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The moment we get diagnosed with diabetes, our minds cringe in fear by the thought of all the restraint on our life, especially diet, which would be imposed on us for a lifetime, taking away the joy from celebrations and fun eat out sessions etc. Diet management is of utmost importance in diabetes not only to control blood sugar levels but also to keep other risks such as body weight and heart risk factors at bay. People with HbA1c levels mild to moderately elevated (<7.5%) at diagnosis, may be advised to take a diet and lifestyle modification trial before they are put on any drugs and some of these people will be able to control their diabetes/pre-diabetes for a significant amount of time without drugs. Even for people on drugs or insulin diet and lifestyle management is equally important. But, the evidence based medical advice, on diet for diabetics, is not that restrictive and allows a lot of room for having fun with food! All the expert agencies on diabetes in the world, such as ADA, AACE, IDF and our own ICMR, have published guidelines on managing your diet in diabetes, which we at FWI analyzed to formulate our advice for diabetics, which you will find below: The three most important considerations in diet management in diabetic people are: Managing the carbohydrate intake to control blood sugar Managing the overall calorie intake to lose weight or to maintain a healthy weight Keeping the intake bad fats and salt in check to reduce the risk of CVD 1. Managing the carbohydrate intake to control blood sugar Diabetes is a primarily a disease of insulin resistance or insulin deficiency, in which the physiological action of insulin, that of helping in uptake of blood glucose by body cells and thereby keeping the blood sugar levels in control, is less than adequate. All dietary carbohydrates are broken down by our digestive system into glucose, which then is added to the blood. Therefore, the most important consideration to prevent or delay complications of diabetes is keeping the blood sugar levels in control Diabetics have to know their carb containing food very well and monitor their carb intake on regular basis, but they are not required to give up totally on sugar, rice or sweets, contrary to what is the general notion! Same amount of carbs whether as whole grains or table sugar, will raise the Post Prandial (two hours post meal) blood sugar to nearly the same level, so substituting regular roti with say a laddoo, once in a while is OK, provided you make sure that laddoo gives the same amount of carbs as the rotis you have given up and your overall calorie intake in the meal is constant as well. This you can manage by portion size control and carb counting But having laddoos instead of roti regularly is not a good idea because good sources of carbohydrates such as whole grains have proteins, dietary fiber, vitamins and minerals in addition, whereas bad sources such as table sugar or laddoo will not have these and will give you empty calories. Also, these sweets will be more calorie-dense (1 tablespoon sugar gives 60 calories whereas one roti gives nearly 80 calories) and will not be very filling! So, if you want to have simple sugar or sweets occasionally, make sure that you replace the healthy carbs with these sweets, such that same amount of calories and carbs are provided by them and don?t just add sweets to your regular meal Remember, quantity control and moderation are absolutely imperative! 2. Managing the overall calorie intake to lose or maintain a healthy weight Losing excess body weight helps in patients with diabetes in several ways. Besides this will help you in controlling your risk of heart diseases and a host of other diseases at the same time! In diabetes, even losing 3-5% of your existing body weight will result in better blood sugar levels, but losing up to 10% results in better blood lipid profile and reduced risk of heart disease To know more, go to ?weight loss for diabetics? and read your way into fitness! 3. Keeping the intake of ?bad? fats and salt in check to reduce the risk of CVD The complications of CVD, include heart attack, stroke (brain attack), foot gangrene etc. All complications of CVD, which is the biggest cause of death in diabetics Therefore, dietary modifications to manage risk factors for CVD are very important in diabetics. These modifications include controlling the intake of salt and ?bad? fats in your diet, and the recommended levels of intake are lower than those in general population Diabetics in general are often advised even by their doctors and dieticians, some times, to consume ?low fat? diet to manage their heart risk. But In India, where average intake of carbs is much higher than recommended intake of fat, for most people, such an advice is not only erroneous, it is harmful! (Read: Indian diet: ?pro?s and ?con?s, to know more) Instead what is needed is to replace the ?bad? fats, present in high quantities in vanaspati (found in snack items and restaurant/ fast food meals etc.), full cream milk, butter, ghee and red meat (but not mutton: read more), with vegetable oils (such as olive, canola, rice bran etc. But not coconut and palm oil)Â
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