Your health: when sugar turns sour

November 14 was World Diabetes Day. On that day, we tried to remember the 63 million adults diagnosed with diabetes and the 230 million who don’t know they have the disease. Almost 73 million diabetics live in India. In total, 10-14% of the urban population and 5-7% of the rural population are affected.

India is the diabetes capital of the world. A similar percentage of ethnic Indians living abroad also suffer from the disease. This is because the majority of Indians, even those of normal weight, have a high degree of insulin resistance. Mitochondria in cells, which are responsible for converting food into energy, do not work efficiently. This leads to high sugar values.

Many remain in denial even after diagnosing diabetes. Advised by well-meaning people, they decide that a controlled diet isn’t really necessary, only refined sugar qualifies as sugar, and swallowing bitter leaves, herbs and vegetables will cure them.

Uncontrolled diabetes causes death – by stroke, heart attack, and kidney failure – due to the side effects of high blood sugar. Complications such as blindness and non-healing ulcers can also occur.

Everyone should be tested for diabetes after the age of 45. Previously, screening tests were essential for symptomatic individuals.

The HBA1c or glycosylated hemoglobin test does not require overnight fasting. A value less than 5.7 is normal; 5.7-6.4 corresponds to prediabetes; 6.5 or more, or a random test value of 200 mg / dL or more, or a fasting sugar greater than 100 mg / dL is considered diabetes.

Once blood sugar values ​​are elevated, the tests should be repeated to see if they return to normal after a trial of diet and exercise. These two elements are the mainstays of diabetes treatment.

There is no single diet for people with diabetes. Basically, one should have three main meals and two healthy snacks per day. Meal times should be regular and fixed. Total calorie intake should be 1,500 to 1,700, depending on your activity level. Second portions should be avoided. Cooking oil should be reduced to half a liter per person per day. Diet can be adjusted according to personal preferences and needs by consulting a dietitian.

Regular exercise helps increase your heart rate, works muscles, uses calories, and lowers blood sugar levels. It is important to use a combination of exercises. A half hour ‘gentle walk’ a day will not be enough, but it is better than nothing.

Aerobic activity – walking, jogging, swimming or cycling – for at least 40 minutes per day is required six days per week. During extended periods of inactivity throughout the day, get up every hour for a few minutes to keep the muscles moving.

Training with light weights builds muscles and also helps control blood sugar. It is not necessary to purchase dumbbells. A one liter bottle of water weighs one kilogram. Thirty repetitions per day are usually sufficient.

Blood sugar can be monitored inexpensively using home blood glucose monitors.

A file must be kept and shown to the doctor. If the control is not satisfactory, the lowest possible dose of a single drug is started and increased to the maximum dose if this does not help. If the sugar is still not controlled, a second or third drug is added. If nothing works, insulin injections are needed.

Some medications have side effects such as vitamin B12 deficiency, nausea, and diarrhea. They are unique to medicine and to the individual. In this case, the drug should be changed. People with diabetes should also have their blood pressure, eyes, kidney function, and ECG reports regularly monitored.

The author is a pediatrician with a family practice in Vellore and the author of Staying Healthy in Modern India. If you have any questions about health issues, please write to [email protected]

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