Understanding Diabetes Better

Living with Diabetes

Just for HeartsHealth, Heart, Lifestyle and more

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TM 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 PhutaneCorporate Wellness ConsultantDiabetes Educator

Ms.Tejas Limaye

Clinical NutritionistDiabetes Educator

Ms. Shweta Kate

Diet Consultant

Diabetes Educator

Understanding Diabetes Better



TM 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:

l In fasting state (fasting blood glucose) – It gives an idea about overnight

control

l 2 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

l 2 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


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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.


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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


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2. Fruits: The best thing of the fruits is Anti 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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Understanding Diabetes Better

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