Book: Understanding Type 2 Diabetes; Author: Merlin Thomas; Publisher: Pan Macmillan India; Pages: 277; Price: Rs.350
So you have been diagnosed with Type 2 diabetes. Take heart as this is not the end. Just follow some simple guidelines and achieve better sugar levels for a longer, healthier life.
In his book, Merlin Thomas, a clinical scientist at the Melbourne-based Baker IDI Heart and Diabetes Institute, has decoded the lifestyle disease in such a way that once you're done reading it, winning over diabetes becomes a lot easier.
First the facts.
According to the World Health Organisation (WHO), India will have 80 million people with diabetes by 2030.
The world has over 387 million diabetics and by 2035, this figure will rise to 592 million, says a latest report by the International Diabetes Federation (IDF).
Having diabetes is not easy as several factors - from obesity and sedentary lifestyle to genes and ageing - come into play, but its management need not to be complex or complicated, says Thomas.
Once diagnosed, manage it well with three easy-to-do steps: physical activity, balanced diet and medication.
"Of all the things that can be done to manage your diabetes, getting more physical activity is the most important," Thomas writes.
Exercise offsets insulin as muscles take up a large amount of fat and glucose from the bloodstream to replenish their fuel stores.
This uptake of glucose by muscles is very useful for people with diabetes as it means less work for insulin and other medication.
For example, Type 2 diabetes can lead to reduced blood flow to your feet.
"Regular exercise demands better blood flow to the legs to allow the muscles to work better. The blood vessels supplying your legs progressively adapt to regular exercise to improve the blood flow," Thomas explains.
So "accumulate" the moderate-intensity physical activity by focussing on everyday tasks such as walking the kids to school, walking or cycling to work, taking the stairs, parking a little farther away from markets and breaking the sitting cycle at the workplace.
When it comes to diet, a typical Indian diet consists of food that is rich in sugars (or carbohydrates).
"Also, on average, an Indian gets between 10 and 15 percent of the total energy (calories) from added sugars in processed foods but in some people, it can exceed even 25 percent," Thomas claims.
What happens in Type 2 diabetes is that there is not always enough insulin to keep glucose under control especially after meals.
For this, reduce your intake of carbs.
Instead of biryani or dal, take low-fat meat curry or tandoori. Include non-starchy vegetables like okra and eggplant for potatoes or rice.
"A good place to start is to limit your carb intake to no more than three or four serves (45-60 grams) in each meal or no more than 10 serves (150 grams) a day," Thomas advises.
There is approximately 15 grams of net carbohydrates in one slice of naan, one tablespoon of jam/jelly/sugar/honey, one piece of fresh fruit, a cup of yogurt, two-three biscuits, one muffin, a cup of rice or a large baked potato.
For fibre intake, eat a breakfast cereal that lists "wholegrain" or bran as the main ingredient.
Switch white bread for wholegrain or wholemeal bread. Shun white rice and go for brown rice.
While making fruit juice, do not get rid of the skin and the pulp. For snacks, instead of processed carbs, eat fruits with edible (whole) seeds.
According to Thomas, "for some people with diabetes, changing to a diet with large amount of wholegrain, bran and legumes is a major shift".
If you cannot resist sugary drinks, opt for "diet" beverages with artificial sweeteners.
"When used in recommended amounts, artificial sweeteners appear to have no adverse effects on human health," Thomas writes.
Most people with Type 2 diabetes will reach a point where some medicines are needed to prevent their glucose levels from rising dangerously. This is simply the nature of the disease.
The simple formula is: Coordinate your medications with your diet and lifestyle to ensure the maximum effectiveness of each.
"Just remember that medicines are not an alternative to good diet and regular exercise and work better if all are combined," contends Thomas who has written over 250 book chapters and books on diabetes management.
To sum up, diabetes is not a punishment for the nutritionally wicked nor is exercise the castigation of the couch potato.
"These are positive steps that have their rewards as you decide to control diabetes. Your effort is never futile," the writer concludes.
(Nishant Arora is Associate Editor with IANS. He can be reached on nishant.a@ians.in)
