Diabetes: Customise your treatment plan

Each individual is different from the rest in many ways. Then how can one person's diabetes plan be the same as everyone else's?

man with his daughterMost people have wrong ideas about diabetes and consider it a restrictive condition. That’s because the advice they get is rarely positive.

Most of the guidance on the topic consists of a generalised list of dos and don’ts [often given by well-meaning friends, relatives and other diabetics], which may not hold true for every diabetic. You are different from others and your body is unique too.

An experienced doctor understands this and will therefore customise your treatment for you based on the specific requirements of your body.

To be able to live a restriction-free life, diabetics need to make changes in three areas: diet, exercise and medication. It is within these areas that customisation becomes important.

Diet

Diet of a diabetic is a matter of great discussion with advice freely flowing in from all quarters. Naturally, a lot of it is based on misconceptions.

For instance, it is strongly suggested that diabetics should give up rice totally or stop eating potatoes. Some diabetics even stop having fruits completely, simply because someone told them to.

It is NOT necessary to make such drastic changes. A South Indian for instance, whose staple diet is rice, cannot suddenly eliminate it from his diet. And if he does, it will have detrimental effects on his health.

The traditional Indian diet comes real close to an ideal diet for diabetics, albeit with slight changes. If you follow this diet, you don’t really have to make any major change to your eating habits other than abstaining from eating simple sugars and reducing your fat intake.

Often, patients are put on ‘fixed’ diets—they have to take the same food in the same quantity daily. This does not work in the long run as patients do not comply with these strict and unnecessary restrictions for long.

Like normal healthy human beings, even diabetics require all their nutrients—carbohydrates, proteins, fats, minerals and vitamins, which they can get through a balanced diet. But many ‘prescribed’ diets leave out the carbs, which is wrong.

Of the total calories consumed by a diabetic, 60 – 70 per cent should be carbohydrate. Avoid carbohydrates only if they are in the form of simple sugars.

The emphasis should be on restricting your fat intake. So, eat more grilled, steamed or baked food instead of fried.

Cooking mediums matter too. Traditional cooking mediums like mustard oil, ghee and coconut oil are better than today’s refined oils because although they are rich in saturated fats, they also have a healthy ratio of essential fatty acids such as omega-6 and omega-3. Whichever the medium, make sure you use it sparingly.

You don’t have to starve yourself at a party or shy away from attending one because you have diabetes.

Opt for boiled, grilled or baked food if available and help yourself to generous servings of salads sans the dressing. Also, eat something before an event, so you don’t get hypoglycaemic in case the food gets delayed.

Often diabetics prefer to have beer thinking it’s a better option than hard liquors. Instead, it is advisable to take hard liquors like whisky, brandy, rum or gin rather than sweet wine or beer. Avoid drinking on an empty stomach though and do not drink more than 60ml per day.

Although fasting is not recommended, if you wish to do it for religious reasons, you may do so after discussing with your doctor.

Also, you can even eat sweets occasionally along with the main meal. Doing so, slows the absorption of pure sugars.

Exercise

Regular exercise is important as it increases the utilisation of glucose by the body, lowering your blood sugar levels.

However, not everyone may be able to exercise. For instance, many diabetics who are overweight suffer from osteoarthritis of the knees or may have corns and calluses of the feet. Walking is difficult in this situation. They require a modified exercise programme involving more of upper limb and trunk exercises.

Your aim when exercising should be to achieve 75 per cent target heart rate. However, if you have heart problems, 40 – 50 per cent may be good enough for you. Consult your diabetologist for the exercise regime that is most suitable for you.

Medication

insulinIn early stages, you can control your diabetes with the help of medication and not all diabetics need to be injected with insulin.

Insulin treatment is only given in advance cases and is not necessarily a life-long treatment. Further, not all diabetics are prescribed the same medicines, as some tablets may interfere with the person’s existing medication or ailment.

In some men, diabetic drugs can illicit an adverse reaction such as erectile dysfunction. Hence, even your medication needs to be customised to suit your lifestyle and health.

Vijay Panikar
Dr Vijay Panikar, MD, DNB, FCPS is a diabetologist associated with Lilavati Hospital & Research Centre.

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