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Have you ever wondered which foods need to be avoided by people with diabetes? Or what can be consumed to keep it in check? Are fruits okay to consume? What about rice, bread, and sugar? “Can I eat them, and are they safe for me?” 

While most people have heard of diabetes, as almost ten crore people in our country are affected, its true nature remains masked in misconceptions and myths. From mindful eating to regular exercise, we will explore the power of lifestyle choices and provide valuable insights to help you achieve balance in your daily routine. It is time to unmask this sweet saboteur, dive into its complexity, and empower ourselves with knowledge and understanding.

What is diabetes, and what causes it?

Diabetes is a condition that develops when your pancreas doesn’t make enough insulin, or any at all or when your body isn’t responding to the effects of insulin properly.

Let me simplify this for you, suppose you keep your garbage (glucose) outside your home. The garbage cleaner (insulin) picks it away for disposal or recycling. This happens daily. Now, what will happen if the garbage cleaner doesn’t turn up? The garbage will keep piling up, leading to unhygienic conditions and issues. 

Similarly, the hormone insulin moves sugar from the blood into your cells to be stored or used for energy. If this malfunctions, you may have diabetes. Prolonged periods of elevated blood glucose can give rise to various health complications, including heart disease, nerve damage, and eye problems. 

Type 2 diabetes is mostly caused due to lifestyle disorders. Too much stress, unhealthy eating habits, eating junk or processed foods too often, no physical exercise, lack of sleep, too much alcohol, obesity or being overweight can cause this. The bright side is that good nutrition and ample activity can control this. 

Why do some need external Insulin and I don’t?

So, there are three types of diabetes:

1. Type 1: The precise cause of type 1 diabetes remains unclear to doctors. However, it is believed that the immune system erroneously targets and destroys the insulin-producing beta cells in the pancreas. This autoimmune response leads to a deficiency of insulin in the body. People suffering from T1d need insulin shots regularly. 
2. Type 2:  It develops due to genetic and lifestyle factors. Being overweight or obese increases the risk of developing type 2 diabetes. 
3. Gestational Diabetes: It arises due to hormonal changes that occur during pregnancy. The placenta produces hormones that reduce cell’s sensitivity to insulin’s effects. Consequently, this diminished sensitivity can lead to elevated blood sugar levels during pregnancy.

What affects blood sugar levels?

Several factors can affect blood sugar levels, but the major ones are:

1. Food and Drink Consumption: The type and quantity of food and beverage you consume directly impact your blood sugar levels. Simple carbs or processed carbs which digest quickly, such as white bread, sugar, pastries, junk and sugary sodas, tend to raise blood sugar quickly.
2. Physical Activity Level: Low physical activity can lead to insulin resistance, thus impairing the rate at which glucose is cleared from the blood. 
3. Stress and Illness: During stress, the body releases stress hormones like cortisol, which can increase blood sugar levels. Similarly, when you’re sick, your body’s inflammatory response can cause insulin resistance, leading to elevated blood sugar levels. 

Who are at risk? How will I know I am diabetic?

While anyone can develop diabetes, some may have a higher predisposition. 

1. Family History: Having a family member with diabetes increases your risk.
2. Obesity: Excess weight, especially around the abdomen, can be a cause. 
3. Sedentary Lifestyle: Lack of physical activity contributes to the development of diabetes.
4. Unhealthy eating habits: A diet high in processed foods, sugary beverages, and unhealthy fats increases the risk.
5. Age: Risk increases with age, especially after 45, but younger individuals are also affected.
6. Gestational Diabetes: Women with gestational diabetes have a higher risk of developing type 2 diabetes later in life.

The symptoms of diabetes include:

• Increased thirst.
• Frequent urination.
• Fatigue
• Blurred vision.
• Slow healing cuts. 

Sometimes these symptoms may not show up. Hence, it is recommended to get your blood tested every six months. 

Which tests should I do?

The Four common tests done to assess blood sugar levels are:

1. Blood Glucose, Fasting: This test measures the glucose level in your blood after an overnight fast (usually 8-10 hours). It provides a baseline measurement of your fasting blood sugar level and helps diagnose conditions like prediabetes and diabetes.
2. Blood Glucose, PP (Postprandial): This test measures blood sugar levels 2 hours after consuming a meal or glucose drink. It helps evaluate how well your body processes glucose after eating and is often used to diagnose gestational diabetes during pregnancy.
3. Blood Glucose, Random: This test measures blood sugar levels at any time of the day, regardless of when you last ate. It is commonly used to diagnose diabetes or monitor blood sugar levels in individuals with diabetes.
4. HbA1c (Glycated Haemoglobin): The HbA1c test estimates the average blood sugar levels over the past 2-3 months. It measures the percentage of haemoglobin in red blood cells with glucose attached. This test monitors long-term blood sugar control in individuals with diabetes and helps assess the effectiveness of diabetes management plans.

How do I manage my Blood Sugar Levels?

• Calorie Deficit & a balanced diet: Ensure you consume lower calories and burn more calories. It will help you maintain your weight and also keep a check on overconsumption. Include a variety of nutrient-rich foods in your meals, such as fruits, nuts, vegetables, lean proteins, and whole grains. These foods provide essential vitamins, minerals, and fibre. 
• Limit processed, sugary foods and drinks: Avoid or limit foods and beverages high in added sugars, such as soda, candy, desserts, and sugary snacks. These can cause rapid spikes in blood sugar levels. Opt for healthier alternatives or moderate your intake of sugary treats.
• Limit carbohydrate intake: Carbohydrates significantly impact blood sugar levels ( PMID:25287761). It is important to be mindful of your carbohydrate intake and choose complex carbohydrates that slowly release glucose. This includes whole grains, legumes, and vegetables. 
• Increase fibre intake: Fibre slows down the rate of digestion, thus controlling the blood sugar spike—whole grain versions of bread, pasta, brown rice, oats and cereals. Whole grains contain more fibre compared to refined grains. Legumes such as lentils, chickpeas, black beans, and kidney beans are high in fibre. Aim to consume 14 gm /1000 calories. (PMID: 26514720)
• Engage in regular exercise: Incorporate physical activity into your routine; aim for a mix of strength training and medium-intensity exercises. Exercise helps improve insulin sensitivity, allowing your body to better utilise blood sugar for energy. Walking daily, preferably around meals, and mere 30-45 mins of workouts 5-6 days a week, will greatly help. (PMID: 21084931)
• Increase protein intake: Aim to consume more protein with every meal. It will help you limit the consumption of carbs. It will keep you full longer, thus avoiding hunger pangs and unnecessary snacking. Also, it is crucial for proper functioning hormones, enzymes and recovery. 

How do I know which foods to eat and which ones to avoid?

Foods with low Glycemic Index(GI) & Glycemic Load (GL): These foods (Low GI & GL) are digested and absorbed slowly, gradually increasing blood sugar levels. Examples include whole grains, legumes, non-starchy vegetables, and most fruits. These foods provide sustained energy and better blood sugar control.

You don’t need to avoid any food. All you need to do is to make sure you add fibre-rich food along. For example, if you want to eat white bread, now, if you add cucumber, lettuce, onion, tomatoes, and beetroot and make a sandwich, the final sandwich will be something that will lead to a smaller glucose spike due to the addition of fibre rich vegetables. This doesn’t give you the liberty to eat junk by adding vegetables.

Also, make a habit of adding a serving of salad to all major meals, and when hungry between meals, opt for foxnuts (makhana), roasted gram, eggs, popcorn, almonds, and walnuts etc, instead of deep-fried snacks and choose fresh fruits over juices. Remember that the snacks must be consumed in moderation or per your calorie window. Use sweeteners like Aspartame, Stevia etc., in beverages to limit simple carb intake. A good rule of thumb is to choose foods high in protein, fibre and healthy fats, all known to help maintain healthy blood sugar levels.

Living with diabetes requires dedication, education, and a proactive approach to self-care. By understanding the fundamentals of diabetes management and adopting healthy habits, you can effectively manage your blood sugar levels, reduce the risk of complications, and lead a fulfilling life. Remember, you are not alone on this journey, and with the right tools and support, you can take control of your diabetes and live well.