Diabetes mellitus has affected a bulk of Indian population, which was predicted by the World Health Organisation (WHO) more than two decades back. Too much of refined sugar, cola culture and sedentary habit have made the country invalid through the metabolic disease.
The author was involved in taking care of the diabetic population of an industrial township for three decades. Obesity, sedentary habits and improper diet have doubled the incidence of this metabolic condition in our society; it has not spared even the tribal population due to industrialisation.
Diet plays a huge role in prevention and management of type 2 diabetes. Here we will discuss a few frequently asked questions by the patients and their relatives on the dietary aspects of diabetic patients. Diabetics are normal persons who too have a desire to eat and drink but due to the metabolic problem in their body, certain restrictions are put on them so that they too lead a long and normal life. The advice is for their benefits; they must not fight against the disease but live with it.
1. Frequently asked questions by diabetic patients
Can I take mango, litchi, grapes, apple and other fruitsIJ Yes, seasonal fruits are allowed provided the person has mental strength to say no! The problem with diabetics is that they have an unfulfilled desire to consume sweets and sweet fruits. Without informing the wife or husband as the case may be, they eat away the forbidden foods. All fruits contain some amount of carbohydrate which gets converted to glucose in the body and raises the blood glucose level. I allow seasonal fruits like mango, litchi, apple or small size banana in a day in place of a sweet dish. In fact, fruits are some of the healthiest carbohydrates a person can consume. They contain lots of antioxidants and vitamins, and the sugar. They contain lots of fibre; so are less likely to spike your blood sugar. If you have other associated disease then consults your doctor.
2. Can I take riceIJ
Yes, but amount is restricted as per your weight, physical activities, sugar level, and other items served with the meal. Ours is a tropical country; hence rice is allowed during summer months. South Indians take rice twice and that too refined rice that might be the reason for high incidence of diabetes. They too are users of highest amount of insulin in India. If your tummy’s girth is more than chest, then be careful, you are a candidate for cardiologist. The glycaemia index of rice and chapatti is little different, plus you can count how many roti you have consumed but not the amount of rice. Most of the cases, it is rice and sweets which are the main culprits of uncontrolled diabetes. Measured quantity of rice with vegetables is allowed for diabetics.
3. What about sweetsIJ
Best is to say no to ice-cream and other sweets for your own benefit. Forget those words of friends-”’once in awhile does not matter”’. Yes once in six months is allowed. If you are living to eat then go ahead. Diabetes patients can’t resist the temptations of sweets even if they know the consequence. The so- called diabetic sweets are to be avoided.
4. Can I take alcoholIJ
If you are above 65 years, maximum allowed is 90ml twice a week. Reduce your food if you had a beer or hard drinks. Remember alcohol interacts with diabetes medicines and cause hypoglycaemia! Your triglyceride will rise further if you consume alcohol.
5. Can we get our son married in a diabetic familyIJ
Difficult to answer. If your family is diabetic too then there are high chances of your grand children becoming diabetic in early age. Diabetic population must be reduced in the world by genetic counselling and diet restrictions.
6. Role of family membersIJ
“‘Why we should suffer for him by not bringing sweets to our house,”’ the wife of a diabetic patient asked. They play a big role. Family cooperation and support plays a big role for diabetic patients.
7. What is glycaemia IndexIJ
Glucose has a glycaemia index (GI) of 100. Food with high GI is bad for diabetics. High glycemic index means there would be sharp rise in glucose level in blood causing persistent high sugar level in blood. Food must contain fibers. All soft drinks have a high glycaemia index, potato chips, candy, all Indian sweets have high glycaemia index.
8. What about cardiac checkupsIJ
Diabetics have high incidence of cardiac problems; hence they must be careful with their lipid levels, weight and blood pressure control. Periodic cardiac check up after the age of 45 is advice for diabetics with stressful jobs.
9. How much water a diabetic should drinkIJ
If there is excessive thirst and frequent urination, then the person should know that his diabetes is uncontrolled. Compulsive drinking of water is not good for a diabetic patient in colder months.
10. What about mutton, chicken, fish and eggsIJ How much a diabetic patient can eatIJ
Roughly one gram per kg of weight of the person can be consumed as protein, if you do not have kidney problem. Egg without the yolk has the best complete protein. Red meat should be avoided. Sea fish is good for diabetics and non diabetics. Remember all vegetables and pulses contain protein. Those vegetarians can compensate their protein intake through milk products.
(The writer is a diabetologist, SAIl, Rourkela, M: 9658165249)