“The tsunami wave of diabetes mellitus and its health and economic consequences is threatening much of the world. The need to prevent and control this debilitating chronic disease is urgent, before desperation sets in.” Journal of Royal Society of medicine.
How does this matter to us South Asians?
Indian Subcontinent (which includes India, Pakistan, Nepal, Bangladesh and Sri Lanka) is the epicentre of this Diabetic pandemic. By 2025, over 2/3rds of the diabetics would be living in our subcontinent.
How are we more vulnerable as compared to other ethnicities?
We South Asians get Diabetes:
• 10 years earlier
• At lower levels of obesity
• Suffer longer with more complications
• Have 3-8 times higher risk of dying from Diabetes than Europeans..
Why are we more vulnerable than other ethnicities?
Again the same answer as for the Heart Disease—Our genetic makeup coupled with our unhealthy lifestyle i.e. faulty diet, obesity, sedentary habits and lack of health awareness.
Can we really do anything?
Yes, research proves that we can avert or at least postpone Diabetes and improve our quality of life through various lifestyle modifications.
What should we know?
First, know that Diabetes is no more the disease of the affluent; even the poor have it.
Second, it is no more a disease of the middle aged. Diabetes Type 2 which was earlier called the Maturity onset diabetes has now been seen to occur amongst the South Asians in early 20s and many get in their 30s.
Thirdly, in order to live a life without Diabetes we need to start early and change our life style. However, it is better late than never.
What should we do?
If you are not a Diabetic
Step 1 : Know whether you are at high risk of Diabetes Mellitus or not.
Check your risk from the risk-factors chart:
Or better see YOUR RISK OF DIABETES from the Diabetic Risk Calculator at the link below.
(ADV*** : Dont skip this ^^ step!!)
Important: In case you are a high risk group, please consult your doctor and ask him to screen for Diabetes. He will do some blood test on you while fasting and after meals to check your blood sugar levels.
Step 2: Get more physically active :
Benefits of exercise:
• You will lose weight
• It will lower your blood sugar
• Boost your sensitivity to insulin –which will keep your blood sugar in the normal range.
More, refer to Blog 1 : https://thinkloud65.wordpress.com/2011/12/31/living-a-healthy-lifestyle/)
Step 3: Lose the extra weight.
Obesity is one of the main culprits in causing Insulin resistance and hence Diabetes- Abdominal fat is the real culprit.
Tip: If you are obese or over weight, loss of every kilo will reduce the risk by 16%. And if you lose 10% of your body weight, you will cut the risk of developing diabetes by 60%.
Step 4: Make long term dietary changes.
Add fibre to your diet. This simply means eat more of fruits, vegetables, beans, whole grains, nuts and seeds as they are rich source of fibre.
Benefits: Fibre reduces the risk of Diabetes, of Heart disease and risk of colon cancers. They also promote weight loss.
Check Glycemic Index of the foods you eat. Choose foods with low Glycemic Index as this maintains more constant blood sugar levels.
Tip: Print out a chart of foods by Glycaemic Index and put it over the fridge, so that it is easy to refer to them while selecting food.
For more on Glycaemic Index : http://www.diabetes.ca/for-professionals/resources/nutrition/glycemic-index/
Step 5 ; Try to manage your stress: Stress increases hormones in the body which predispose to Diabetes.
IMPORTANT NEWS: The research has shown that if one follows the above measure, at least 50 % postponement of DM is possible.
For those who are already Diabetic
Diabetes is a lifelong responsibility.
You may not feel unwell in the initial years but persistently raise blood sugar levels can gradually harm each and every organ of the body, more seriously the organs essential for life-heart and kidneys.
To the Diabetic, I would just give a few outline tips here, as it is important for you to be under a regular care of a QUALIFIED DIABETOLOGIST to manage your health:
Step 1: Make a promise to yourself that you will take care of your diabetes by being FULLY INFORMED of the disease. (Just google ‘Diabetes Mellitus’ and there you are).
Step 2: Try to keep the blood sugar in normal range through diet, exercise, weight control, medications and regular smedical consultations. A normal sugar levels maintained are as good as being non diabetic.
Step 3: DIET: Diabetics should be very watchful of their calorie intake, and must take meals LOW in SUGAR, FAT and SALT content. You must consult a DIETICIAN to make meal plan, ideally.
See links for dietary guidance: http://www.diabetes.ca/files/JTB17x_11_CPGO3_1103.pdf
Try this SOUTH ASIAN DIABETIC MEAL PLAN BOOK :http://www.diabetes.ca/documents/about-diabetes/Recipe_Booklet_high_res.pdf
Other SA recipes: http://www.pamf.org/southasian/healthy/recipes/
Step 4: Get blood sugars checked at regular intervals…at home and by the doctor.
Through your doctor: Make sure you have HbA1c tested every 3-6 months. The test that shows the average amount of sugar in your blood over 3 months. It tells how well you are controlling your diabetes.
An HbA1c of 6% or less is normal. See the other levels:
Home Glucose Monitoring : Home sugar testing is also important. You must have a glucometer for this. Ask your doctor how frequently and when should you check your blood sugar yourself at home.
Step 5: Keep your Blood Pressure and Cholesterol under control.
Step 6: Regular health checkups to assess complications of diabetes—Have your KIDNEYS, HEART, NERVES and EYE check ups EVERY YEAR .
Ask your doctor by name —> to check for COMPLICATIONS of Diabetes.
Warning*: Long periods of uncontrolled Diabetes can cause painless Heart Attack, Kidneys to fail, Nerves to get numb and Eyes with loss of Vision. (This is intended not to scare you, but inform you of the seriousness of the problem).
Step 7: Take care of your FEET: Diabetes causes nerve damage which can cause injuries to feet without being noticed due to loss of pain sensation.
- Check your feet everyday for cuts, blisters, redness or swelling. Consult the doctor is any such thing is seen.
- Keep the feet clean, dry and moisturized everyday to prevent any infections.
Step8: Brush your teeth and floss them everyday. Have dental checkups every year and mention to the doctor that you are a diabetic.
Step 9: Ask your doctor if you need to take a Aspirin tablet everyday to prevent heart attack and stroke.
See the benefit of aspirin in Diabetes in this link: http://www.diabeticlive.com/diabetes-101/diabetes-news/new-study-on-aspirin-and-diabetes/#.TzwKiE4gf1k
Step 10: DO NOT SMOKE as it accelerates all the diabetic complications. If you drink, do it in moderation.
Step 11: Manage STRESS: Stress increases Blood Sugar levels , increases food indiscretions and one tends to neglect the health. Hence manage your stress smartly.
Last but not the least, maintain a sense of humor. You may not ‘delete’ Diabetes from your life but you can ‘minimize’ it by knowing and following the right steps.