WORLD DIABETES DAY
Keep the sugar down
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Dr. SANJIVA WIJESINHA looks at the causes of diabetes and ways to control it.
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VINO JOHN
Eat plenty of fruit and vegetables.
MOST of us know somebody — a family member, relation or friend — who has Diabetes, It is a condition very common in Indians (and South Asians in general) yet few have a reliable understanding of what it is or how serious it can be.
The simple explanation is that Diabetes is a disorder in which there is too much sugar (also referred to as glucose) in the blood. This happens when the body lacks a hormone called Insulin, whose function is to control the amount of sugar in the body. Insulin is made in an organ called the pancreas at the back of the stomach.
Two kinds
Basically, there are two types of Diabetes — Type 1 (also called Juvenile Diabetes Mellitus), which occurs essentially in young people, where the pancreas just does not produce insulin. These people require daily injections of artificial insulin to keep their blood sugar normal.
The other form is Type II Diabetes or Non-Insulin Dependent Diabetes Mellitus (also called NIDDM).
Here we believe that the pancreas is still able to produce some insulin, but this is either inadequate or is not effective in controlling blood sugar.
Type II Diabetes usually affects people over 35, most of whom are overweight and have been consuming either too much food or the wrong kind of food.
Most Type II diabetics can control their blood glucose by changing their eating habits and getting more exercise, but often they need medicines in the form of tablets. Some may require insulin injections to achieve control.
Risks
The Ayurvedic physicians of ancient India knew about diabetes. As far back as the 5th Century B.C.E. they knew it as the Sweet Disease — because when there is too much sugar in the blood, this sugar leaks into the urine and these early physicians noticed that the urine of diabetic patients attracted ants!
Although the "too much blood sugar" aspect of diabetes has been known for many years, only recently we have realised that this inability to balance the body's sugar content is only one aspect of the disorder.
We now know that diabetes is, in many ways, a problem of the body's blood vessels — one of whose manifestations is an inability to manage glucose.
AP
Diabetics need to take care of their feet to prevent infection.
Since someone with diabetes has vulnerable blood vessels, the excess blood sugar (if uncontrolled) can wreck the body's blood vessels and other organs — just like putting sugar into the petrol tank of a car will wreck the vehicle's moving parts, from carburettor to spark plugs.
This is why untreated or poorly controlled diabetes results in kidney failure, blindness, impotence and gangrene.
Diabetics are much more at risk of heart attacks than the average person — statistics show that 40 per cent of today's diabetics will suffer a fatal heart attack.
Take control
Diabetes cannot be cured yet. But it can be well controlled, provided the person with diabetes accepts responsibility for doing so.
It is imperative to eat sensibly (avoiding foods that increase the blood sugar and body fat) and exercise every day (muscular activity burns up sugar — it has recently been shown that gym workouts and strength training like push-ups are excellent in controlling blood sugar levels).
If adequate control cannot be achieved with diet and exercise, it may be necessary to add tablets or injections. Of course, taking tablets does not mean that you can skip the diet and avoid exercise!
All diabetics need a special diet, the aim being to achieve an ideal weight and to keep the blood sugar level in the normal range. Consulting a qualified dietician for practical advice is a great help.
Useful tips
Eat at regular times and cut fat foods to a minimum
Avoid sugars and refined carbohydrates (cakes, chocolates, soft drinks, gulab jamun, kulfi
Eat vegetables and fruits
Eat foods that delay the absorption of sugars from the gut — like red rice, kurukkan (ragi) and karavila (bitter gourd)
Exercise regularly. Brisk walking for 30 to 45 minutes, swimming, jogging — all utilise blood sugar and help reduce elevated sugar levels. Ideally one should exercise every day, but if this is not possible, aim for a minimum of three days a week.
Classic symptoms
Feeling very thirsty
Passing lot of urine
Needing to urinate frequently
Feeling tired and unwell
Losing weight despite a good appetitte (common in Type I)
Tendency to get repeated infections
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