WHAT IS DIABETES?

What is diabetes? What causes diabetes?

Diabetes (diabetes mellitus) is classed as a metabolism disorder. Metabolism refers to the way our bodies use digested food for energy and growth. Most of what we eat is broken down into glucose. Glucose is a form of sugar in the blood - it is the principal source of fuel for our bodies.


When our food is digested the glucose makes its way into our bloodstream. Our cells use the glucose for energy and growth. However, glucose cannot enter our cells without insulin being present - insulin makes it possible for our cells to take in the glucose.


Insulin is a hormone that is produced by the pancreas. After eating, the pancreas automatically releases an adequate quantity of insulin to move the glucose present in our blood into the cells, and lowers the blood sugar level.


A person with diabetes has a condition in which the quantity of glucose in the blood is too elevated (hyperglycemia). This is because the body either does not produce enough insulin, produces no insulin, or has cells that do not respond properly to the insulin the pancreas produces. This results in too much glucose building up in the blood. This excess blood glucose eventually passes out of the body in urine. So, even though the blood has plenty of glucose, the cells are not getting it for their essential energy and growth requirements.

Measuring the glucose level in blood

Why is it called Diabetes Mellitus?

Diabetes comes from Greek, and it means a siphon. Aretus the Cappadocian, a Greek physician during the second century A.D., named the condition diabainein. He described patients who were passing too much water (polyuria) - like a siphon. The word became "diabetes" from the English adoption of the Medieval Latin diabetes.

In 1675 Thomas Willis added mellitus to the term, although it is commonly referred to simply as diabetes. Mel in Latin means honey; the urine and blood of people with diabetes has excess glucose, and glucose is sweet like honey. Diabetes mellitus could literally mean "siphoning off sweet water".

In ancient China people observed that ants would be attracted to some people's urine, because it was sweet. The term "Sweet Urine Disease" was coined.

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There are three main types of diabetes:

• Diabetes Type 1 - You produce no insulin at all.
• Diabetes Type 2 - You don't produce enough insulin, or your insulin is not working properly.
• Gestational Diabetes - You develop diabetes just during your pregnancy.

(World Health Organization)

Diabetes Types 1 and 2 are chronic medical conditions - this means that they are persistent and perpetual. Gestational Diabetes usually resolves itself after the birth of the child.

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Treatment is effective and important

All types of diabetes are treatable, however Type 1 and Type 2 diabetes last a lifetime; there is no known cure. The patient receives regular insulin, which became medically available in 1921. The treatment for a patient with Type 1 is mainly injected insulin, plus some dietary and exercise adherence.


Patients with Type 2 diabetes are usually treated with tablets, exercise and a special diet, but sometimes insulin injections are also required.


If diabetes is not adequately controlled the patient has a significantly higher risk of developing complications, such as hypoglycemia, ketoacidosis, and nonketotic hypersosmolar coma. Longer term complications could be cardiovascular disease, retinal damage, chronic kidney failure, nerve damage, poor healing of wounds, gangrene on the feet which may lead to amputation, and erectile dysfunction.

Diabetes Statistics:
In the USA - 2007

17.9m people are diagnosed with diabetes
5.7m people are undiagnosed with diabetes
57m people have pre-diabetes
186,300 (0.22%) people under 20 have diabetes
1 in every 400 to 600 under 20-year olds have Type 1 diabetes
2m adolescents have pre-diabetes
23.5m (10.7%) of those over 20 have diabetes
12.2m of those over 60 have diabetes
12m men (11.2%) have diabetes
11.5m women (10.2%) have diabetes

American Diabetes Association

DIABETIC DIET

This is the question my diabetic patients always ask. Hopefully this article will enhance your knowledge about diet for a diabetic patient.

AVOID THESE FOODS

If you are a diabetic patient try to avoid following list of foods.

1-Sugar, artificial sweeteners and honey. However you may take sweetner like stevia. It is difficult to omit sugar from your diet at-once, I will recommend you to decrease sugar in your diet gradually.

2-You should stop taking sweets and chocolates. If you are in a party and want to take chocolate, then preferably try to take Continental dark chocolate with at-least 70% or more cocoa solids, and try to avoid chocolates where sugar is the first named ingredient

3-Try to avoid foods containing ingredients end in (ol) or (ose) as these are mainly different forms of carbohydrates like fructose, glucose, dextrose.

4-Avoid grains like cakes, biscuits, pies, tarts, breakfast cereals, wheat, rye, barley, corn, rice, bread, pasta, pastry,

5-Avoid vegetables which contain larger amount of starch and carbohydrates like potatoes,carrots, peas, beans, parsnips, beet.

6-Also avoid fruits like water mallon, mangoes, banana, Chikoos(Pakistani), jackfruit, grapes, Strawberry, Sugarcane.

7-You may take milk but in small quantity. Avoid fat yogurts and cheeze. Also be careful not to drink too much coffee or tea and add only as much sugar as in needed for taste.

8-Avoid commercially packaged foods like TV dinners, “lean” or “light” in particular, and snack foods, fast foods.

9-Avoid fresh fruit juices as these are highly concentrated carbohydrates. If you like fruit juices you may dilute one part of juice with 3 or 4 parts of water.

10-Always avoid saturated fats like fatty meat, full fat dairy products, butter, lard. Try to prefer unsaturated fats like olive oil, corn oil, canula oil, sunflower oil,soya oil.Avoid cottage cheese as it has a high carbohydrate content and very little fat

You must be thinking that I have mentioned here all the stuff, and nothing is left to eat, these are foods you can eat:

1-You may take fruits like apple, Grapefruit, Lime, Peaches. You must divide your fruit and vegetable diet in five portions through all the day, by Spreading the fruit you eat through the day helps to avoid a sudden rise in blood sugar levels.

2-You must take high fibre diet. Fibrous diet is Cereals, Fruits, Nuts, Pulses, Seeds, Vegetables. Fibrous diet not only lowers your glucose level but also decreases blood cholesterol.

3-Always try to take whole grain rather than processed food and take things like whole-wheat spaghetti and brown rather than white rice(Indian Pakistani). Pakistani and Indian people do like white rice very much, but if you are diabetic, please avoid these.

4-You may take meat of lamb, beef once or twice a week. Organ meats can also be taken like liver kidneys and heart to meat your vitamin needs.

5-Try to take white meat like poultry chicken fish meat duck etc.

6-You may take Fish and seafood of all types. It is recommended to boil, steam, bake or grill fish rather than frying it.

7-Always prefer non-fatty dairy products such as “skimmed milk”, non-fat cheese and yoghurt.

8-You may take eggs as well but try to take whitish part not the yellow one as it may increase your cholesterol level.

9-All cheeses can be taken except cottage cheese.

10-You may take all vegetables, onion and garlic are known for decreasing blood glucose level.

Generally Type 2 diabetic patients need 1500-1800 calorie diet per day to promote weight loss, however calories requirement may vary depending upon patients age, sex, activity level and body weight. 50% of total daily required calories should come from carbohydrates.One gram of carbohydrate is about 4 calories. A diabetic patient on a 1600 calorie diet should get 50% of these calories from carbohydrate. In other words it will be equal to 800 Calories from Carbohydrates, it means you have to take 200gms of carbohydrates everyday.It is better that you buy food tables with calories measurements to know more about your daily required food.

Hope this article will help you understand, what to eat and what not to eat in diabetes.

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