Diabetes Mellitus by Reema Virmani, Registered Dietician

Diabetes is a silent epidemic and India is the diabetes capital of the world. It is currently estimated that 40 million people suffer from diabetes in India and by 2025, that number will swell up to 70 million.

Diabetes mellitus is a clinical syndrome characterised by hyperglycaemia due to absolute or relative deficiency of insulin.

Types of diabetes

• Type-1 diabetes or insulin-dependent diabetes
• Type-2 diabetes or non-insulin-dependent diabetes
• Gestational diabetes (during pregnancy)

Symptoms

Investigations

1. Urine test:

Glucose-testing the urine for glycosuria (glucose in the urine) is the usual procedure for detecting diabetes.

Ketones in the urine is another test for detecting diabetes. 

The presence of proteins in the urine can help detect diabetes as one of the complications of diabetes is diabetic nephropathy.

2. Blood test:

When symptoms suggest diabetes, the diagnosis may be confirmed be a random blood glucose test. When random blood glucose values are high but are not diagnostic of diabetes, glucose tolerance is usually assessed either by a fasting blood glucose or by an oral glucose tolerance test.

Glycated haemoglobin provides an accurate and objective measure of glycaemic control over a period of weeks to months.

Complications

Long-term complications of diabetes develop gradually. The longer you have diabetes — and the less controlled your blood sugar — the higher the risk of complications. Eventually, diabetes complications may be disabling or even life-threatening.

The complications include:

• Cardiovascular disease
• Neuropathy
  
• Nephropathy
• Retinopathy
• Foot damage/Gangrene 
• Alzheimer’s disease
• Hypoglycemia
• Diabetic Ketoacidosis

Management

• Exercise and diet control

• Insulin: Rapid, short acting, intermediate and long acting

• Oral antidiabetic drugs

Diet control

Diet advice should be placed within a holistic context of care, which includes supporting patients to manage their diabetes. Dietary advice must take account of the individual’s personal preferences, cultural background and lifestyle.

8 steps to healthy eating in diabetes:

1. Choose whole-grain foods like wheat, whole-grain cereals and pulses.
2. Reduce intake of fat, especially animal fat. Choose low-fat dairy foods, replace fried foods with grilled, steamed items. Use a small quantity of MUFA.
3. Eat more vegetables and fruits.
4. Avoid refined sugar.
5. Cut down on salt. Herbs and spices can be used as an alternative.
6. Avoid alcohol.
7. Lose weight if overweight.
8. Avoid foods with high glycaemic index.

References:

• Principles and Practice of Medicine – Davidson
  
• Food, Nutrition and Diet Therapy – Krause and Mahan
• Oxford Handbook of Nutrition and Dietetics

Download the Grow Fit app on Google Play or App Store today for a specialised diabetes diet plan.

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