LEARNING TO LIVE WITH DIABETES MELLITUS

Living with Diabetes means making many changes in your life, and these changes may seem over-whelming. That’s normal reaction. When you feel down, reach out to your family and friends. Your health care team is there when you have questions, want advice, or just need to talk.

 

‘Diabetes Mellitus’ is a disorder in which the glucose in the blood is higher than usual. This condition is known as-‘hyperglycemia’, wherein the level of glucose in the blood rises above 120 mg/100ml.

 

Normal blood glucose level:

Normal fasting blood glucose= 60-100mg/100ml of plasma.

Normal two hours after meals (post prandial blood sugar- PP₂BS) is 100-140 mg/100ml of plasma.

 

There are two types of diabetes: Type 1 or insulin dependent or juvenile diabetes mellitus (IDDM) and Type 2 or non-insulin dependent or adult diabetes (NIDDM).

 

Factors causing Diabetes:

·    Hereditary Age & Stress are common causes.

·    Obesity: Obese individuals have to produce more insulin than those of ideal weight to preserve normal glucose tolerance.

·    Infection: Pancreatitis following mumps, congenital Rubella, and Coxsackie B4 infection are known to be followed by diabetes.

·    Others: some kind of pancreatic disease (like pancreatitis, haemochromatosis, malignancy, cystic fibrosis, etc.), some hormonal imbalance and certain medicines (like corticosteroids, thiazide diuretics, phenytoin, etc.).

 

Symptoms:

Symptoms of diabetes mellitus include frequent urination, increased thirst, increased appetite (polyphagia), recurrent infections, itching, fatigue, numbness in certain parts, pain in muscle weakness in the legs, drowsiness, rapid weightloss, general weakness, delayed healing of the wounds and in later stages deterioration of vision from cataract or retinopathy.

Common complications of diabetes or hyperglycemia and lipid disorders include coma, diabetic ketoacidosis, ischaemic heart disease, stroke, myocardial infarct, diabetic nephropathy, kidney failure, diabetic neuropathy, eye complications including blindness, burning of feet, tingling or numbness of feet, trophic ulcers and increased susceptibility to infections. In short, it affects nerves, eyes, heart, blood vessels and kidney.

Testing the urine for glucose is the usual procedure for detecting diabetes mellitus in the initial stages. Another test done for this condition is the oral glucose tolerance test (OGTT).

Guideline for Diabetics:

1. Adhere strictly to the prescribed diet. Remember that diet is a nutritional therapy, i.e. treatment by adjusting food habits. It is not possible to make up for dietary errors by an additional tablet or more insulin.
2. Drink at least one glass of liquid every hour. If you are eating, these liquid should be sugar free.
3. Do not miss a meal after insulin or oral anti-diabetic drugs. This may result in ‘hypoglycemia’ (too low blood glucose).
4. Do not change the dose of anti-diabetic drugs except under medical advice.
5. If hypoglycemic symptoms develop (hunger, sweating, trembling, dizziness, palpitation, weakness, headache, restlessness), immediately eat some sugar or jaggery. Follow it with a snack.
6. Exercise regularly. Practice yoga.
7. Do not overdo with the exercises as this may cause hypoglycemia.
8. Test urine regularly to monitor and control the sugar level. Since the test of urine sugar does not give sufficient information, blood test must be done on a regular basis ( at least once every 3 months)
9. Avoid alcoholic drinks including beer. Alcohol worsens diabetes as it affects the liver and pancreas.
10. Do not smoke or use tobacco. Tobacco is particularly dangerous in diabetes.
11. Avoid exposure to infections as the defense mechanisms of a diabetic may be poor.
12. Do not open blisters with a pin or needle- diabetics are prone to get infected.
13. Do not walk bare-foot as reduced sensation (numbness) can result in injury. Any injury (big or small), should be medically treated immediately and the wound must be covered as negligence can cause gangrene.
14. Do not wear tight or ill-fitting shoes or tight bandages in order to avoid hampering the already poor blood circulation of the diabetic feet.
15. When you travel, carry extra snacks & fast acting sugar. Wear a card that you have diabetes. Stick to your meal.
16. If you feel down, do things that you enjoy, like seeing favorite movie, reading a good book, listening to music, talk to good friend, or take a walk; a little exercise and fresh air are great mood lifters.

Home remedies:

(Follow at least two from the remedies given below)

·    Prepare a mixture of margosa leaf (neem) juice with a pinch of black pepper in it and have it in the morning. This reduces the blood sugar and helps control diabetes.

·    Eat as much cooked and raw garlic as possible. Also raw onion useful in lowering the blood sugar levels.

·    Daily consuming one glass of bitter gourd (karela) juice is highly beneficial for diabetics.

·    Mixture of equal quantities of Indian gooseberry (amla) juice and bitter gourd (karela) juice taken every morning will reduce the blood sugar levels.

·    Mix two teaspoonful of sweetlime (mosambi) juice with four teaspoonful of amla juice and teaspoonful of honey. Have this mixture daily in the morning on an empty stomach. This is good for diabetes.

·    Fenugreek (methi) seeds, when given in varying doses of 25 grams to 100 grams daily, diminishes reactive hyperglycemia in diabetic patients. Soak 10-12 fenugreek (methi) seeds in one fourth cup of water overnight and have both- the seeds and the water, next day in the morning with a glass of water. This is beneficial for people with diabetes. you can also powder the methi seeds and take one teaspoonful of this powder with low fat milk daily for at least two months. This will keep the blood sugar level under control.

·    Fig (anjeer), especially their seeds when crushed and taken with honey are considered to have anti-diabetic properties.

·    Turmeric powder mixed with some honey is said to keep diabetes under control.

 

Food for diabetes:

·    Alfalfa, Bengal gram, beans, bitter gourd, black gram, black jamun, broccoli, cabbage, cauliflower, cinnamon, citrus fruits, coriander seeds, cucumber, curry leaves, fenugreek seeds.

·    Fiber-rich foods, foods rich in antioxidants like dark orange and dark green leafy vegetables, dried apricots, carrots and pumpkin, French beans, garlic, ginseng herb grapefruit, Indian gooseberry (amla), ishabgul, kidney beans, lettuce, mango leaves, margosa, onions (raw).

·    Potassium rich food such as – dried fruits, nuts, vegetables, bananas, potatoes and red peppers, spinach, sweet potato leaves, soybeans.

·    In each meal, have only one source of protein either dal or curd or low fat milk. The protein should be diluted in water means don’t consume thick dal, it should be diluted in water.

·    Reduce the consumption of fat in your daily diet. Reduced oil intake and avoid fried food. Always bake, steam or sauté the food instead of deep frying or shallow frying.

 

Food to be avoided in diabetes:

·    Aerated drinks, alcohol, bananas, butter, canned food, confectioneries, creamy salad dressings, desserts, dry fruits, fried food, fruits and fruit juices, full fat dairy products, ghee, honey, jaggery, mithai, nuts (any) including peanuts, (excess) oil in food, oil capsules, pickles, preserved foods, refined foods like refined flour, pasta, sugar and polished rice, rice in general, sago, sweets, sweet potato, sugar, sugarcane and any other food that is very rich in carbohydrates.