Managing Diabetes

By now it is common knowledge that there are two main kinds of diabetes: Type 1 and Type 2. A third type of diabetes less commonly known is Gestational Diabetes, a ‘temporary’ condition affecting some pregnant women only.

Type 1 diabetes starts at a young age and is also known as juvenile or insulin-dependent diabetes. . This is because these patients have to be given insulin as treatment, since in their case the pancreas is diseased and does not produce the hormone insulin, as would happen in normal circumstances. Insulin is responsible for converting sugar (glucose) in foods into energy, which everyone needs for living.

On the other hand, Type 2 diabetes is also known as maturity-onset diabetes because it affects patients at a later stage of their life, around the age of 50-60 years, although in some cases this could be earlier if patients are genetically predisposed. Here the diabetes results from a phenomenon called insulin resistance; essentially this refers to the inability of the body to use the insulin to convert glucose into energy, resulting in a high level of glucose in the blood. But unlike Type I, Type 2 diabetes is classified as non-insulin dependent, meaning that it can be adequately managed by means of chemical drugs and physical exercise.

The triggering of insulin resistance is generally attributed to the accumulation of fat because of high calorie diet coupled with a sedentary lifestyle. Disproportionate weight gain, along with abdominal obesity is a tell-tale sign of insulin resistance, as well as being responsible for a host other health complications.

In both Type 1 & 2 diabetes, patients are faced with the daily challenge of monitoring blood sugar levels either by taking appropriate doses of medications or insulin injection, or a combination of both, as the case may be.

Proper eating habits through the consumption of a balanced diet evenly spread over the day Is a very important part of control of diabetes, through controlling the type and portion sizes of food one consumes. If diabetes is poorly controlled, over time this can lead to other problems like heart disease, kidney failure and poor blood circulation in the legs that may result in amputation.

Diabetics must avoid processed sugar and junk foods, and choose sufficient lean protein, complex carbohydrate, good fats and adequate fibre in the food regimen. Preferred protein sources are nuts, legumes, beans, tofu, eggs, fish, lean meat and skinless chicken. The basic recommendation is to fill half of one’s plate with fruits and vegetables, one quarter with lean protein and the rest with carbohydrate. Also, since carbohydrate is the crucial determinant for an optimal blood sugar balance, the sources of carbohydrate should preferably be complex coming from whole grains, legumes and low-fat dairy products.

Under the guidance of one’s a medical practitioner and a dietitian/clinical nutritionist, a meal-plan can be individualized to suit the body-type and the severity of the disease in a given patient.

This approach has the merit of also reducing the doses of drugs prescribed by physicians.

In addition to supplements containing micronutrients like vitamins, minerals and omega-3 fatty acids, it has been established that fenugreek seeds (methi) contain an alkaloid known to reduce blood sugar level. Additionally, fenugreek seeds have the advantage of lowering blood levels of bad cholesterol and triglycerides which themselves are precursors to the onset of diabetes.

The seeds can be eaten whole after overnight soaking in water or in powder form as a drink, and should be taken 15 minutes before a meal. The powder can also be incorporated in preparations such as chapatti, rice, dal and vegetables for overall beneficial effect. Pregnant women should however seek medical advice before having fenugreek seeds.

As for gestational diabetes, it is mainly a result of insulin resistance. In fact during pregnancy hormones block some of the usual action of insulin in order to allow the baby to get sufficient glucose. There is also the mistaken belief that a pregnant women should eat for two and this situation gets further complicated if the mother indulges in too many refined carbohydrates. However, gestational diabetes generally disappears once the baby is born but this is conditional upon the general health of the mother.

The usual symptoms in the onset of diabetes are:-

•       Frequent and copious urination

•       Abnormal thirst

•       Rapid weight loss

•       Extreme hunger

•       General weakness, drowsiness and fatigue

•       Itching of the genitals and skin disorders

•       Visual disturbances and blurred vision.

Since diabetes is a silent disease, it is highly recommended that people become aware of its possibility and attend screening programmes available that allow for early detection. And once a diagnosis of diabetes is made, patients must see their doctor and a dietitian as well for the purpose of designing an optimal meal plan. Patients are exhorted not to resort to medical drugs alone as they generally tend to do.

On a side note, frequent bed-wetting by children may be a first clue to possible diabetes and is not necessarily a behavior disorder. If this is observed in a child, expert advice must be sought, and It may be necessary for the child to undergo a blood glucose test.

Teenusha Soobrah
(Accredited Practicing Dietician – Australia)



* Published in print edition on 14  November 2014

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