Diabetes

Today diabetes mellitus. the most common form of diabetes is easily managed professional sports people cope, and even young children go about their day-to-day lives without any fuss lust question of understanding how your body can compensate for its inability to control blood sugar levels Experiences and lifestyle challenges differ, depending on age and the severity of diabetes. but the more normal you consider the situation the less over protective you are of your child or a diabetic partner, friend or relative, the more likely you all are to buy and healthy life.

What is diabetes?

Diabetes mellitus takes three forms distinguished by the treatment protocols. Some diabetes controls their diabetes simply by monitoring their diet others need cables to stimulate the body to produce more Insulin: some diabetics require insulin injections

The condition is characterized by an increased amount of sugar in the blood. This happens because there is a lack of insulin the hormone the body needs to process sugar effectively After you have eaten foods containing sugar, your blood sugar level rises, whereupon the pancreas releases insulin help the cells absorb and use the sugar the blood sugar level should then return to normal. With diabetes there is not enough insulin in the body to help the absorb the sugar. The sugar is present, but the body cannot use it.

This happens for two main reasons. In some people the pancreas is incapable of producing at insulin, as is most commonly found in children and young adults. In this case they need to have insulin injections This type of diabetes is called insulin-dependent diabetes mellitus IDDM) In other people the pancreas can produce some insulin, but not enough for the Body’s needs. This type. non-insulin-dependent diabetes mellitus is more common in older people, especially those who are overweight Either the pancreas gets tired for the cell particularly fat, cells, seem unable to take up the sugar.

Some diabetes in this category can control their blood sugar levels by losing excess weight fin particular, fat). as this takes the strain off the pancreas arid improves the body’s ability to utilize the small amounts of insulin produced. In some cases, the pancreas is capable but seems unable to produce the install when Who needed; it needs a kick start from tablets

Abnormally high quantities of sugar in the blood can cause potentially serious problems. In the long term, if the sugar levels continually run high state called hyperglycemia, several tissues in the body start to suffer, especially the eyes kidney and blood vessels leading to the arms and legs. But once the sugar level is corrected and controlled diabetics lead normal healthy lives One of the first symptoms noted by diabetes is an excessive, unquenchable thirst. often associated with frequent passing of urine most effective way for the body to get rid of excess sugar is by passing urine).

This can be coupled with fatigue, headaches and nausea: Children appear listless and tetchy. Some people feel unusually hungry, because even though your body has excess sugar in the blood it cannot utilize it without insulin Many people do not recognize the symptoms of diabetes and go to the doctor reporting a different complaint for example, men go to the GP believing they have a prostate problem, only to find that they are diabetic Other people are diagnosed as diabetic by accident, a routine blood test can reveal a raised blood sugar level.

Every year around 60,000 people in the UK are diagnosed with diabetes: 1,500 of these are children Some children are diagnosed at birth other develop diabetes a little later, or even in their late teens.

Treatment

Many factors determine the type of treatment that will be effective. It is usually the case that the younger you are where you develop diabetes, the more likely you are to need insulin Older people are often able to control their condition with a few adjustments to their diet and lifestyle.

Diabetics lives have changed profoundly over the past decade Tablets cat how stimulate the pancreas to produce more insulin, arid synthetic and animal Insulins have become so efficient that they can act both on a short- and long-term basis, which gives those of you who need insulin injections a greater flexibility with eating and lifestyle. Injections are now administered by pen like needles which are so fine they can be popped into the body through clothes making them almost fuss free Equally, gone are the days when it was almost a foregone conclusion that you would have to eat at set times, measure all carbohydrates,

and banish all sweet foods, including fruit, from your diet with young children it is sometimes necessary to measure foods to begin with a they can get an idea of how much food they need to take and at which times For others, It may be necessary to sick to same sort of schedule until the insulin and diet balance is achieved. Same doctors find that the best way to control a diabetic diet is to measure the blood sugar levels. However, not all diabetics need to do this, it is usually suggested only for insulin dependent diabetics and uncontrolled diabetics whom the doctors want to stabilize.

Tablet takers may be asked to monitor their blood sugar levels from time to by testing their urine for sugar. Insulin dependent diabetics are often encouraged to monitor their blood sugar level regularly by taking small samples of blood from a pinprick to the thumb Accurate and easily available devices offer precise blood sugar level measurements and so assist in making adjustments to the insulin or diet. This should always be overseen by your doctor and dietitian .

Diet and diabetes

In terms of what diabetes need to ear the principles are the same as for a non-diabetic person: a healthy, balanced diet that includes a regular intake of high fiber foods, plenty of water, some fresh vegetables and fruit some lean proteins and dairy products, and a small amount of fat The only differences are that you need to be extra diligent about balancing your diet with your medication, if you take it, and that you need to be more regular in your eating habits. While non- diabetic people can go for days before a bad diet catches up with them, diabetics don’t have this flexibility,

A diabetic diet is a healthy diet There are foods such as chocolate gateau in which you shouldn’t overindulge – Out neither should con diabetics. As long as you are aware of the elect the food will have on your body and act appropriately you should be able to enjoy birthday party, restaurant meals and all foodie occasions There is no need to include special diabetic product in a diabetic diet. Not. only do many of them taste very unlike their non-diabetic equivalents, they often contain unnecessary substances that have no part in a healthy diet.

For example, many diabetic products contain sugar substitutes such as sorbitol and mannitol which car have a laxative effect the calorie content is sometimes higher than the non-diabetic. normal equivalent, which can lead to weight gain the last thing you need. There are two major targets to achieve with your diet:

to achieve and maintain control of your blood sugar level

to regulate your body weight within the deal range the key points of a healthy diabetic eating plan are as follows.

HIGH FIBRE CARBOHYDRATES

Your body needs sugar for energy, and when you are diabetic, it’s a question of regulating the amount. The best way of maintaining a steady release of sugar into your blood is from high fiber carbohydrates, such as whole meal bread, whole-wheat und out cereals, brown rice, potatoes. The fire in these foods slows down the release of sugar into the blood. This makes it easier to keep the blood sugar level within the desirable range.

Try to keep to roughly the same amount of carbohydrate in each of your meal with the help of your doctor and dietitian, work out how much carbohydrates you need to maintain good blood sugar and energy levels and maintain your weight at a comfortable level. The majority of people will find they need toughly the same amount they would choose had they not been told they were diabetic.

The advantage of high fiber carbohydrates is their satiety value – they make you feel appropriately full and contented which can help you judge when you have eaten enough Don’t think that high fiber foods are all heavy dry and boring. These days you can buy delicious wholegrain and seeded breads with nuts, sun-dried tomatoes, herbs and spices.

Look for the dark German rye breads, or Irish whole meal soda breads Serve strawberries or poached pears with your porridge, or try homemade apricot muesli recipes for high fiber desserts.   Having said this, various groups of diabetics need to moderate their consumption of high fiber carbohydrates. For example, children – and diabetic people with other medical conditions such as cancer need a combination of high fiber and low fiber foods.

If they just eat high fiber carbohydrates, they may not receive enough energy and essential vitamins and minerals from their food. People with digestive complains such as irritable bowel syndrome or Crohn’s disease may have a problem balancing a diabetic high fiber diet with their other medical requirements Seek the advice of your doctor or dietitian If you need to include some lower fiber carbohydrate in your diet, you should regulate the portion size of the lower fiber carbohydrate and boost the fiber content of the meal with vegetables, pulses or fruits. There are no more calories or carbohydrates in white bread or rice than in the wholegrain versions, it’s just that they release their sugar into the bloodstream more quickly: you are aiming to slow down that release by including some non-corral fiber in the meal.

FRUIT AND VEGETABLES

As with any healthy diet, try to have live portions of fresh vegetables or fruits every day – not only does their fiber content help to regulate your blood sugar levels they are also high in health-giving vitamins and minerals Some people mistakenly believe that fruit is too high in sugar for diabetics to enjoy. Although fruits do contain some sugar, mainly fructose, the fiber within the fruit helps to slow down the release of the sugar and therefore poses few problems for diabetics.

It is good to get into the habit of having a portion after and in between meals, A portion would be a whole pear orange, apple, a large plum, half a paw (papaya), about ten grapes or fresh strawberries or rasp berries the water fruits such as pineapples, mangoes. Gallia or Charente’s melons, bananas and figs have a little more sugar than apples and oranges.

so, I would suggest that you just have one of these a day as well as puddings or toppings for breakfast cereals, serve melon or figs with Parma ham as a first course. or make fruit shakes strawberry and passion fruit or raspberry and orange are just two delicious ideas. Tinned or frozen fruits are fine, as long as they are stored in their natural juice rather than sugary syrups. Aim to have at least two helpings of vegetables during the day.

This could be a main course salad, a bowl of vegetable soup, or salad in your sandwich at lunchtime and then vegetable main course or selection of vegetables with your evening Frozen or tinned vegetables can be fine on occasion they often contain as many if not more vitamins and minerals as fresh not count potatoes as part of you of vegetables they should be treated.

FATS

are more prone to developing heart disease because their blood contains more sugar than in non-diabetics, causing the blood cells to become and more likely to pick up circulating fats that can obstruct the blood vessels. It is therefore important to keep your intake of saturated fats down to the same advice is given to non-diabetics. Avoid large amounts of butter and cream, as well as hydrogenated oils (found in bought pastry biscuits and many other manufactured products). Instead, use just a small amount of vegetable oils such as olive oil and choose lean fish, game and lean cuts of meat.

DAIRY PRODUCTS

Dairy are a valuable source of which is particularly important for women and children Calcium is needed when you are for healthy teeth and bones, and also when you are going through the menopause and have an increased risk of developing osteoporosis. Men rarely develop but anyone taking medication that interferes with the balance of calcium in the such as strong should pay attention to their calcium intake.

The elderly or bedbound, and people who don’t do much exercise, should also take care to include some dairy products in their diet – exercise helps to build and maintain strong Generally the advice is the same as for try to include a certain amount of skimmed or calcium enriched soya milk in your daily eating plan together with a small pot of live yoghurt containing acidophilus and bifid us From age frays and cottage cheeses are lowest in fat: small amounts of other cheeses are fine for most people. Dairy products don’t adversely affect blood sugar levels, unless they are sugary products such as ice cream or sweetened.

ALCOHOL

If you have diabetes, there is no reason why you shouldn’t continue to drink alcohol, unless your doctor has told you not to. The only difference is that once you are a diabetic you need to modify the way that you and drink only in Drinking to excess can make the control of diabetes problematic because of the way it affects your blood sugar levels. In the of a hypoglycemic attack are very similar to those experienced when you have had too much alcohol to drink, so your friends may not distinguish from the other.

This is potentially It is essential to accompany alcohol with some food, especially if you take insulin. Choosing wine with its meat is fine but drinking on an empty stomach the pint after work or six o’clock whisky – should be avoided. This is because alcohol causes your blood sugar level to drop by inhibiting the breakdown of sugar from the glycogen stores within the liver. Don’t be fooled into thinking this is advantageous, because the level drops in an uncontrolled, unhealthy way All alcoholic drinks are metabolized in a similar way, so choose one you like and drink a small amount of it.

The ones to watch are, firstly, sweet wines such 2s Sauternes These contain a lot of sugar, so are best left for very special occasions and only when you have eaten plenty of high fiber foods, Spirits combined with mixers should be kept to a minimum, ideally you should choose diet mixers as these contain less sugar Low sugar Pills) beers were created for diabetics. but this was long before current thinking on the management of diabetes. These beers tend to be high in alcohol, so avoid them for this reason.

WATER

As with other people, adults should drink at least two and a half liters/four to five pints of water a day. This amount of water helps excess sugar to be excreted from your body, helps to keep your kidneys and other organs healthy, and allows the fiber in your diet to regulate your blood sugar, as discussed above.

SWEETS AND SUGARY FOODS

Sweet foods are high in a type of sugar which very rapidly enters into the blood stream. If they are eaten on an empty stomach, they can cause your blood sugar to rise very high by sweet foods I mean the obvious candidates such as cakes, biscuits, sweets, liquor ice and chocolate, honey and sugar-coated cereals, ice creams, canned drinks, squashes and fruit juices.

Try to wean yourself off sweetening tea or coffee with sugar or honey However, sugary foods can be enjoyed on occasion, as long as you have them in small amounts within meal times, making sure some fiber is present to cushion the effects of the sugar. For example, instead of having a large chocolate bar in the middle of the afternoon, wait until your evening meal and have a small amount of a good quality, high cocoa bean chocolate after the main course Choose cakes and biscuits made with whole meal flour or oats (see the Taste Good section for recipes for fruity malt loaf, apple flapjacks and brownies).

or fruit-based desserts such as whole meal or oat crumbles, fruit kebabs or fig and orange boats which all contain some fiber. Instead of sweet ice creams, consider fresh fruit sorbets made with less sugar Be aware that even when a boiled sweet or other candy contains no sucrose or glucose, just fructose. in a low fiber setting the fructose will increase your blood sugar level in the same way as the other types of sugar. They are all best avoided.

Lifestyle concerns VEGETARIANS AND VEGANS

Vegetarianism or veganism can be easily integrated with diabetes as long as you Follow a healthy, balanced eating pattern Because a vegetarian diet can be bulky, diabetic children need to have their diets carefully planned so that they still receive enough energy as well as other fiber-containing foods.

MILK INTOLERANCE

People with milk intolerance should be aware that some say milks have added sugar, frequently labelled sucrose, so choose an unsweetened one.

PREGNANCY

If you’re a healthy woman there is no reason for diabetes to stand in the way of a very happy and healthy pregnancy the better controlled you are prior to conceiving the better as this helps prevent any unnecessary complications cropping up during the pregnancy You may need to change the pattern of your meals and snacks while you are pregnant as your hormone levels change, which can make you feel sick, starving at unusual times of the day and prone to strange cravings. If you know your body and diabetes well enough you should be able to work found these, but if in doubt ask your dietitian or doctor for their advice Bear in mind that when you’re pregnant, the baby will take and use some of your sugar this should help you to realize the importance of eating regularly and keeping an eye on your sugar and medication levels,

EXERCISE

As with non-diabetic people you should include some aerobic exercise in your daily routine. Exercise helps keep the body tissues supplied with oxygen, the muscles toned, the heart healthy and the mind content. The only thing to remember is that exercise lowers your blood sugar level, as the muscles use glucose as a form of fuel. You therefore need to make sure that you have enough carbohydrate to keep your sugar level normal Insulin dependent diabetes should have a sugary snack before any strenuous exercise.

It is important to stress to diabetic children that they can and should partake in sports, point out famous sports people who are diabetic, to reassure them that the two are compatible. Provide them with a sugary snack to eat before they have a sports event at school and make sure that their teacher is fully aware that they are diabetic, so that they give them plenty of time to have a snack before doing any sport.

The teacher should also know how to spot the signs of hypoglycemia, just in case the sport is more energetic than expected, Same older people seem to find that delaying the taking of insulin can help athletic performance, but you should discuss this with your doctor before you change your routine. This is only advisable for people whose diabetes is well controlled and who are mature enough to juggle the insulin and their bodies For non-insulin-dependent diabetics, exercise should not pose any problems and indeed can bring down excess body weight, which can help your body regulate the sugar levels more efficiently.

ILLNESS

When you are ill your metabolism slightly changes. The body naturally produces more glucose so blood sugar levels tend to rise. It is therefore vital if you’re an insulin-dependent diabetic that your insulin is taken, regardless of whether or not you eat anything. Even if you don’t fancy eating something solid. you should have a regular intake of carbohydrates, such as glasses of milk, fruit juice, soup, ice cream or yoghurt. When you have a temperature, your body loses a lot of water through sweating, so it is extremely important to drink plenty of clear water If you have a young baby with diabetes, I suggest you contact your GP and dietitian when they are unwell so that you can discuss the issue of their blood sugar control .

Hypos and hyper

Blood sugar levels change all the time, according to what you have eaten and what you have been doing to use up the sugar, such as exercise. If your sugar level goes too low because there is too much insulin in the body and too little sugar, you may suffer from hypoglycemia (also called a hypo”) If there is too little insulin and too much sugar, the condition is referred to as hyperglycemia Both of these scenarios can on the whole be avoided by eating properly and taking medication if necessary. If you are unfortunate enough to experience them, they can be easily rectified.

HYPOGLYCAEMIA

Hypos are episodes when your blood sugar drops too low Symptoms include dizziness, headaches, extreme hunger, blurred vision, odd behavior such as crying, sweating pins and needles, trembling, paleness and inability to speak. The symptoms can come on extremely quickly, sometimes in a matter of minutes, but the condition is easy to correct.

It can arise for various reasons most often if you haven’t eaten enough carbohydrates, if you’ve left too long a gap between your injection of insulin and eating: or if you have done some energetic sport that has used more of the body’s sugar reserves than you’d anticipated. Once you’ve worked out how your body responds to exercise and how much carbohydrate you need to get through the day, you shouldn’t occur.

The best way of avoiding them is to be aware of what is happening in your body, for example if you are feeling slightly sweaty or dizzy, and don’t push your body to the limit. Remember to have a mid-afternoon snack if this is what you normally do: don’t think your body can hang on until you have journeyed back from the office, it won’t. Always play safe. Your doctor will explain what to do when you have a hypoglycemic attack. but the first thing is to have something sweet as quickly as possible. To stop a little hypo from escalating into a big one always carries a sugary snack around with you. This is especially important for children, and their careers should be notified as to where it is.

Good portable snacks include bananas, biscuits, places of cake or chocolate, bottles or cartons of fruit juice, milk or milk shakes, or full- calorie fizzy drinks. Diet drinks won’t help as they don’t contain the right sort of sugar Follow your sugary snack with a nourishing meal. Containing some high fiber carbohydrate as soon as possible.   You should contact your doctor immediately if you don’t feel any better. If you’re treating a friend whose blood sugar has dropped so low that she has lost turn her on to her left side consciousness, you should.

• make sure that her airway is clear by tilting the chin up slightly.

• check that the tongue hasn’t rolled back, as this could obstruct the throat.

• then call the doctor or ambulance Never give anyone who is not fully conscious anything to eat or drink If you are having frequent hypos and you’ve checked that you are taking the correct dosage of medication and eating properly, consult your doctor Non-insulin dependent diabetics should not have hypos See your doctor for advice, as your symptoms may indicate something else Always inform your diabetic child’s friends, parents, playgroup organizers and school teachers.

Make sure that they know the basic things to do Asking them to be diligent and flexible when it comes to your child’s eating habits can save a lot of unnecessary worry.

HYPERGLYCAEMIA

The opposite to a ‘hypo’ is a hyperglycemic attack. Hyper are commonly experienced when you have not taken enough insulin, you have eaten something too high in sugar, or you haven’t done the sport or activity you planned. Mild hyper, which you detect by testing your urine or taking a blood sample, can be easily corrected by avoiding very sugary foods and taking the correct amount of insulin on time.

Sometimes diabetics can have severe hyperglycemic attacks, if for example they are ill or unable to take their insulin. The symptoms are similar to the experienced before diagnosis, including extreme thirst, lethargy, weight loss and frequent urination. It is important to realize that these symptoms are different to ‘hypo symptoms – you must seek medical advice immediately and not treat it yourself by taking a hypo correcting sugary food. This will make your sugar level go even higher.