By Kiran Sukhani | 01/21/2019

Diabetes is the common word used for diabetes mellitus, It is a group of metabolic diseases in which the person has high blood glucose (blood sugar). This is because of inadequate production of insulin,or because the body's cells do not respond properly to insulin, or both.

Diabetes Mellitus is mainly of 4 types in Human

  1. Type 1 Diabetes is also called insulin-dependent diabetes. It used to be called juvenile-onset diabetes, because it often begins in childhood. It is an autoimmune condition in which body attacks its own pancreas with antibodies resulting in no production of insulin to control sugar. This type of diabetes may be caused by a genetic predisposition. It could also be the result of faulty beta cells in the pancreas that normally produce insulin.


  1. Type 2   People with type 2 diabetes have insulin resistance. The body still produces insulin, but it’s unable to use it effectively. Several lifestyle factors may contribute, including excess weight and inactivity. Other genetic and environmental factors may also contribute. When you develop type 2 diabetes, your pancreas will try to compensate by producing more insulin. Because your body is unable to effectively use insulin, glucose will accumulate in your bloodstream.


  1. Gestational Diabetes


  1. Specific Types of Diabetes due to other causes


Symptoms of Diabeties

Both types of diabetes, if not controlled, share many similar symptoms, including:

  • frequent urination

  • feeling very thirsty and drinking a lot

  • feeling very hungry

  • feeling very fatigued

  • blurry vision

  • cuts or sores that don’t heal properly


As per the reports from ADA Standards more than 95% patients are suffering from Diabetes type 2 and about 5% patients are with diabetes type 1


Numbers and Reasons of Increasing numbers in Diabetes cases

Diabetes is a very common disease which can happen to any person of any age group.

Every 6 seconds a person dies from diabetes (5.0 million

deaths) .In whole world about 12% of global health expenditure is spent on diabetes(US$673 billion) and By 2040, 1 adult in 10 (642 million) will have diabetes

Type 2 diabetes is growing worldwide due to population growth, increased rates of obesity, unhealthy diet, and physical inactivity. Risk assessment methods can effectively evaluate the risk of diabetes, and a healthy lifestyle can significantly reduce risk or prevent complications of type 2 diabetes. However, risk assessment alone has not significantly improved poor adherence to recommended medical interventions and lifestyle changes. 


Major diseases associated with Diabetes


The chronic hyperglycemia of diabetes is associated with

long-term damage, dysfunction, and failure of different organs.


complications are divided into two categories:


Microvascular Complications

Retinopathy (damage to eyes)

Nephropathy (diabetic kidney disease)

Neuropathy (damage to nerves)


Macrovascular Complications

Coronary artery disease (heart disease)

Cerebrovasular disease (damage of brain arteries)

Peripheral arterial disease (arteries get narrow which reduce blood flow to limbs


Objectives of Diabetes Treatment

1. To alleviate acute hyperglycaemic symptoms

2. To prevent life-threatening acute complications

3. To prevent the long-term diabetic complications

especially hypoglycaemia and atherosclerotic cardiovascular diseases


The good news

You can live a long and healthy life by keeping your blood sugar levels in the target range set by you and your health-care provider. You can do this by:


_ Lifestyle management

_ Nutrition therapy

_ Physical activity

_ Weight management

_ Smoking cessation

_ Anti-diabetic drug therapy

_ Aggressive management of other CV risk factors

  • Managing stress effectively



Here are some important tips on Nutritional Management for Diabetes.


Basic Meal Planning

  • Glucose comes from foods such as fruit, milk, some vegetables, starchy foods and sugar. To reduce your risk of diabetes complications such as heart disease,A proper planning of eating at regular intervals is required. Eat three meals per day at regular times and space meals no more than six hours apart. You may benefit from a healthy snack.

  • Portion Guide

Did you know your hands can be very useful in estimating appropriate portions? Use this portion guide when planning a meal to estimate how much you should eat.

Choose an amount the size of your fist for each of Grains & Starches, and Fruit.

Choose as much as you can hold in both hands.

Choose an amount up to the size of the palm of your hand and the thickness of your little finger.

  • Carbohydrate Counting

Carbohydrate counting is a flexible way to plan your meals.

  • Your body breaks down carbohydrate into sugar. This raises your blood sugar levels.

  • Carbohydrate is found in many foods including grains and starches, fruits, some vegetables, legumes, milk and milk alternatives, sugary foods and many prepared foods.

  • Meat and alternatives, most vegetables and fats contain little carbohydrate. Moderate servings will not have a big effect on blood sugar levels.




The Glycemic Index

The glycemic index (GI) is a scale that ranks a carbohydrate-containing food or drink by how much it raises blood sugar levels after it is eaten or drank. 

Foods with a high GI increase blood sugar higher and faster than foods with a low GI. There are three GI categories:

  • Low GI (55 or less) – Choose most often (wheat , oatmeal, oat bran, barley, bulger, legumes, lentils and non-starchy vegetables

  • Medium GI (56-69) – Choose less often (brown rice, basmati rice potatoes, raisins, prunes and bananas.

  • High GI (70 or more) – Choose least often (high sugar beverages, white rice, pasta, cuscus, potatoes and sweetened fruit juices and low fiber cereals.



Alcohol & Diabetes

  • For people with high blood pressure and diabetes, alcohol should be limited to one drink/day for women and two drinks/day for men.


Cholesterol & Diabetes

Most adults with type 1 or type 2 diabetes are at high risk for cardiovascular diseases such as heart attack and stroke. So cholesterol intake has to be managed well.

  • Choose lower-fat foods

  • Limit saturated fats

  • Avoid trans fats

  • Limit food sources of cholesterol

  • Choose high-fibre foods

To help lower LDL-cholesterol, replace saturated and trans fats with small amounts of unsaturated fats, such as:

  • Olive oil

  • Canola oil

  • Peanut oil

  • Nuts and seeds such as peanuts, almonds and ground flax




Fibre often takes a back seat as dietary fashions change, but it remains an essential nutrient and a vital part of healthy eating for everyone, including those with diabetes.

Soluble fibre may be especially helpful for people with diabetes. Soluble fibre can help improve blood sugar management by slowing down digestion, leading to more stable blood sugar levels after eating. The cholesterol-lowering effect of soluble fibre may also help reduce the risk of heart disease in people with diabetes. Soluble fiber is found in oat bran, barley, nuts, seeds, beans, lentils, peas, and some fruits and vegetables.


  • Reducing Salt Intake

Foods naturally contain small amounts of sodium, but most of the sodium in our diet is added during food processing. Learn more about how you can reduce salt intake without losing taste.

  • Sugar & Sweeteners

Worried about the calories in sweeteners like sugar and honey? Are sugar substitutes better? Let’s consider the choices available to people with diabetes, and how they fit as part of a healthy diet.


Ref: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4820210/


ADA Standards of Medical Care in Diabetes-2017

Diabetes Care 2017;40(Suppl 1):S11-24

HKU-SPACE Notes on Diabeties








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