As the world marked Diabetes Day recently, the right diet and nutrition should be the major priority, says an expert, where diabetes care should be comprehensive and centred around the person living with diabetes.
According to Sumaira Fatima Mirza, Clinical Dietician and Diabetes Educator at IMC Apollo Sugar, diabetes care includes an individualised management plan developed between the person with diabetes and their healthcare providers.
There are three segments of care objectives and they are prevention, diagnosis and management of diabetes and the area of focus is on the approach and systems that are ideally in place to improve care for the people.
“People of 35 years of age and those younger than 40 years with risk factors should be screened for diabetes. Glycosylated haemoglobin (A1C), fasting plasma glucose (FPG) or rarely two hour plasma glucose (2hPG) as part of a 75g oral glucose tolerance test (OGTT) can be used for diagnosis and screening,” explained Sumaira.
She said A1C can be measured every three months to assess if glycaemic goals are met.
“One can consider testing every six months if targets are consistently met and treatment, diet and lifestyle are stable. Goals include reducing hyperglycaemia and its symptoms, reducing risk and occurrence of hypoglycaemia and improving quality of life,” she pointed out.
According to her, a standard care plan should include regular blood investigations, consultation with doctor, clear explanation on dose and time of medicines, insulin technique hypoglycaemia management, nutrition and diet management, sick days management, home blood glucose monitoring if needed and exercise and physical activity.
However, the most important factors of dietary care include the affordability, availability of resources, nature of work and timings.
Sumaira said it is essential to plan individualised diets based on needs and requirements.
Key things to keep in mind, she said are, “Choosing wisely healthy main carbohydrates on your plate, the cereals and grains which are not only the major energy source of the meal, but also provides huge impact on blood glucose levels.”
WHAT TO EAT
“Eat more variety of non-starchy vegetables and in abundance, take colourful fruits in portion control and give priority to full fruit over juice or shakes and most importantly follow the serving size,” Sumaira said.
Not just carbohydrates, one has to be conscious about the type of protein. “Add lean protein in the diet to aid muscle building and boost immune system. Avoid processed meats as it can cause hypertension and fatty liver. Avoid or cut down on added sugar. Use salt in moderation, choose low sodium food products. Choose healthier fats and oils in portion control,” she said.
Often diabetic patients do come across specialised food, but this is what the clinical dietician has to say: “Don’t get overwhelmed by the so called diabetic foods or ‘no added sugar’ labels as this does not mean it will not impact blood sugar levels. They do increase blood glucose levels because of the other ingredients.”
“Opt for simple and time saving meals. Be smart in choosing the mid snacks like nuts, fruits and dairy products like low fat milk, laban in order to get a boost of nutrients,” she advised.
“Exercise frequently as time permits, and stay hydrated. Avoid smoking and consuming alcohol.” And an important message is not to get carried away by fad diets or quick weight loss strategies eventually it will lead to faster regain.
“Choosing consistent ways begin with small changes. Low carb diet, intermittent fasting and Mediterranean diet are some of the important options,” she added.
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