How much you know about Diabetes?

  1. Is it okay that my 65-year-old mother stops taking insulin on days when she feels better? Or does she need to stick to her insulin regimen regardless of how she feels?

Insulin therapy is usually not to be skipped. However, insulin being an active therapy can only be skipped or dosages reduced in cases when patients are having low sugar. We need to understand “feeling good” is only when sugar levels are under control, and that control is achieved by adhering to optimised drug therapy and proper meal balance. The right way to manage medication is by regular blood sugar check ups, which informs the correct way to adjust the doses. From the above image, we can see there are many diff erent types of insulin available rapid insulins and shots are usually required to be taken with meals, whereas long acting ones can be given at a fi xed time, irrespective of food intake. So based on the type of therapy the patient is taking, you can discuss with the doctor if a dose can be skipped or not.

  1. My 37-year-old brother was recently diagnosed with type 2 diabetes. Is he also at a higher risk for other medical problems?

Diabetes affects several major organs, including heart, blood vessels, nerves, eyes and kidneys. In type 2 diabetes, body either resists the effect of insulin or doesn’t produce enough insulin to maintain normal glucose levels. Newly diagnosed T2DM patients tend to be ignorant to management once they start feeling fi ne. Although, these complications are long term and develop gradually, they can be disabling or life threatening. Thus, complications can be prevented by following a good lifestyle and having healthier food choice.

  1. My child who’s in 8th grade is overweight. What precautions can be taken to ensure that he doesn’t develop diabetes in the future as both my husband and I are diabetic?

You should aim to base your meals around protein. Include lots of fresh foods and limit your intake of carbohydrates and processed foods. Carbohydrates should comprise only 40-50 per cent of calories. Try to get 20 to 25 per cent of your calories from protein. Not more than 25 to 35 per cent of your calories should come from fat. Also, pay attention to portion sizes to avoid overeating.

  • Milk and milk products – Drink toned milk twice a day, and instead of ice cream shakes, drink fruit juices. Also, consume curd and smoothies in place of desserts rich in calories.
  • Cereals – Cereals with lots of fresh vegetables must be included in the diet such as vegetable upma, poha or vermicelli. Vegetable stuffed paratha with less oil is also good.
  • Protein – Adequate protein is needed for body building; therefore, sprouts, cheela, grilled or sautéd chicken, meat and fish. Fish, eggs, and chicken can be used in dry preparations. Avoid eating red meat and organ meats.
  • Fat – Avoid using too much oil when cooking.
  • Fruit and Vegetables – Seasonal fresh fruits and vegetables must be included in the diet in either their raw or cooked form.
  1. How much are diet and exercise effective in helping a diabetic person control his/her sugar levels?

As we all know, ‘we are what we eat.’ First step in diabetes management includes managing your diet and exercise. If that doesn’t control your diabetes, then it can be supported by medication. There must be a balance of different food groups being included in the diet for a diabetic patient.

  • The key to a healthy plate is a well balanced variety of food, which focuses on fibre, quality and quantity of fat. Moreover, the type of carbohydrates and timing of each meal is also important. Eating too much fat can lead to weight gain, which, in turn, causes insulin resistance. People with diabetes have high risk of developing heart disease, so it is important to eat less saturated fat.
  • Fibre helps to improve glycemic control and slows the release of sugar in blood stream, decreasing sudden blood glucose spikes. Fibre can also be increased by including complex cereals and whole pulses.
  • Regular physical activity also plays a key role in managing diabetes along with proper meal planning and adherence to antidiabetic drug therapy. Exercises control weight gain,helps regulate blood sugar, increases the body’s senstivity to insulin, helps reduce blood pressure, and lowers LDL cholesterol (bad cholesterol) and increases HDL (good cholesterol). It helps to strengthen muscles and reduce anxiety. However, patients taking insulin or medication must avoid unplanned exercise, as it may lead to hyperglycemia. Make sure you adjust your carbohydrate intake accordingly (extra CHO must be consumed pre exercise if RBS< 100mg/dl).