Sweet-check no cure for dibetes

BANGALORE: Sweets are a sure no no for diabetics. But there are many other food items too that could increase your sugar level and derail you from a strict diabetes management regime.
Diet compliance is a major issue affecting patients, simply because they don't know whether what they are eating is affecting their well-being.
When TOI spoke to diabetologists and nutritionists across the city on the eve of World Diabetes Day on diet compliance, doctors said that only a fraction of patients understand the importance of maintaining a good diet.
According to Vidya K P, nutritionist and diabetes educator at Karnataka Institute of Diabetology (KID), one of the most common trend in patients is that they have a staple diet. "They take similar kind of food for all three meals continuously for many years. They also have very long gaps between meals. Very few patients understand the quantity of their calorie intake. The same type of nutrients on a daily basis is dangerous."
Vidya, who caters to the needs of several patients from rural and fringe areas too, says that she has often found these people eating ragi mudde and rice on a daily basis -- both of which are high in glycemic index. "They also eat vegetables high on carbohydrates like potatoes, roots, tapioca, yam and others. However, they should be eating more of green vegetables. But these patients have a compliance issue because of their background, financial status and family problems," she says.
YOUTH CAUGHT IN THE NET
Many doctors are also witnessing compliance problems in patients aged between 30 and 32 years. "Many young patients diagnosed with diabetes consult me. But compliance is a huge problem with them because they have misconceptions that if you stop eating sweets, it's enough. What they need to watch out for are fruits that are high on the glycemic index. I am surprised to see so many young people with diabetes, but what's worse is the stigma attached to this medical disorder that keeps them away from maintaining a good diet," explains endocrinologist at Narayana Hrudayalaya, Dr Satishkumar.
He stresses that young patients don't eat on time and have a very irregular diet.
FRUITY TALK
Apple and musambi are low on the glycemic index and highly beneficial, while fruits such as banana and papaya are best avoided. However, very few diabetics are aware of this.
South Indian patients also end up eating rice almost three times a day, not knowing that it could affect them. The South Indian breakfast or snack is often chitranna (lemon rice), idli or dosa that is high on carbs. Doctors suggest that these snacks should be supplemented with other cereals like oats and more fibre-rich foods.
DIET DIARY
According to consultant endocrinologist, Manipal Hospital, Dr Arpandev Bhattacharya, "It's very difficult to assess compliance rates. It's a good idea to maintain a diet diary because if patients comply with such practices, diet management will become easier as we test their understanding of their diet during dietary counselling," he says.
KEEP IT SMALL AND FIBROUS
However what you should ideally be doing is that eating small portions frequently, "We recommend three meals (breakfast, lunch and dinner) and three snacks. You can space the snacks in between your meals according to your profession and lifestyle. There are six components in a diet: carbohydrate, fat, protein, mineral, vitamin and water. Restriction and distribution of carbohydrate throughout the day is important. The amount of calories in rice and wheat are the same, but protein content is high in wheat. Wheat has more fibre compared to rice too," Dr Arpandev adds.
EAT RIGHT, KEEP DIABETES AT BAY
Fibre-rich food like bran, cereals, vegetables, fruits, brown bread, pulses like lentils, rajma and whole meal flour are an important part of the diet for diabetics as they make absorption smoother and keep bowel habit healthy
A mixed diet containing both rice and wheat is preferred, with a generous helping of salads and vegetables to strike a nutrition balance. These are also natural sources of vitamins, minerals and fibres
Stick to your ideal weight and lose some calories if you are overweight. Increase fibre intake to lose that extra fat.
There is no bar on non-vegetarian food unless in special situations like kidney problems. Chicken and fish are better than red meat as the quantity of saturated fat is lesser in them. Those with high cholesterol should best avoid egg yolk and red meat.
HERE IS YOUR DIET CHART
(Prepared by Shalini Arvind, dietitian, Fortis hospitals)
Eat a variety of food everyday. Do not skip meals. Avoid snacks, unless you are advised to (example during insulin treatment). Don't over eat
Eat fruits and vegetables. Use less oil in cooking. Avoid fried foods, milk cream or food cooked in coconut milk
Avoid ready-to-eat foods, sweets and sugary drinks (canned beverages) that provide empty calories (no vitamin or essential minerals)
Keep a regular check on weight
Check your haemoglobin and protein level in blood samples every 6 months to a year and correct the diet format or supplements accordingly
Despite a good control of blood glucose, if your blood lipids are high, you will need lipid-lowering drugs regularly
Match your meal time to the form of insulin and insulin injection schedules as explained by the doctor.