Diabetes And It's Management.
Diabetes And It's Management.
Diabetes is a disorder where there is relative or absolute deficiency of insulin which is required for the break up of carbohydrates to give energy and there is a pile up of unused sugars in the body. Diabetes is a chronic metabolic disorder which causes hyperglycemia or an elevated blood sugar level. Insulin is produced by pancreas. Carbohydrates which we consume are converted into energy by insulin in the presence of vitamins and minerals. If our diet consists of devitalised food vitamin A and minerals are diminished hence the conversion of carbohydrates to energy is reduced and over a long period of time the pancreas looses it's capacity to cope with the increased amounts of sugar provided by a highly refined and devitalised diet.
The exact cause of diabetes still remains unknown however congenital factors, obesity, sedentary lifestyle and stress are considered to be as predisposing factors. Insulin is required for blood sugar to go from the blood to the cells to convert it into energy, if that doesn't happen then sugar floats in the blood and is then removed by the kidneys.
There are 2 types of diabetes:-
1) Insulin Dependent Diabetes Mellitus or (IDDM).
2) Non Insulin Dependent Diabetes Mellitus or (NIDDM).
In the case of IDDM their bodies do not produce insulin at all and they have to obtain it through injection. Patients with NIDDM produce some insulin but it is not sufficient. NIDDM progresses to IDDM over a long period if part of the precipitating causes are left untreated. When IDDM suprevenes it becomes mandatory to use insulin for the control of diabetes. Risk factors for IDDM include autoimmune disease, viral infections, and hereditary factors. Risk factors for NIDDM are obesity, physiological or emotional stress, pregnancy, certain medications, age and family history.
Some of the symptoms of diabetes are excessive thirst, dry skin, itchy skin, slow healing of cuts, blurry vision, increased apetite, weight loss, skin infection, numbness or tingling sensation in feet, breadth odour and Amenorrhea. Some additional symptoms are also observed like bleeding gums, ear noise buzzing, diarrhea, depression and impotence in men. Some of the signs and tests are urinalysis showing glucose and ketone bodies in urine. Tests are glucose tolerence test, FBS or fasting sugar and glycosylated hemoglobin.
Diabetes cannot be cured only controlled hence management plays a vital role for a diabetic. The body metabolism has to be stabilized, body weight should be controlled and high glucose symptoms need to be eliminated. The long term goal should be to prolong life, improve quality of life, relieve symptoms and prevent long term complications through education, dietary mangement, weight control, medication, exercise, and foot care by preventing wounds for unhealed wounds might lead to gangrene.
Diet:- Diet again plays a very important role. A diabetic has to choose healthy foods, eat the right amount of food and at the right time. For IDDM patients consistency in the time when meals are eaten and the amount and type of food taken is very important inorder to allow food and insulin to work together to regulate blood glucose levels. If there is imbalance in meals and insulin then there will be extreme variations in blood glucose level. Whereas in case of NIDDM patients weight is most important in addition to a well balanced diet.
The caloric content of a diabetic is similar to a normal person with some few modifications. A balanced diet at regular meals is advised for IDDM patients. Mid meal is recommended to prevent fluctuations in blood sugar levels. Feasting and fasting is a complete no for them. There is no need to cut down carbohydrates completely. However, simple carbohydrates like sugar and jaggery need to be avoided as they are absorbed fast and increase blood glucose level. Rice and potatoes can be eaten in moderation.
Fruits can be eaten but fruit juices should be avoided as it elevates blood sugar levels. Diabetics are at a high risk of developing coronary heart disease and hence fats have to be restricted upto 25% of the total calories. Saturated fats like butter, ghee and egg yolk etc should be avoided. Boiled, grilled poached and roasted items which requires less fat can be consumed.
Fibre is highly recommended for diabetics since it slows down the absorption of carbohydrates and regulates the rise in blood sugar levels after meals. Hence, include sprouts, vegetables, whole cereals and grains in your regular diet.
Exercise :- Regular exercise is a must for diabetics. Walking is one of the simplest exercise. One should not exercise on an empty stomach or when sugar level is high. Blood glucose level should be monitored regularly. Fluid intake without sugar should be taken after exercise. Change in exercise intensity and duration require diet or medication modification to keep blood glucose levels within normal range. Exercise helps to maintain body weight which is good for NIDDM patients. It also helps pancreas to secrete insulin and reduce the need for medication. A diabetic should avoid walking bare foot and should carry some fast acting sugar like chocklates and be aware of low blood sugar symptoms.Try and prevent injuries to your feet.
Medication:- Insulin lowers blood sugar by making the floating sugar in blood enter the cells. People with IDDM cannot produce their own insulin and have to depend on insulin injections for survival since insulin is not available in oral form. Incase of NiDDM they take oral hypoglycemia pills to control blood sugar. They prevent sugar from entering the blood stream by increasing the secretion of insulin from the pancreas. If people loose weight then their own insulin works better without extra weight, fat and sugar.