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Managing blood sugar

Diabetes management is a team effort. Continued nutrition education is essential for all the newly detected patients.

Dietary measures are an essential part of the treatment of diabetic patients. Diabetes is no longer a dreaded disease.

A well-managed diabetic has a good life expectancy and can live his life to the fullest.

The diet for diabetic is prescribed in terms of exchange lists, food exchange lists are groups of measured foods of the same calorific value and similar protein, fat and carbohydrate (CHO) and can be substituted one for another in a meal plan.

Daily energy intake must be estimated after considering such factors as age, sex actual weight, in relation to desirable weight, actively and occupation.

The first priority for food and meal planning is total number of CHO that the person with diabetes chooses to have for meal or snacks. This is basis of carbohydrate counting, whereby food portions contributing 15g of carbohydrate regardless of the source is considered to one CHO serving. CHO should contribute 55-65 per cent of the total calories.

Glycemic Index: The rise of blood sugar after a meal does not merely depend upon the amount of CHO ingested but also the rapidity of absorption which varies with fibre content, phytate, tannins and enzyme inhibitors.

Low glycemic index foods, which are generally rich in fibre and hence improve the glucose tolerance. Ice creams, groundnut and milk, which are high in fat have low glycemic index but not recommended for diabetes because they have high calorfic value which leads to obesity when consumed more. The body weight of a diabetic should be maintained five per cent below ideal body weight.

Alcohol: Should be consumed in modulation. The effect of alcohol on blood glucose level depends not only on the amount of alcohol ingested but also on its relationship to food intake. In the fasting state, alcohol may cause hypoglycemia.

Patients with medical problems such as pancreatitis, advanced neuropathy, serve hyper triglyceridemia, should avoid alcohol.

Eat small meals with snacks in between meals and at bedtime.

Avoid beverages and food containing caffeine that may cause the same symptoms on hypoglycemic.

Decrease fat intake: A high fat diet especially saturated fat has been shown to affect the body’s ability to use insulin. Decrease fat intake can also help with weight loss.

Diabetes management is a team effort. Persons with diabetes must be at the center of the team because they have the responsibility for day-to-day management. Continued nutrition education is essential for all the newly detected patients.

(Dr Thara Murali, chief dietician , Mallya Hospital.)