A perfect combo

BEAT THE SACCHARINE

Having diabetes isn’t the end of the world. Nor does it mean that you have to live on a sugarless diet for life. Right medicines and regular monitoring are important aspects to living life with diabetes, but what becomes equally important is what you eat and how much you exercise every day.

Some would even say that diet and exercise could make all the difference between good control and bad control of diabetes. Together, exercise and diet help you maintain good blood sugar balance so that there are no dangerous swings in the levels, which can prove to be risky for a diabetic.

Management of diabetes is critical and there are different types, or classes of drugs to lower blood glucose levels. The first stage of treatment includes medicines that stimulate the pancreas to release more insulin right after a meal and then over several hours; that help lower blood glucose levels by blocking the breakdown of starches; bile acid sequestrates that decrease the amount of glucose released from liver; and that make the body more sensitive to the effects of insulin.

A more recent development is the Glucagon-Like Peptide-1 (GLP-1), which stimulates insulin secretion and inhibits glucagon secretion. Such advancements in diabetes management provide us with the opportunity to start early treatment and management  therapies, so that it does not escalate into full-blown diabetes, which is not only painful to manage, but becomes an economic burden as well.

Steering clear

So, here are some pointers and a few words of caution on the things you should and shouldn’t do if you are a diabetic. Regardless of the type of diabetes you have, watching your diet and performing regular physical activity forms a crucial part of diabetes management. Let’s start with what to eat. Having diabetes shouldn’t keep you from enjoying most of the foods you love. However, there might be some that may not be good for you. So, some sort of compromise has to be made. For instance, foods with a high glycaemic load cause our blood glucose levels to rise rapidly and hence, need to be avoided.

Given below are some high glycaemic foods which can be eaten occasionally in small quantities, but they should always be accompanied with balanced portions of other food groups:

Foods rich in highly processed carbohydrates:

 White bread
 Snacks made from refined flour

Sugar-sweetened beverages:
Soft drinks
 Sodas and party punches
 Fruit juices made from fruit with a high sugar content such as bananas, chikoo,
watermelons and mango

Desserts rich in sugar:
 Cakes
 Pastries
 Muffins
 Sugar-sweetened candies and ice cream
Instead, opt for complex carbohydrates that have a low glycaemic load and provide you with sufficient energy without causing high blood glucose levels. The best in this category are:

Lentils

Oats, wholegrain breads and cereals Strawberries, blueberries, apples  Green leafy vegetables, beans and carrots Nuts like almonds, walnuts  Fish like sardines and mackerelAs a diabetic, you would probably have heard about the importance of portion
control. This means that serving sizes of the different foods and beverages must be
determined based on their calorie count and fat content. So, the best meal combination for a diabetic would be — 25% protein, 25% grains and starchy food and 50% non-starchy vegetables. Rich in protein, vitamins and minerals and low in carbohydrates, this combination will give you all the nutrition you need. Add fruits to your diet at breakfast or lunch and never miss breakfast as this will only increase your food cravings for the rest of the day and affect your body’s metabolism.

Choose a cooking oil low in saturated fat and trans fat but rich in omega-3. Common vegetable oils are all low in saturated fat, so choose the one that has the least of it. Keep your salt intake very low. A balance between glycaemic load and glycaemic index is
important in meal planning for diabetics.

When it comes to exercise, many of us know we ought to do it, but don’t quite know which exercise to choose or how this benefits us. Exercise assumes even greater importance for a diabetic. This is because our muscles are the main organs involved in the absorption of glucose in response to insulin. Regular physical exercise improves our muscle’s sensitivity to insulin, thus ensuring stable blood glucose levels and better diabetes control.

There are two types of physical activity that should be combined for optimal
results:

Aerobic exercises: These exercises are known to improve the health of your heart and lungs. Examples include walking, jogging, running, cycling, swimming and dancing. Such exercises help you burn calories and effectively utilise blood glucose better.

Weight-bearing exercises: These exercises build stronger muscles and bones. Examples of such exercises include push-ups, sit-ups, squatting, jumping and lifting weights. Such exercises contribute to an overall increased level of fitness, which in turn decrease your chances of diabetes complications. Such exercises should be limited and individualised.Sweating it outAbout 30 minutes of moderate exercise per day and an additional 75 minutes of moderately intense exercise such as jogging or running are recommended per week. If you think this is a daunting target, start with 10 minutes every day and build it up from there. It is crucial to test your blood glucose levels before and after exercise, so as to avoid any case of hypoglycaemia.

But exercise some caution here. Avoid running, jogging, or cycling without sturdy footwear to prevent blisters, foot ulcers and numbness. If you suffer from high blood pressure (hypertension), refrain from performing any resistance exercises unless suggested by your doctor. Consistency is key to any exercise plan, so avoid ‘stop-start’ routines. These are not only ineffective but can also cause injuries.

Ultimately, good diabetes management comes down to three simple things: taking your medicines on time, taking care of your diet and being physically active. Discuss with your doctor and plan a diabetes diet that is best suited for you, keeping in mind your BMI, physical activity levels and medication. Learn to read food labels and become more aware as a consumer.

Being diagnosed with diabetes is certainly not the end of the road. Making these simple lifestyle changes will allow you to lead a normal life and ensure a better state of overall health, fitness and wellbeing.

(The author is senior consultant, diabetes and endocrinology, Apollo Gleneagles
Hospitals, Kolkata)