One of the major complications of poorly managed diabetes is heart disease. Uncontrolled blood sugar is as severe a risk factor as smoking, high blood pressure or high cholesterol levels.
High blood sugar levels can affect the walls of the blood vessels and increase the likelihood of fat depositing on the walls. This, in turn, can lead to complications ranging from chest pain to heart failure, heart attack or even death.
Keeping diabetes under control will help protect heart health. A change in diet is one of the most important aspects of the diabetes treatment plan, as the food you eat affects your blood sugar levels.
To keep your blood sugar levels in range, first and foremost, eat short and frequent meals through the day. People with diabetes (and those at risk of it) must break down their meals—to eat small at meal times and to munch on something healthy every two or three hours.
What is healthy, to a great extent, depends on how the food affects your blood sugar levels. Carbohydrates often have the biggest impact on blood sugar levels and these are present in almost every Indian food—from rice to dals to fruits. A wise choice would be to pick a food that has carbohydrate with a good amount of fibre in it, which can regulate the release of sugar in the blood and avoid sudden highs and lows. Choosing brown rice or millet over white rice; whole-wheat roti over rumali roti or naan; rolled or steel cut oats over refined oats; sweet potatoes over white ones and fruits over fruit juice are small changes that can have a huge and positive impact on your blood sugar control.
It is important be make every meal well-balanced. A plate of your main meal must be 50 per cent vegetables; 25 per cent cereals and the balance 25 per cent protein from lean meat, eggs or dals and curd. Currently, most Indians have a plate that has the cereals and vegetables portions swapped.
Grazing throughout the day may negatively impact blood sugar. Constantly taking in carbohydrates and extra calories can result in consistently high blood sugar, which leads to weight gain, which also affects blood sugar. Have a scheduled meal time and fill your mid-meal times with nutrient and fibre-rich food like fruits, sprouts, nuts and dried fruits like figs, unsweetened prunes and apricots. It is very important for diabetics, especially those on insulin, to have a bedtime snack to avoid a dip in blood sugar levels at night. Sandwiches with egg whites or low-fat cheese or paneer, a handful of sprouts, or a glass of buttermilk, are some options.
If you are travelling and want to pick up some snacks, it is very important for you to read the label. A common marketing gimmick is to call a food multi-grain when 70 per cent of the grain used is refined and only the remaining 30 per cent is a mix of five unrefined grains. Hence, when you read the label, look out for the first three to four ingredients—they make up for most of the product.
Food items that claim to be sugar-free, reduced-sugar or have no added sugar are not necessarily carbohydrate-free or lower in carbohydrate than the original version of the food. They mostly contain low-calorie sweeteners which are concentrated doses of sweetness that are not absorbed by the body and hence do not affect the blood sugar levels. Most commonly used artificial sweeteners are saccharin, aspartame, sucralose and stevia—all of which have been approved by the FDA for use in moderation. Among these, since stevia is derived from a plant, it is considered better than the rest. Some sugar-free or no added sugar food items contain sugar alcohols (sorbitol, mannitol), or natural sweeteners (agave nectar, honey, maple syrup), which are again considered safe when used in moderation. Though several sugar substitutes are available in the market, it is always better to sweeten your breakfast cereal with some raisins and berries instead.
If you have forgotten to pick up a mid-meal snack and cannot get your hands on a fruit, a glass of buttermilk would be a healthier option than a glass of fruit juice—even if it is fresh—as the protein will not only make you feel full, but also make sure the blood sugar levels don’t spike after your drink. Packaged drinks, energy drinks, aerated drinks (even diet versions) are definitely a no-no as they are most often filled with sugar or more-than-required quantities of sugar substitutes.
For those who enjoy their glass of alcohol during the week, it is important to keep a check on the quantity. Though alcoholic drinks have no nutritive value, they are calorific. It is better to have alcohol with water or some diet soda instead of a cocktail as most mixtures are rich in carbohydrates and calories. Alcohol can decrease the release of sugar from the liver, so one must not drink on an empty stomach and must always include a snack with one's drink. Sliced vegetables with hummus, unsalted nuts and lentils with salad are some snacks options.
While correcting your diet is an important aspect of managing diabetes, it is also important to do physical activity and maintain an ideal weight to keep your blood sugar in check. With so many factors to look out for, getting everything together can be stressful and challenging. It is easier to manage when you have an expert from each facet to take care of you. The sooner you reach out to the expert, the better your quality of life.
Suhasini Viswanathan is dietitian, certified diabetes educator and certified paediatric nutritionist, Qua Nutrition.