Understanding Diabetes Better

Living
with Diabetes
Just for Hearts
Health, Heart, Lifestyle and more
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Living with Diabetes
Contents
1) Understanding Diabetes Better
2) Myths & Facts about Diabetes
3) How to monitor blood sugar regularly?
4) Glucometer & Home Monitoring of Blood Sugar
5) Top 10 Diabetes Superfoods
6) Fruits for Diabetes
Authors
Dr. Rasika Phutane
Corporate Wellness Consultant
Diabetes Educator
Ms.Tejas Limaye
Clinical Nutritionist
Diabetes Educator
Ms. Shweta Kate
Diet Consultant
Diabetes Educator

Understanding
Diabetes Better
Just for Hearts
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Understanding Diabetes Better
How do people get energy for the activities of day to day? Energy comes from
food we eat, specifically carbohydrates, proteins and fats. Once the food is
digested, the glucose moves into blood and travels to body cells and liver. But
the cells cannot use glucose for energy unless there is insulin present in blood.
People who do not have diabetes have normal blood glucose levels because
they (the pancreas) release insulin into blood proportional to the amount of
glucose in blood. Insulin works with the cells to help the cells turn glucose into
energy hence brings down the blood glucose level. The muscle cells in
particular, utilize glucose to provide energy. The brain cells need constant
supply of glucose to function optimally.
Any glucose that is not utilized by the cells gets stored in the liver and/or
converted to fat. Stored glucose can later be used when needed, for example
when a person is fasting or doing an activity that requires more energy than
available.
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Diabetes is characterized by abnormally high glucose levels in blood resulting
from defects in insulin secretion (deficiency) or insulin action (resistance) or
both.
Diabetes was first identified as a disease in ancient world associated with
excessive muscle loss as well as presence of ‘sweet urine’ which attracted ants
and flies. Elevated level of glucose leads to spillage of glucose into the urine,
hence the word ‘mellitus’ was added which indicates ‘sweet urine’. Now the term
is collectively known as ‘Diabetes Mellitus’.
Diabetes Mellitus is a group of metabolic disorders and it is known as a chronic
disease, meaning it persists for a long time- almost a lifetime. Exposure to high
blood glucose levels over a time may damage tissues in organs throughout the
body. But good control over diabetes helps prevent complications and improve
disease outcome.
Understanding Diabetes Better
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Myths & Facts
About Diabetes
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Diabetes is a contagious disease……eating too much sugar causes diabetes..If
you have diabetes then you can never eat sweets……and the list goes on. Can
you differentiate between the myths and facts related to diabetes? If no, then you
are the one amongst those diabetics who is lost in the huge list of these myths.
So, get acquainted with the diabetes facts so that next time you can decide what
is right for your health.
1) Myth: Eating too much sugar causes Diabetes.
Fact:Type I Diabetes is caused by destruction insulin producing beta cells of
pancreas, which is unrelated to sugar consumption. Type II Diabetes results
from body’s inability to produce enough insulin.Although the tendency to get
type II Diabetes is genetically inherited in most of the cases, eating too much
sugar can cause weight gain, which can increase the risk of developing
Diabetes.
Myths & Facts about Diabetes
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2) Myth:You can catch Diabetes from someone else.
Fact: Although we are unaware about why some people get diabetes, we
know diabetes is not contagious. It can’t be caught like a flu or cold. There
seems to be some genetic link in diabetes, especially type II diabetes.
Lifestyle factors also play a major role.
3) Myth: Diabetes is not a serious disease.
Fact: Diabetes causes more deaths than any other major illnesses like
breast cancer. Two out of three people with diabetes die due to heart
disease or stroke.
4) Myth: People with diabetes need to eat special diabetic food. Fact: A
healthy meal plan for diabetics is same as a healthy diet for anyone –
high in whole grain foods, fruits and vegetables, moderate in salt and
sugar and low in fat (especially saturated and trans fats).
5) Myth: If you have diabetes you should eat only small amounts of Starchy
foods like potatoes, pasta and bread.
Fact: Starchy foods are a part of healthy meal plan. What is important is
portion size. For most of the people with diabetes, having 3 to 4 servings of
carbohydrate containing foods per meal is right. Whole grain starchy foods
are also a good source of fibres. Whole grain pasta, breads, cereals, starchy
vegetables like potatoes, peas and corn can be included in your meals and
snacks.The key is portions.
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7) Myth: If you are overweight or obese, you will eventually develop type II
diabetes.
Fact: Being overweight or obese is a risk factor for developing diabetes, but
other risk factors such as family history, age and ethnicity also play a major
role. However too many people think weight to be the only risk factor for type
II diabetes and disregard other risk factors. Most overweight people never
develop diabetes and many of the people with type II diabetes are at a
normal weight or only moderately overweight.
8) Myth: If you have diabetes and you need to take insulin, it means you are
failing to take care of your blood sugar levels properly.
Fact:All the people with type I diabetes need to take insulin as their pancreas
no longer produce insulin. For most people, type II diabetes is a progressive
disease. Initially many people with type II diabetes can keep their blood
sugar at a healthy level with oral medications. But over a period of time, body
gradually produces less and less of its own insulin and eventually oral
medications may not be enough to maintain normal blood sugar levels.
Using insulin to get blood sugar to a healthy level is a good thing, not a bad
one.
9) Myth: Diabetes will eventually lead to blindness or amputation.
Fact: Controlling your blood sugars means having little to no risk of any health
issues like eye problems or having to undergo amputation. You need to be
cognitive of what is happening in your body and know how to make
modifications to avoid diabetes complications. Diet control, exercise, regular
check up, medications and awareness are the cornerstones of Diabetes
management.
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10) Myth: Diabetics can feel whether their blood sugar levels are high or low.
Fact: There is no way for sure that will tell you your blood sugar levels, except
for testing them. Although some diabetics may feel physical symptoms like
extreme thirst, hunger, fatigue when blood sugar levels are high or low but
some people may not show any symptoms even if their blood sugar levels are
very high or low. And also some of the symptoms of high and low blood sugar
levels are similar; it becomes difficult to know exactly what it means. The only
potion to make it sure is get your blood sugar level tested.
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Your blood sugar test should act as your road map, telling you which turns to
take. Frequent up & downs in blood sugar levels may lead to serious
complications. Some of these could be risky in the short term and result in a life-
threatening crisis. For example, if your blood glucose levels drop too low
(hypoglycemia) and if it is not treated promptly, you could even become
unconscious. Other problems can develop that may not cause an emergency,
but instead lead to severe complications such as eye disease, kindly disease,
circulation problems, or nerve disease over time.The best way to lead a normal
and healthy lifestyle is to take charge of your diabetes. You can do this by
controlling glucose levels with food, exercise, medications & most importantly
regular monitoring of blood sugar levels.
How to monitor blood sugar regularly?
How to monitor
blood sugar regularly?
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How to measure your blood sugar levels?
There are two ways in which you can do so, namely testing sugar in urine or in
blood.
1. Urine sugar testing
Urine sugar testing remains the simplest, cheapest and painless method for
long-term monitoring of diabetes. The main limitation of urine sugar testing is
it cannot detect hypoglycemia (low blood Sugar). For most patients the cost
is the main factor in choosing a method of monitoring. Hence, despite its
limitations, urine testing remains method of self-monitoring of sugar control
for many patients with diabetes.
2. Blood sugar control testing:
This can be done in two ways –
In a pathology laboratory- Laboratory blood sugar testing is precise and can
also help in testing the accuracy of other methods of monitoring sugar levels.
Home/ self monitoring (with glucometer) – This is a useful tool, particularly for
those who are on insulin. This method involves finger pricking to draw blood
and checking blood sugar using strips. It is relatively more expensive but
convenient. Glucometer reports are quite accurate & may show 10-15%
variation when compared with lab reports.
Blood sugar testing can be done:
lIn fasting state (fasting blood glucose) – It gives an idea about overnight
control
l2 hours after a meal (post- prandial blood glucose) – It helps you know if
you’ve had the right doses of medication to cover the food that you have
eaten.
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Good blood sugar levels are usually in the following ranges:
l
l2 hours after meals: less than 140 mg/dl or
The best person to determine the frequency of sugar testing is your
doctor but it is a good practice to check blood sugar at least once a week
(fasting & post meal)
Other important methods of monitoring for people with diabetes
Glycosylated hemoglobin: Blood and urine glucose testing provide useful
information on day-to-day management of diabetes. However, these tests
cannot provide the patients and the doctor with a reliable measure of
diabetes control over an extended period of time.
Before meals: 70-110 mg/dl
This limitation can be overcome by performing a glycosylated hemoglobin
test which shows previous three months of diabetes control. This test has
to be performed 3-4 times a year. A test reading of less than 7% indicates
that diabetes is well under control whereas a reading of above 8 percent
suggests an increased risk of complications.
Measurement of blood facts (Lipid profile): Once a year
Kidney function tests (renal profile): To be conducted yearly
Blood pressure measurement: To be done every week or more often, if
not under control.
Eye examination (for retinopathy): Dilated fundoscopic examination to
be done yearly.
Foot examination (for neuropathy): At least once every six months or
more often as necessary.
Weight: To be assessed every month.
Doctor consultation: Minimum of once every three months if all above-
mentioned assessments are under control or more often, as suggested by
the doctor.
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Regular monitoring of blood glucose is the cornerstone of diabetes
management. People with diabetes must learn to self monitor their blood
glucose levels, interpret the results & know how to respond to them. It is equally
crucial to maintain a systematic record / a log book of these reports which assists
doctors in selecting, modifying treatment regimen. Home monitoring can be
done with the help of a simple device – ‘Glucometer’.
Blood glucose meters are reliable if used properly. They are small, portable &
user-friendly. The results are available in just a few seconds. Some people
initially find pricking the finger uncomfortable, but the lancets (pricking needles)
available today are very thin & short, making this less of an issue. Quantity of
blood required is also very little
A small drop of blood obtained by pricking the skin of a finger is placed on a
disposable stripe (which is usually inserted in the glucometer first). Meter reads
the stripe & calculates blood sugar levels (Unit: mg/dL) in just a few seconds.
Many meters now allow the blood to be drawn from alternate sites such as the
arm or palm of the hand, which may be more comfortable for some people. Most
meters have memories that will store a specific number of blood glucose results
with date & time.
Glucometer & Home Monitoring of Blood Sugar
Glucometer &
Home Monitoring
of Blood Sugar
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Following are some important points to remember while monitoring blood
sugar at home:
1. Blood sugar level must be checked either immediately before a meal or 2
hours later. Blood sugar targets must be set in consultation with doctors,
interpretation must be correctly done & appropriate action should be taken
over the reports.
2. Washing hands thoroughly before blood sugar checking is important. Spirit
swab is not needed if hands are washed properly.
3. Washing hands in warm water before pricking the finger& holding hands
below the waist line make obtaining a blood sample easier.
4. Prick on the side of the finger, not too close to the fingernail.
5. Check expiry date of the stripes before using. Old & outdated stripes give
false results.
6. The stripe container must be closed immediately after the stripe is removed
and should be stored in a cool, dry location; away from direct sunlight.
Blood sugar test should be done as often as needed to learn specific trend of
sugar levels. Testing frequency must be increased during illness or when
activities vary from the usual routine. Blood sugar testing thus helps decision
making, indicates effectiveness of therapy, determines presence of
hypoglycemia (low blood sugar levels) or hyperglycemia (high blood sugar
levels) etc. People with diabetes who test frequently soon learn how meals,
specific food, activities, medications affect their blood glucose & thus can
manage their diabetes very well.
Glucometer & Home Monitoring of Blood Sugar
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Diagnosed with Diabetes and worried about the food choices? Ever thought of
top ten foods for Diabetes that can superpower your Diet? Making best food
choices can help you maintain good health and control your blood glucose
levels. But you don’t need to worry. Here’s a list of top 10 diabetes Super foods.
As with all foods, you need to add these Diabetes super foods to your
individualized meal plan in proper portions. This list includes the foods with low
glycemic index and the key nutrients.
1. Vegetables: Loaded with nutrients, rich in fibres and low in calories. Hence
you can eat as much as you want. Tomatoes, cabbage, cauliflower, onions,
garlic, carrot, bitter gourd (karela) and green leafy vegetables like Spinach,
kale (broccoli) could be good choice.
Top 10 Diabetes Superfoods
Top 10 Diabetes
Superfoods
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2. Fruits: The best thing of the fruits isAnti oxidants. It helps protect your eyes,
nerves and heart. Fruits are also packed with nutrients, fibres and are low in
calories and fats. Berries (straw berries, black berries) are packed with anti
oxidants, vitamins and fibre. Apple, grapes, oranges, lemon and lime could
be a better choice. Because fruit have more natural sugar and calories than
vegetables you need to pay attention towards the portion. Choose whole fruit
over juice.
3. Beans: Be it kidney, black, white or soya beans any type of beans you won’t
find better nutrition than that provided by beans. They are very high in fibre
and make you feel full longer; it actually slows digestion and keeps the blood
sugar from spiking after meals. Beans also contain magnesium and
potassium. They are rich source of proteins. Canned beans can be used but
be sure to drain and rinse them.
4. Whole grains: Whole grains are rich in fibre, omega 3 fatty acids and
magnesium. Start your day with a whole grain breakfast that added most of
the fibres. This will make you eat less later on. Bran can be added to wheat
atta. Blended atta can also be used (7 kg wheat + 1.5 kg barley + 1.5 kg soya
bean + ½ kg channa). Use brown rice, it has more flavor and fibre then white
rice. Oatmeals, Popcorns are also good for Diabetes.
5. Nuts: Nuts are loaded with good fats mainly omega 3 fats coming from
walnuts, almonds and flax seeds that protect your heart. They are rich in fibre
and magnesium and help to reduce the insulin resistance. Keep in mind that
nuts have plenty of calories so sprinkle them on salad, yogurt or any favourite
baked food recipes.
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6. Fish: Fish is best source of protein and better substitute for higher fats meat.
Fatty fish salmon is a rich source of Omega 3 fatty acids (good fats). Diabetics
are often found with high triglycerides (bad cholesterol) and low HDL (good
cholesterol). Fatty fish can improve both the numbers. Include at least two-
three servings a week.
8. Olive oil: Olive oil is a rich source of heart protective monounsaturated fats. It
helps you keep your blood cholesterol within a healthy range and protect you
from risk of Heart Disease. It also helps to keep the blood sugar steady by
reducing insulin resistance. It can be used in cooking, to prepare your
dressings or simply drizzle over your foods.
9. Fenugreek Seeds: They are packed with fibers and antioxidants which helps
to lower down sugar levels. Include 2 teaspoons of fenugreek seeds in your
daily diet in the form of sprouts or powder.
10. Cinnamon: You would be surprised to know that sprinkling the cinnamon on
your foods can help to lower blood sugar. Cinnamon helps the body to use
insulin more effectively and more glucose enters the cell. You can add
powered cinnamon to whole wheat toast, oatmeal. Or else soak a cinnamon
stick in hot water to have a soothing cup of cinnamon tea.
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Many diabetics have the mistaken belief that fruits are not good for them as they
believe all fruits have high sugar, not well for diabetic patients and worsen their
condition thus; diabetics often ask whether it is safe for them to eat large
quantities of fruit. This is not true completely.
Fiber rich foods are generally safe for diabetics to eat because they tend to have
a lower glycemic index (GI) it means they do not spike blood sugar levels, such
as Avocado, Cherries, Lime, Kiwifruit, Pears, Apricots, Pomegranates,
Blueberries, Grapefruit, Rose apple, Apple, Papaya, Watermelon, Plums,
Strawberries, Muskmelon etc.
Fruits with high amounts of the sugars tend to have high GI values and should
not be eaten as they can spike blood glucose levels very quickly. Hence it is
better if you stay away from these fruits like custard apple, grapes, mango,
banana and sapota.
Diabetic patients should also remember that even if you choose high fiber, low GI
fruits, you should consume it with the cover or without peeling off the outer cover.
And you must avoid fruit juices as they do not contain enough fiber and thus are
useless for diabetics. Enjoy your day by adding at least 1 fruit daily.
Fruits for Diabetes
Fruits for Diabetes
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