals like maida/flour, rawa/semolina, corn

     -Other sugars like table sugar, brown sugar, honey, jaggery

  • Do not consume saturated fats from whole milk/toned/double toned milk or their products like yogurt/curds, paneer/cottage cheese, butter, ghee, etc
  • Do not consume trans fats like breads, biscuits, baked foods, margarine, processed meats(salami, sausages, bacon, ham).
  • Do not consume packaged foods with sugars high in glycemic index such as sucrose, maltose, dextrose/glucose.
  • Do not over consume packaged foods high in starches such as corn syrup, waxy maize, amylopectin, molasses or high fructose.
  • Do not indulge in smoking as it is associated with insulin resistance and inflammation. (For reference click here)

 

 

 

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