DIABETES MELLITUS

 

Diabetes Mellitus is a chronic metabolic disorder that prevents the body from utilizing glucose completely or partially. It is characterized by raised glucose concentration in the blood. The pancreas produce a hormone insulin which controls the amount of glucose in the blood. Without insulin, the blood sugar increases as the body cannot use or store glucose. The most commonly-used screening tests are the determination of the fasting blood glucose level and the blood glucose level tested two hours after a meal. The normal fasting blood sugar content is 80-120 mg per 100 ml of blood; this can go up to a level of 160 mg per 100 ml of blood two hours after meals. Anything above these levels can be termed as diabetic levels. Diabetes is common among older, obese people.
Types of Diabetes:

Type 1 or insulin-dependent diabetes mellitus (IDDM) occurs when the pancreas fails to make enough insulin. It usually occurs in childhood or adolescence but can develop at any age. These patients need insulin everyday.
Type 2 or non-insulin dependant diabetes mellitus occurs when body cells become resistant to insulin. This is more common among adults, especially those who are overweight and over age 40. These people are able to control their blood sugar levels through weight control, regular exercise and a well-balanced diet. Some people require oral medications or insulin injection to lower blood sugar.

Symptoms of Diabetes

Initial Symptoms

Increased thirst, increased urination, increased appetite are the initial symptoms.
In type 1 weight loss is seen and in type 2 obesity is seen.

Other Symptoms

Other possible symptoms are blurred vision, skin irritation or infection, weakness or loss of strength, and decreased healing capacity.
Clinical lab test data reveal glycosuria (sugar in urine), hyperglycaemia, abnormal glucose tolerance tests.
If diabetes is not diagnosed at the right time symptoms like fluid and electrolyte imbalance, acidosis, coma is seen.

Causes of Diabetes

Cause for IDDM

IDDM mostly results from a virally initiated autoimmune destruction of beta cells of the pancreas.

Cause for NIDDM

NIDDM is determined genetically and is expressed with age or other factors like obesity, diet and inactivity.

Home Remedies for Diabetes

Diabetes treatment using Bitter Gourd

Among the several home remedies that have proved beneficial in controlling diabetes, perhaps the most important is the use of bitter gourd. It has lately been established that bitter gourd contains a hypoglycaemic or insulin-like principle, designated as 'plantinsulin', which has been found valuable in lowering the blood and urine sugar levels. It should, therefore, be included liberally in the diet of the diabetic. For better results, the diabetic should take the juice of about four or five karelas every morning on an empty stomach. The seeds can be added to food in a powdered form. Diabetics can also use bitter gourd in the form of a decoction by boiling the pieces in water or in the form of dry powder.

Diabetes treatment using Indian Gooseberry

Indian gooseberry, with its high vitamin C content, is considered valuable in diabetes. A tablespoon of its juice, mixed with a cup of bitter gourd juice, taken daily for two months, will stimulate the islets of Langerhans, that is, the isolated group of cells that secrete the hormone insulin in the pancreas. This mixture reduces the blood sugar in diabetes.

Diabetes treatment using Jambul Fruit

Jambul fruit is another effective home remedy. It is regarded in traditional medicine as a specific against diabetes because of its effect on the pancreas. The fruit as such, the seeds, and fruit juice are all useful in the treatment of this disease. The seeds contain a glucoside 'jamboline' which is believed to have the power to check the pathological conversion of starch into sugar in cases of increased production of glucose. The seeds should be dried and powdered. One teaspoon of this powder should be mixed in one cup of milk or water or half a cup of curd, and taken twice daily. The inner bark of the jambul tree is also used in the treatment of diabetes. The bark is dried and burnt. It will produce an ash of white colour. This ash should be pestled in mortar, strained and bottled. The diabetic patient should be given ten grams of this ash on an empty stomach with water in the morning, and twenty grams in the afternoon, and in the evening an hour after taking meals. An equal quantity of amla powder, jamun powder, and bitter gourd powder also makes a very useful remedy for diabetes. A teaspoon of this mixture once or twice a day would be effective in checking the progress of the disease.

Diabetes treatment using Grapefruit

Grapefruit is a splendid food in the diet of a diabetic patient. If grapefruits were eaten more liberally, there would be much less diabetes. If you have sugar, use three grapefruits three times a day. If you do not have sugar, but a tendency towards it and want to prevent it, use three a day.

Diabetes treatment using Fenugreek

The seeds of fenugreek have been found effective in the treatment of diabetes. Fenugreek seeds, when given in varying doses of 25 gm to 100 gm daily, diminish reactive hyperglycaemia in diabetic patients. Levels of glucose, serum cholesterol, and triglycerides were also significantly reduced in the diabetes patients when the seeds were consumed.

Diabetes treatment using Bengal Gram

Experiments have shown that the intake of water extract of Bengal gram enhances the utilization of glucose in both diabetic and normal persons. When kept on a diet which included liberal supplements of Bengal gram extract, the condition of tile patient improved considerably and his insulin requirement was reduced to about twenty units per day. Diabetes patients who are on a prescribed diet which does not severely restrict the intake of carbohydrates, but includes liberal amounts of Bengal gram extract, have shown considerable improvement in their fasting blood sugar levels, glucose tolerance, urinary excretion of sugar, and general condition.

Diabetes treatment using Black Gram

For a milder type of diabetes, two tablespoons of germinated black gram, taken with half a cup of fresh bitter gourd juice and a teaspoon of honey, is said to be useful. It should be taken once daily for three to four months. A restriction should be placed on the intake of carbohydrates. Even in severe cases, regular use of this combination, with other precautions, is useful as a health-giving food for the prevention of various complications that may arise due to malnutrition in diabetics.

Diabetes treatment using Mango Leaves

The tender leaves of the mango tree are considered useful in diabetes. An infusion is prepared by soaking 15 gm of fresh leaves in 250 ml of water overnight, and squeezing them well in the water in the moming. This filtrate should be taken every morning to control early diabetes. As an alternative, the leaves should be dried in the shade, powdered and preserved for use when necessary. Half a teaspoon of this powder should be taken twice a day.

Diabetes treatment using Parslane

The seeds of parslane are useful in diabetes. A teaspoon of the seeds should be taken every day with half a cup of water for three to four months. It will increase the body's own insulin and help in curing diabetes.

Diabetes treatment using Other Foods

Besides bitter gourd, certain other vegetables have been found useful in diabetes. These include string beans, cucumber, onion, and garlic. Tea made of the pods of string beans is valuable in diabetes.

Diet for Diabetes

Dietary Guidelines for Diabetes Management

Three methods of treatment are generally followed depending on the individual and severity of the conditions.
1) Diet alone
2) Diet and Oral hypoglycaemic drugs and
3) Diet & insulin.
A mild diabetic can manage his disease with control on his diet alone. A severe diabetic requires dietary control along with insulin. However, whatever the form of controlling diabetes, regularity, routine and regulation should be strictly followed.

Types for Foods to be eaten for Diabetics

A diabetic should follow a low carbohydrates, low fat & moderate protein diet. The diet should be high in complex carbohydrates ie. High fibre diet like vegetables, whole legumes, whole wheat products, oats etc. Products made from refined wheat flours should be restricted. Salads can be consumed in a any quantities but high fat salad dressings should be avoided. Fruits can be taken as per recommended by your dietician, fruit juices should be avoided and whenever possible fruit should be taken with the skin eg. Apple, Pear etc. Preferably avoid fruits along with your meals and you can take it 2 hours after or before a meal.
Each meal should contain some source of protein as it doesn't increase the blood sugar immediately
For eg. In breakfast you can consume oats porridge, which contains oats as well as milk. Proteins should not be taken too much in excess as it may lead to renal problems.
A diabetic patient should worry about the fat content of his diet. Many foods have some amount of invisible fats such as whole milk, egg yolk, and red meats.
Choose skimmed milk, egg whites, de-skinned chicken and use very little quantity of visible fats like oil, Ghee, butter in your daily diet.

Other Suggestions for Diabetes

Guidelines for Diabetics

-Exercise regularly, it keeps you fit and helps in controlling diabetes. Light exercise such as jogging, swimming or brisk walking are good.
-Do not walk bare feet. Decreased sensations can result in injury.
-Do not miss a meal after insulin or oral anti diabetic drugs.
-Do not change the dose of the anti-diabetic drugs, except under medical advice.
-Test urine regularly.
The main goal of nutrition for diabetics is to avoid highs & lows of blood sugar so you can feel well today and in the future. So it is important to remember these 3 points.
1) The timing of your meals & snacks is very important. Eat meals & snacks at the same time every day or as close to the same time as possible. Include a snack if you are exercising or if your blood sugar gets low. If these are happening regularly then consult your physician.
2) If you are taking insulin or a diabetic pill, always eat bed time snack. Stick to your serving size. If you eat more then what you are required to may raise your blood sugar.

Glycaemic Index of Foods

Glycaemic Index:

It is found that factors other then fibre may result in a food producing relatively flat blood profiles. These foods may favorably influence blood lipids. Classification of foods in terms of their glycaemic effects may facilitate application of this information in day-to-day management. Increase in levels of plasma insulin and glucose produced by various carbohydrate containing foods vary considerably from one food to another. For example, the post-prondial blood glucose response of glucose and potato of similar value is higher than that produced by bread or rice. Many such researches are being carried out to elicit the glycaemic response must also be considered. This system may be used as a part of the exchange system. The glycaemic index provides a means of identifying starchy foods with a lower glycaemic potential. (i.e foods less likely to cause a rise in blood glucose) that may be offered on trial to diabetics.