Diabetes

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Diabetes

World Diabetes day- November14.

Diabetes:

v The food we eat is converted into glucose during digestion and mixes the blood.

v Glucose is what gives us energy. Glucose cannot be used directly by our cells.

v To help with this, the pancreas secretes insulin.

v Insulin, which mixes in the blood, helps cells use glucose to keep blood sugar levels under control.

v If insulin is not secreted properly or is not enough to control blood sugar levels, blood sugar levels will rise. This is what we call diabetes.

Types of diabetes:

v Type I Diabetes

v Type II Diabetes

v Gestational Diabetes

v Secondary Diabetes

v MODY Diabetes – Maturity onset diabetes of the young

v Juvenile Diabetes.

Type I Diabetes:

v About 5% of diabetics in India belong to type I Diabetes.

v In these people, the pancreas does not secrete insulin.

v Once diagnosed with type I diabetes, you can live a healthy life by taking artificial insulin for the rest of your life.

v Type I diabetes is more common in children and those under 20 years of age. We can’t prevent this type of diabetes.

v After an illness like typhoid, our immune system, due to the auto immune problem that attacks our body, insulin secretion may stop completely within a couple of months.

v By preventing viruses, dengue fever, etc., the chance of sudden onset of type I diabetes can be reduced to some extent.

Diet plan for type1 diabetes:

Breakfast (By 8:30AM)	A bowl of wholegrain cereal such as Porridge or bran flakes with skimmed milk (or) Egg and wholegrain toast with unsaturated spread.
11:00-11:30AM	Anyone unsweetened fruit such as blackberries, guava, lemon or tomato etc (or) vegetable salad.
12:00-2:00PM	A sandwich made with wholegrain bread or a wrap with chicken turkey, or fish, filled with plenty of salad (or) A healthy soup such as cauliflower and leek soup paired with wholegrain/ rye crispbreads with unsweetened yogurt.
4:00-6:00PM	Green tea + Chickpea/ Steamed sprouted pulses.
7:00-9:00PM	Lasange and salad/ Roast chicken with potatoes and vegetables/ Mixed vegetable and bean curry/ Chicken tortillas and salad (Mexican diet).

Type II Diabetes:

v 95% of diabetics in India have type 2 diabetes.

v For them, insulin is secreted in the pancreas. But, its efficiency is low or it is not secreted enough.

v Type2 diabetes is more likely to be hereditary.

Causes:

1.     Food: Generally, high fiber foods should be taken at night. There is a gap of eight to ten hours between dinner and breakfast. When you eat easily digestible foods at night, you feel hungry sooner. So, the dishes like chapati, veggie stew etc. are suitable for night time.                                      Glycemic index:

High Glycemic index – 70 and higher.

Medium Glycemic index – 56 to 69.

Low Glycemic index – 1 to 55.

v A Glycemic index refers to how quickly the sugar in food is mixed into the blood.

v Of all easily digestible foods, sugar is easily digested and mixed into the blood. So, these contain high glycemic index.

v In general, it is best for diabetics to consume foods with a low glycemic index.

v Idly, idiyappam, rice, finger millet, some fruits etc. have high glycemic index. So, it is better to eat very little of these.

v Diabetics should consume more fiber rich foods like wheat, vegetables, greens etc.

v Because for diabetics, the sugar in the food should be absorbed slowly by the blood. Only then, insulin can work properly.

Diet:

For those who like to eat idly, it is best to have 2 idlis, a cup of vegetable sambar, an egg white, vegetable salad etc. for breakfast.

High Glycemic index foods:

v Sugar and sugary foods

v White bread

v White rice

v Sugary soft drinks

v Potatoes

v Macaroni

v Dates

v Lychee

v Sago porridge

Medium Glycemic index foods:

v Basmati

v Digestive biscuit

v Papaya

v Raisins

v Dosai with chutney

v Boiled potato

           Low Glycemic foods:

v Barley

v Yam

v Cabbage

v Tomatoes

v Watermelon

 

 

 

Fruits, Dairy, Drinks, Sweeteners, Veggies, Snacks	Glycemic index
Raspberries	30
Apple	38
Pears	38
Blueberries	40
Strawberries	40
Oranges	42
Peach	42
Grapes	46
Kiwi	47
Banana	52
Pineapple	59
Cantaloupe	65
Watermelon	72
Butter	0
Whole Milk	31
Sweetened Yogurt	33
Chocolate Milk	40
Plain Ice Cream	61
Cheese	0
Skimmed Milk	32
Low Fat Yogurt	33
Soy Milk	44
Red Wine	15
Tomato Juice	38
Orange Juice	50
Fanta Orange	68
Gatorade	78
Beer	15
Apple Juice	44
Coca Cola	63
Cranberry Juice	68
Stevia	0
Agave Syrup	15
Maple Syrup	54
Honey	61
Splenda	80
Fructose	15
Glucose	100
Sucrose	65
Coconut Palm Sugar	35
Carmel	60
Kale	5
Spinach	6
Cabbage	10
Tomato	15
Green Peas	48
Brussels Sprouts	6
Corn On the cob	54
Broccoli	10
Cauliflower	12
Carrots	47
Peanuts	13
Corn chips	42
Blueberry Muffin	59
Popcorn	65
Donuts	76
Pretzels	83
White Rice	85
Nutella	33
Fruit Rollup	99
Snickers Bar	50
Raisins	64
Graham Crackers	74
Baked Potato	76
Rice Cakes	84

2.     Physical inactivity

3.     Alcohol: Although alcohol does not directly cause diabetes, it does indirectly cause the biggest impact. It indirectly predisposes to diabetes because of liver damage and weight gain to alcohol drinkers. Alcohol can indirectly lead to diabetes because of liver damage and weight gain in alcoholics.

4.     Cigarette: Cigarettes contain many chemicals. A single cigarette alone contains approximately 80 types of highly toxic substances. When these affect the blood vessels, pancreas, etc., diabetes is more likely to occur. Most people who smoke cigarettes develop diabetes later on.

Symptoms of Type II Diabetes:

v Polyuria. In particular, they wake up at night and urinate two or three times.

v Polydipsia.

v Polyphagia.

v Physical fatigue will occur; Sleepy during the day.

v Hand, leg pain, body pain etc. will occur.

v Pai in joints.

Impacts:

v Itchy feet.

v Blurred vision.

v Kidney damage.

Secondary Diabetes:

Secondary diabetes is a condition in which the secretion of insulin is affected due to diseases or damage in the body. If the cause of diabetes is identified and treated, this problem can be cured to some extent.

Causes of Secondary Diabetes:

Steroid:

Few of the people who take steroid drugs are likely to develop diabetes because of the excess of steroids in the body. If they avoid taking steroids, the diabetes will be cured.

Gallstones:

Due to not eating on time and obesity, gallstones are formed. Gallbladder stones, bile duct stones, etc., can press on the pancreas, hurting the pancreas and causing problems with insulin secretion.

Hormonal deficiency:

v A steroid hormone is secreted from the adrenal gland. If this hormone is secreted excessively, the problem of ‘Cushing’s Syndrome’ occurs and diabetes may occur.

v Diabetes can occur if the adrenaline hormone is secreted excessively due to a tumor in the adrenal gland.

v People with acromegaly, the problem of excessive growth hormone secretion, are more likely to get diabetes.

v To a certain extent, the pancreas will provide the excess insulin required by women suffering from PCOD. At some point this function becomes affected and diabetes is likely to occur. Controlling body weight and correcting PCOD Can prevent the chances of developing diabetes.

Alcohol:

Rarely, alcohol can cause pancreatitis in some people. Because of this, diabetes can occur.

MODY Diabetes:

v It is a type of diabetes caused by genetic mutations. This type of diabetes is very rare in India.

v Generally, this type of diabetes occurs in people under 30 years of age.

v There are 12 types of MODY defects such as HNF1A, Hepatocyte Nuclear Factor-1 Beta, Glucokinase.

v Each has a different treatment. A blood test should be used to find out which DNA causes diabetes and treat it.

v Diabetes can be controlled by giving simple pills for some MODY deficiencies.

Gestational Diabetes:

v Some women may develop gestational diabetes during pregnancy. The placenta connects the mother and the baby. It is from here that various hormones pass through to the baby.

v After 24 weeks of pregnancy, the body needs more insulin due to the hormones in the placenta. Pancreas itself produces it.

v In some pregnant women, gestational diabetes occurs when the pancreas does not produce enough insulin.

v Blood sugar levels will return to normal within 24-48 hours after the birth of the baby. Gestational diabetes is temporary.

v But, after a few years, they have a chance of developing diabetes again. By following your doctor’s advice, you can reduce your chances of developing diabetes.

Diabetes in children:

v If a baby has diabetes within the first six months of life, it is wrong to assume it is Type 1.

v They are more likely to develop MODY Diabetes.

v Diabetes can be controlled if the genetic cause of diabetes is found and treated accordingly.

v Diabetes that occurs after six months of age is usually Type1.

v Type 2 diabetes can occur due to obesity. Avoiding obesity in children can prevent them from developing Type 2 diabetes.

Diabetes test:

v Blood test should be done on an empty stomach in the morning, 10 hours after dinner (FBS).

v Then after having, two hours later, the blood test (PPBS) should be done again.

v We can soon know how much sugar is in the blood with glucometers. By pricking a very thin needle into the finger, with just two drops of blood, the blood sugar level can be determined instantly.

Blood sugar level:

Condition	Fasting blood sugar(mg/dl)	Post prandial blood sugar(milligram/deciliter)
Default state	70-100	Less than 140
Pre-diabetes	100-125	140-200
Diabetes	More than126	Above200

HbA1C Test:

4 - 5.7%	Normal
5.7 - 6.5%	Pre-diabetes
6.5 - 7%	Sugar is under control
7 - 8%	Sugar is out of control
Above 8%	Sugar is at its worst

v Fearful of diabetes, some people pretend that their sugar levels are under control by eating moderately and walking a little for four or five days before the test.

v HbA1C test is usually done to determine whether or not diabetes is present and whether diabetics are keeping their sugar levels under control or not.

v The HbA1C test calculates the ratio of sugar in hemoglobin.

v This test can find out how much blood sugar has been in the last two or three months.

HbA1C Test- Exception:

For whom is the HbA1C Test exempt?

v Anemic people have low hemoglobin. Some people have fluctuations in hemoglobin levels. For these people, this blood test will not be useful.

v This test is also not suitable for diabetics whose creatinine is high due to kidney damage.

Diabetic patients should undergo annual check-ups:

v Retina.

v Creatinine levels in blood and Albumin levels in urine.

v Examination of the feet.

v HbA1C.

v Lipid profile.

v Liver function test.

v ECG.

Insulin:

v Type 2 diabetes can take pills to stimulate the pancreas to secrete insulin.

v If don’t secrete enough insulin even after taking the pill, you may need to take insulin by injection.

v It is best for diabetics to protect themselves from water, mosquitoes, and foodborne illness as much as possible.

v Many people are in doubt whether they need to take insulin injections for the rest of their life after taking insulin injections once. In general, diabetics will require higher doses of insulin if they have any other condition. That’s why insulin injections are prescribed.

v If the disease is identified, treated accordingly, and the disease is completely cured, insulin will not be needed in large amounts again. Even after two or three years, you can go back to the pill again.

v Insulin pump:

v Type1 diabetics must take insulin for life.

v In order to avoid daily injections, modern technology now has an insulin pump.

v If the insulin pump is implanted in the stomach, it will know the function of the pancreas and give insulin to the body accordingly.

Diet chart for diabetics:

Time	Food
By 8 AM	3 Unleavened flat breads (Chapati)+ Hodge Podge (Vegetable kootu), 3 Idly/ 3 Crisp savoury pancake (Dosa)+ Mint/ Peanut/ Celery/ Tomato Chutney. (Just something).
11:00 AM	Any fruit like Guava / Papaya / Buttermilk / Vegetable salad / 2Wheat biscuits. (Just something).
12:00 PM	1Cup of rice, 1/2 Cup lentil based, vegetable stew (Sambar), 1Cup Hodge Podge, 2CupsSteamedvegetables, 1cupSpinach, 1Cup Pepper water (Rasam).
4:00PM	Green tea (or) Coffee/Tea without sugar, Half-boiled sprouted pulses (or) Chickpeas.
7:00PM	Upma is made from semolina or cream of wheat (Wheat upma), Upma is made from rice flour with vegetables (Vegetable upma), Crisp savoury wheat pancake (Wheat dosa), Unleavened flat bread (Chapati), String hopper, with Lentil based vegetable rich broth (Vegetable rich Sambar). (Just something).

Do’s and Don’ts:

v Take anyone greens every day.

v All other vegetables can be eaten except tubers.

v Non-vegetarians should avoid red meat, such as mutton and beef. Chicken meat that is not raised with hormone injection can be eaten once a week. Have the white part of chicken eggs. Fish is good for health. Fish and chicken meat can be eaten steamed or boiled without frying in oil.

v Nuts like almonds can be eaten.

v Diabetics can eat apple, guava, pear, orange, papaya, kiwi, jamun, dragon fruit.

v You can eat protein-rich pulses, chickpeas, green peas, peanut, and egg whites.

v A daily average of 1,500k. calorie is sufficient for diabetics.

v Eat on time. Eat two hours before going to bed at night.

v Drink as much as water as you need.

v Seven hours of uninterrupted sleep is required.

v Avoid stress.

v Both physical work and walking should be strictly followed.

v Cigarettes and alcohol should be strictly avoided.

v HbA1C should be tested at least once every six months.

v A full body check up is necessary once a year.