Diabetes

What is Diabetes:

Diabetes (often called sugar diabetes) is a condition where a person has high blood sugar (glucose) level in the body. You develop diabetes when your body doesn’t produce enough insulin. Without insulin your body cannot get the energy it needs from your food. Normally, a gland called the pancreas makes insulin which carries the sugar in the blood into the cells. In diabetes, the pancreas fails to supply enough insulin, or the insulin doesn't work properly.

There are two major types of diabetes: Type I, commonly called juvenile diabetes, and Type II, commonly called adult on-set diabetes. Both have similar symptoms but very different causes.

Type I diabetes, usually diagnosed in childhood, is a disease whereby the body's own immune system attacks and kills the cells in the pancreas which produce insulin, leaving a person's body without insulin, and unable to regulate its blood sugar levels.

Type II diabetes is a disease that results when the body's cells become resistant to insulin. In Type II diabetes, unlike in Type I, insulin is still produced by the body; it just isn't used appropriately.

How would I feel or know if I have Diabetes?

Although there may be no obvious symptoms, the following are common:
Always thirsty Always tired Frequent urination Unexplained weight loss Itching Changes of vision (blurry) Slow healing cuts and bruises Numbness in hands and feet
These are all results of the body's inability to transport sugar (energy) from the bloodstream to the body cells.

Who is at risk?

Anyone, anywhere, at any age can get diabetes. Being overweight and having a family history of diabetes increase the risk.

How is diabetes treated?

Depending on the type and severity of the diabetes, either:

with diet plus exercise,
or diet, exercise and medication.

Medication may be insulin injections or tablets, or both.

The good news is that having diabetes does not mean the end of a normal healthy life. You need to accept that you have the condition and then learn how to manage it.

Management and control of blood sugar is very important as it prevents or reduces the risk of developing the complications of the disease. The abnormally high blood sugar levels (hyperglycemia), can cause kidney, eye, heart, blood vessel, and other diseases. Without proper management it can lead to heart and kidney disease, blindness and amputation.

It is important to consult a Dietitian when diagnosed with Diabetes

The Role of Food:

A healthy diet is the foundation for good blood sugar control in any type of diabetes, even without medication in some cases. Whether you are being treated with insulin injections or tablets, you still need to follow a sensible diet.

The so-called "diabetic diet" is not in fact a diet, but rather a healthy eating plan which can, and should be followed by the whole family.

Keeping to a healthy food intake not only controls blood glucose levels (and so delays the onset of diabetic complications) but also helps to maintain body weight and prevent heart disease.

Guidelines for Healthy Eating:

Enjoy a variety of foods
Include foods from two or more food groups at each meal

Make starchy food part of most meals
Fortified maize meal and bread provide extra vitamins and minerals. Include whole grains

Fish, chicken, lean meat or eggs could be eaten daily
Choose fish with fatty flesh (pilchards, sardines, mackerel and salmon). Use lean meat, remove fat and skin from chicken and limit use of cheese and processed meat, e.g. polony and sausages is high in salt and fat.

Eat plenty of vegetables and fruit every day
Include dark green leafy vegetables and yellow or orange fleshed vegetables and fruit (preferably with their skin on).

Eat dry beans, split peas, lentils and soya regularly
These foods should be eaten at least two to three times per week. They are high in protein and fibre and low in fat

Have milk, maas or yoghurt every day
Use low fat or skim milk or mass and low fat yoghurt. Limit the use of milk with added sugars

Use salt and food high in salt sparingly
Use very little salt at a time during cooking or at the table. Limit the use of seasoning salts, stock cubes, soup powders, commercial salad dressings rather make use of herbs, curry powder, ginger, garlic etc.

Use fat sparingly; choose vegetable oils rather than hard fats
Use a little fat at a time and choose fats or oils such as tub margarine or sunflower, canola or olive oil. Too many high fat foods can result in weight gain and make your diabetes more difficult to control. They can also increase your risk of heart disease.

Use sugar and food and drinks high in sugar sparingly
A small amount can be added to food and drinks

Drink lots of clean safe water
Children and adults need 6-8 glasses of liquid per day

Be Active!
Exercise for at least 3-5 times a week for 20 – 50 minutes

There are two types of carbohydrate:

Starchy foods and Sweet foods

Starchy foods

The best starchy foods to choose are those high in fibre as they are digested slowly making it easier for your body to control your blood glucose. Try to choose high fibre foods more often e.g. high bran cereals, porridge, brown or wholegrain bread, rice, dried or baked beans, samp and beans, potatoes, roti made with brown or wholegrain flour, phutu, lentils, oats and mealie meal, vegetables and fruit with skin.

Include a starchy food with each meal
Starches by themselves do not make you gain weight or worsen your diabetes especially those rich in fibre.
However, be careful of having large amounts of starches in one meal (e.g. potato curry and rice).

Sweet foods

Sweet foods are quickly taken up by your body and cause blood glucose to rise very quickly. The best food choices of sweetened foods are those which have lots of fibre in them such as bran muffins. However, if you are going to eat sweet foods, try to eat them seldom and in small amounts, then have them with a high fibre meal rather than alone eg. plain cake following a meal rather than eating as a snack.

A guide to healthy snacks

It may be important for some people to have a snack at mid-morning and at bedtime. Try to choose a high fibre snack -the following are some examples:

Best snack choices	Not so good snack choices
• Fresh fruit and raw vegetables • Wholegrain cereal with low fat milk • Brown or wholegrain bread with thinly spread peanut butter • High fibre biscuits • A bran muffin • Low fat yoghurt • "Diet" or "sugar free" drinks is a better choice in moderation • Fresh fruit juice and sweetened juice are better diluted with water as otherwise they are a very concentrated form of sugar.	• Meat pies, sausage rolls, fried samoosas • Potato crisps and hot chips • Chocolate/ cream biscuits/ chocolate bars/ ice-cream • Sponge cake, sweet pastries/ cream cakes/ sweetmeats

Exercise

It is important to exercise regularly and this can be achieved during a busy day as well by way of exercise 3-4 times per week for 20-50 minutes. This may take:

Walking up and down a flight of stairs instead of taking the lift.
Walking to the shops instead of taking a car/taxi/bus or getting off a bus/ taxi a couple of stops early.
50 –100 skips / day with a skipping rope.

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