Topic-wise Questions and Answers on Diabetes
Diagnosis, Signs and Symptoms of Diabetes
Diagnosis, Signs and Symptoms of Diabetes Questions and Answers
Question 1 : What is diabetes?
Answer : Diabetes is a condition in which the glucose (sugar) level in blood increases above the normal limits. This condition develops due to the lack or inefficiency of insulin, a hormone produced in the pancreas. The normal limit of blood sugar is :
Fasting : 70-100 mg/dl
Postprandial (2 hours after meal): 100-140 mg/dl
Random: <140 mg/dl
To label a person as diabetic, only one reading is not sufficient. One must get at least three readings and all three must come positive.
Question 2 : What are the symptoms by which we can suspect diabetes?
Answer : Diabetes is a disease which may remain asymptomatic for a long period of time before getting detected. A disease known to cause a number of complications involving almost all the organs of the body, this disease commonly gets detected on routine examination or when the patient reports with one of its complications.
The classical symptoms of diabetes are the three P’s i.e. polyuria (increased urination), polydipsia (increased thirst) and polyphagia (increased hunger), combined with loss of weight. People with diabetes usually complain of non-healing of their wounds. They also suffer from frequent infections. Due to more urination there is loss of water leading to excessive thirst known as polydypsia. Excess urination also results in weight loss because of the glucose lost in the urine. There is fatigue, muscular weakness and the person feels lethargic. There may also be impotence.
In certain diabetics, white spots may be seen on the shoes after urination. In the advanced phase of diabetes some people face complications like kidney failure, loss of sensations (neuropathy) and blurred vision (retinopathy).
Question 3 : What is Non-Insulin Dependent Diabetes Mellitus (NIDDM)?
Answer : Non Insulin Dependent Diabetes Mellitus (NIDDM) is also known as Type-II diabetes. This type of diabetes is the commonest. Most of the people suffering from this type of diabetes are obese or overweight and are above 40 years of age. The onset is gradual . The insulin present in this type is less or inadequate to control the blood sugar level. It can be easily controlled by drugs. Lifestyle changes, yoga, stress management, weight reduction, dietary changes and meditation also help to control this type of diabetes.
Question 4 : What is Insulin Dependent Diabetes?
Answer : Insulin Dependent Diabetes (IDDM) is also known as Type-I diabetes. This type of diabetes is rare and usually occurs at a young age, below the age of 18 years. People with IDDM usually have a damaged or non-functioning pancreatic islet cells. As a result insulin is not secreted in the required amount. People with this type of diabetes regularly require insulin to control their blood sugar level. Oral diabetic drugs are not beneficial in controlling blood glucose level in these patients.
Question 5 : It is said diabetes patients do not feel chest pain or angina. Why is it so?
Answer : In case of long-standing or uncontrolled diabetes, neuropathy (nerve damage) occurs. In this the nerves become weak and are unable to transmit the message to the brain. Thus the feeling of pain is grossly reduced. Normally heart patients suffer from angina, which is a pain that occurs on the let side of the chest on exertion. Whenever a person walks the pain is felt and whenever he stops the pain goes off. But in the case of diabetes this pain may not be felt because of neuropathy.
Diabetic patients may complain of breathlessness on walking or exertion. However, it is not necessary that all diabetic patients will not have chest pain. Only 20% to 30% of diabetics do not have chest pain. This is the reason for silent ischemia (heart disease) in diabetic heart patients.
Question 6 : Is it a must that diabetic patient must have sugar in their urine?
Answer : It is not always compulsory that a diabetic patient must have sugar in their urine. Our normal blood glucose level after food is 120 mg%. Glucose appears in the urine only when its level in the food rises beyond 180 mg%. This is known as “renal threshold”, i.e. the kidneys start to leak sugar in urine only when the blood level in glucose starts exceeding 180 mg%. Before this sugar will not appear in the urine, i.e. when it is above 120 mg% and below 180 mg% and this it will not be revealed in routine urine examinations.
Question 7 : Can we feel anything if the blood sugar is very high?
Answer : No, we cannot feel anything if the blood sugar is very high. Many a time diabetes goes undiagnosed for years and is discovered only by chance. These patients do not show any symptom except for delayed healing of wounds, recurrent infection and increased urination. There are some patients whose blood sugar is as high as 400 mg% but they also do not show nay specific signs. However if the blood sugar goes down below 70 mg% then severe symptoms of hypoglycemia can be seen.
Question 8 : What are the sings and symptoms of hypoglycemia?
Answer : Hypoglycemia is a condition in which the blood sugar goes down below 70 mg%. In a hypoglycemic patient severe symptoms can be seen such as excessive feeling of hunger. There is pain in the abdomen, sweating, double vision, weakness, numbness, muscular itching, mental confusion. These patients may also go into coma or fall unconscious.
A hypoglycemic patient improves immediately if some sugar or glucose is given instantly. If by chance they happen to take an extra dose of insulin they may go into hypoglycemic condition. Also if they do more of exercise or exertion on a particular day without increasing their insulin dose this condition may occur. This condition may also be seen if the meal of these patients is delayed.
Question 9 : Why is the disease called diabetes mellitus?
Answer : Diabetes literally means “running through” and mellitus means “sweet”.
In diabetes when the blood glucose level exceeds 180 mg% glucose starts appearing in the urine. Also there is excessive urination (polyuria). Since the taste of urine in diabetes is sweet this condition is termed as diabetes mellitus.
Question 10 : Is glaucoma related to diabetes?
Answer : Although glaucoma (increased pressure inside the eye balls) can occur in people who do not have diabetes, there is a slightly increased risk in those who do have it. This is usually confined to those who have advanced diabetic eye problems.
Occassionally the eye drops that are put in your eyes to dilate the pupil to allow a proper view of the retina (inner layer of the eye-ball) can precipitate an attack of glaucoma. The signs of this condition would be pain in the affected eye together with blurring of vision coming after some hours of the drops. Should this occur you should seek urgent medical advice either from your own doctor or from the accident or emergency department of your local hospital, as it is reversible with rapid treatment but can cause serious damage if not treated.
Causes of Diabetes Questions and Answers
Question 11 : Why diabetes occurs?
Answer : Insulin is produced in the pancreatic cells (islet of Langerhans). In diabetes insulin is either inadequately produced in these cells or is ineffective despite being produced in adequate quantity. As a result glucose is not broken down (utilized) completely and the blood sugar level rises up. However the real cause of diabetes is still not know. But most often diabetes is seen in people who are more stressed, have a genetic predisposition, those who lead a sedentary lifestyle, and have low physical activity and have increased abdominal girth.
Question 12 : Why diabetes occurs in children?
Answer : In children diabetes occurs mainly due to non-production of insulin. In most of these children, the pancreas is completely damaged. As a result insulin is not produced. This may be due to autoimmune phenomenon or due to some injury. Many a time pancreas is not properly formed leading to diabetes.
This type of diabetes is commonly known as insulin dependent diabetes mellitus (IDDM). Though the percentage of people having this type of diabetes is very low but it is not uncommon to find people having Type-I or IDDM.
The only treatment available at present for this type of diabetes is insulin which has to be injected orally. These insulin injections need to be taken only for controlling the blood sugar. However, it is not curable but if an IDDM person controls his dietary habits, does regular exercise and walking, he can definitely lower his insulin dose.
Question 13 : If the parents have diabetes, is it necessary that their children will have diabetes?
Answer : If the parents have diabetes their children will have increased chances of diabetes.
If one of the parent is diabetic then there is 4-5% chances that the children will also develop diabetes in the long run, but if both the parents are diabetic then the chances are higher.
However if the children do regular exercise, yoga, walking meditation, control their stress level and do proper diet control they can definitely prevent diabetes.
Question 14 : Can sever illness cause diabetes?
Answer : It is not always necessary that severe illness will cause diabetes. Many illnesses like septicemia, meningitis, paralysis, typhoid in which the person is on bed for months and the physical activity is reduced to minimum do not lead to diabetes. However it can definitely precipitate it in someone who is destined to have diabetes in future.
Question 15 : Do other diseases increase the chance of getting diabetes?
Answer : Yes, obesity is one of the diseases that can lead to diabetes. Heart disease, high blood pressure, diabetes and obesity are like four cousins of the same family. All of them have a tendency to co-exist and promote each other. However other diseases do not lead to diabetes.
Question 16 : Does obesity lead to diabetes?
Answer : Yes, obesity definitely leads to diabetes. If you are overweight i.e. your weight is 10% more than your ideal body weight then there are chances of developing diabetes. This is because in obese individuals insulin does not work effectively to lower blood sugar level. If you are very obese then the chances of your developing diabetes are very high. It is generally seen that obese people have poor food habits. They consume lot of fatty foods, simple carbohydrates and less of fibre. Also they do not exercise leading to increased chances of developing diabetes.
Question 17 : Does hypertension lead to diabetes?
Answer : There is no direct connection between hypertension and diabetes. It is commonly seen that many diabetic individuals have hypertension or vice-versa. The real cause is not known but there is a possibility that during high blood pressure some of the cells especially the ones that release insulin get damaged leading to diabetes.
Tests in Diabetes Patients Questions and Answers
Question 18 : What is fasting blood sugar?
Answer : It is the blood sugar that is measured when a person has not had anything for 10-12 hours. It should never be more than 100 mg/dl or mg%. The normal level is 70-100 mg/dl. It is usually checked after overnight fasting.
Question 19 : What is postprandial blood sugar?
Answer : It is the blood sugar that is measured 2 hours after meal. In this test the person is given food and after two hours the blood sample is taken and checked for blood glucose. Many prefer this test after ingestion of 75 grams of glucose and measuring sugar after two hours. Some people take the sample after two hours of breakfast or even two hours after lunch, once the food is absorbed and goes into the blood in the form of glucose. Normal reading is 100-140 mg/dl.
Question 20 : What is random blood sugar?
Answer : It is the blood sugar that is measured at any time during the day irrespective of whether the person has had meal or not. It should never be more than 140 mg%.
Question 21 : What is the limit of normal blood sugar?
Answer : Our normal blood sugar ranges from 70-100 mg/dl.Everyone should try to keep their blood sugar within this range. This is ideally known as fasting blood sugar level. This because blood sugar is properly tested when a person fasts for 12 hours i.e. no glucose is added for 12 hours. At this time blood sugar remains in a normal state that our basal body will get.
Blood sugar that is measured at any time during the day, when some amount of food is taken in the last 12 hours, is known as random blood sugar and the one that is measured after a meal is known as postprandial blood sugar. These should never be more than 140 mg%.
Question 22 : What is glucose tolerance test?
Answer : It is an extensive sugar examination test for diabetes people. It can reveal to us how insulin is being secreted by status of insulin secretion mechanism. It is usually conducted in the morning. In this, the blood sample is first taken empty stomach to determine the fasting blood sugar. 75 gm of glucose dissovled in water is then given orally to the patient. Blood samples are then collected at every 1/2 hours interval for three hours and their glucose content is estimated. The result of this test shows a particular kind of graph coming up. This graph shows how glucose is stimulating insulin secretion. This test is important for those who are in their initial phase of diabetes to test their tendency towards diabetes.
Previously this test was extensively practised but since it requires multiple needle pricks it is not practised so much these days ,instead other tests that are equally reliable are conducted.
Question 23 : What is serum glycosylated haemoglobin?
Answer : Haemoglobin is manufactured in our body everyday and once formed it remains in the body for next 90 days. If at any time the glucose level is high in the blood the haemoglobin manufactured on that day will get a bit of glucose in their structure. This glucose tagged haemoglobin can be measured by withdrawing blood in the fasting stage. When blood sugar is out of control the glycosylated haemoglobin rises. Under normal conditions only 6.0% of HbA1 is present in our blood. If diabetes is badly controlled then glycosylated harmoglobin level goes up and up. For each uncontrolled day of blood glucose, the glycosylated haemoglobin increases by 0.1%. This test is frequently used to confirm the continuous control of blood glucose in the last three months.
- Normal: 4-6%
- Okay : 6-7%
- Not good control: 7-8%
- Bad control: 8-10%
- Very bad control: greater than 10%
Question 24 : How by testing urine can we monitor diabetes patients?
Answer : Our body has a unique organ called kidney. Whenever sugar is in excess in our blood this organ excretes it out in the urine. Kidney works as a safety valve for our body. Sugar only appears in the urine when its level in the blood increases to 180 mg% or more. This is because kidney cannot tolerate sugar beyond 180 mg% and starts excreting it out in the urine. It is at this point that urine gives a positive test for sugar.
People with diabetes may get their urine checked but it will only test positive if its level in the blood is 180 mg% or more. Thus this test is not always a true indicator of one’s diabetes status. However if one wants to get one’s urine checked for diabetes very frequently, there are paper sticks available in the market for this purpose. These sticks should be dipped in the urine and if they show a colour change it means sugar is present.
Question 25 : Where is the best place to obtain blood for measuring blood glucose levels?
Answer : Blood glucose level can be measured by two methods. One is by pinprick in the finger pulp using a glucometer and another is by withdrawing blood from a vein and getting it checked in a laboratory. However the former method can be carried out at home. In this one has to prick the finger with a needle and a single drop of blood is enough to measure blood glucose. Most of the laboratories withdraw blood sample from the vein in the elbow and check the blood glucose. There may be 10% difference between the two (finger method gives lower figure as some tissue fluid may mix with the blood).
Question 26: Can diabetes be discovered by chance?
Answer : Yes, as diabetes does not show any symptoms or complications in the initial phases it is usually discovered by chance during routine examinations.
Many times people complain of excessive thirst and non-healing of their wounds. This is also a clear indication of diabetes.
Question 27: Will my fingers take a long time to heal after finger pricking and am I more likely to pick up an infection of the finger?
Answer : Before pricking your finger for collecting the blood sample you must clean your finger nicely with spirit and use sterilized needles for the purpose. This will minimize your chances of getting infection. Also, immediately after taking off the needle the pricked area closes off thereby lowering the chances of infection. Healing takes place within one day.
Thus is use proper aseptic measures you will never pick up an infection.
Diet and Diabetes Questions and Answers
Question 28 : What are the food restrictions for diabetes?
Answer : Sixty percent of diabetes can be controlled only by food. The three main nutrients present in our food are carbohydrates, proteins and fats. Amongst these, carbohydrate is the main source of glucose in our blood.
There are two types of carbohydrates: one is simple carbohydrate which is good for diabetes because it is readily absorbed in the blood and increases the blood sugar level rapidly. The other one is complex carbohydrate which is safe for diabetes because in complex carbohydrate glucose is released slowly and the blood sugar does not increase rapidly.
The second change that diabetics must do is to decrease the amount of refined foods. Instead of refined food a diabetic should take lots of fibre because fibre slows down the absoption process of glucose from the intestine. Thus blood sugar level will gradually increase and by this time insulin present in the blood will be able to utilise the glucose and gradually control the rising sugar or glucose level.
Third and the most important restriction for the diabetics is the high amount of fat because diabetic patients are very close to heart disease. So, they must cut down the fat.
Question 29: How our gastrointestinal (GI) system works?
Answer : The gastrointestinal system or the digestive tract consists of a number of organs where the food is ingested, digested and excreted. In the process energy and nutrients that are necessary for the functioning of our body are derived.
The GI system consists of the following components:
- Small intestine
- Large intestine
The food is taken in through mouth, where it is partially broken down. From here it passes through the oesophagus (food pipe) to the stomach, where the process of breakdown continues. It then passes to the small intestine where further breakdown occurs, and the useful particles are absorbed into the bloodstream. The remaining food particles pass through the large intestine and are ultimately expelled as faeces.
Question 30: How is food absorbed in the gastrointestinal tract (GIT)?
Answer : In the GIT carbohydrates are broken down into glucose, proteins are broken down into amino acids and fats are broken down into triglycerides and fatty acids. Glucose, amino acids triglycerides and fatty acids are then absorbed in our intestine. 2/3 of it is absorbed in the duodenum and jejunum (early part of small intestine). The remaining 1/3 is absorbed in the ileum.
Question 31: What are carbohydrates?
Answer : Carbohydrates form a major portion of the food we eat daily. It is present in all cereals like rice, wheat, ragi, jowar, bajra, millets. Carbohydrates are composed of carbon, hydrogen and oxygen in varying proportions. It supplies energy for work, play and other forms of vital activity and furnishes fuel to maintain heat. They provide energy 4 cal/gm. There are three kinds of carbohydrates: monosaccharides, disaccharides and polysaccharides.
Monosaccharides are the simplest form of carbohydrate. There are three kinds of monosaccharides, viz glucose, galactose and sucrose.
When two monosaccharides join they form disaccharides and when more than two monosaccharides join they form polysaccharides.
The simple carbohydrates, glucose and fructose, are found in fruits, vegetables and honey; sucrose in sugar, lactose in milk and glycogen in animal foods. Whenever a carbohydrate containing food is eaten, it is broken down by the saliva in mouth and gastric juice in the stomach. It is then absorbed in the intestine and goes into the blood in the form of glucose leading to a rise in blood glucose level.
After a meal it takes about an hour for the blood glucose to rise.
Question 32: What is glucose?
Answer: Glucose is the smallest unit of carbohydrate. It is the only and the most important source of calories (energy) for many blood cells, most important being the brain cells. It is very sweet in taste. Two glucose units join to form maltose which is a type of sugar.
After a meal is eaten, the pancreas produces insulin to enable glucose to be matabolized. If you have eaten lot of carbohydrates, your body will become accustomed to producing a lot of insulin and over the time, you may experience insulin resistance. As a result your body may store the excess carbohydrates as fat to be made available as fuel during starving.
Question 33 : What are simple and complex carbohydrates?
Answer : Carbohydrates form a major part of our food in spite of the fact whether you are a diabetic or not. They are of two types: simple and complex. Simple carbohydrates are those in which glucose molecules are arranged in such a way that they can be broken down immediately. They do not contain fibre, hence they are readily absorbed in the intestine and our blood sugar level rises. On the other hand, in complex carbohydrates the glucose molecules are arranged in such a manner that they cannot be broken down readily as a result of which they are slowly absorbed in the intestine and our blood glucose level does not rise immediately.
Therefore, a diabetic person must not consume simple carbohydrate. Instead, they should include lot of complex carbohydrates in their diet. Examples:
Simple carbohydrate: raw sugar, jaggery, honey, sweet fruits like mango and banana, jams, jelly, softdrinks.
Complex carbohydrate: brown bread, rice, vegetables, chapatti, suji, idli.
Rice and potato have a mixture of both simple and complex carbohydrate and this can be consumed in limited quantity only.
Question 34 : How simple and complex carbohydrates can be identified by a common person?
Answer : The best way to identify between simple and complex carbohydrate is by using our tongue. Simple carbohydrates have a tendency to release glucose molecules present in carbohydrate immediately. As soon as we eat simple carbohydrate, glucose molecules are released immediately. Taste buds present in our tongue sense glucose and inform the brain that glucose or sweet has been received.
On the other hand, in complex carbohydrate glucose molecules do not break fast. They break slowly into smaller and smaller units and ultimately release glucose. Since the glucose is not available these do not taste sweet to the tongue.
Hence, it can be said that simple carbohydrates are those that taste sweet to the tongue and complex carbohydrates are those that do not taste sweet.
Question 35: How are carbohydrates broken down in the GIT?
Answer : The digestible carbohydrates are broken into simpler molecules by enzymes in the saliva, in juice produced by the pancreas, and in the lining of the small intestine. Starch is digested in two steps; first, an enzyme in the saliva and pancreatic juice breaks the starch into molecules called maltose; then an enzyme in the lining of the small intestine (maltase) splits the maltose into glucose molecules that can be absorbed into the blood. Glucose is carried through the bloodstream to the liver, where it is stored or used to provide energy for the work of the body.
Question 36 : What are proteins?
Answer: Proteins form a major portion of the food we eat. 1 gm of protein provides 4 calories. It is made up of amino acids. Amino acids when joined in a long chain is called polypeptide. There are two kinds of proteins: animal protein and plant protein.
- Animal protein includes: meat (beef, mutton, chicken, fish and eggs) and milk and milk products.
- Plant proteins: Legumes are a rich source of plant protein and are considered very good for diabetics if taken in a good quantity (except for patients who have damaged their kidney very badly).
Diabetic patients are otherwise advised to take a lot of proteins from all 18 kinds of dals which includes arhar, chana dal, moong dal, moong chilka, moong saabut, moth, kala chana, chole, lobia, nutrella (soyachunks), matara and soyabean. If one does not have a heart problem, then the can also consume animal protein because animal proteins contain all the essential amino acids in right proportions. However proteins do not increase blood sugar level. Therefore, a diabetic patient should increase protein in his diet. The best way to increase is to include combination of flours i.e. 60% wheat flour, 30% gram flour and 10% soya flour.
Question 37 : How are proteins broken down in the GIT?
Answer : Foods such as meat, eggs, and beans consist of giant molecules of protein that must be digested by enzymes before they can be used to build and repair body tissues. An enzyme in the secretion of the stomach starts the digestion of swallowed protein. Further digestion of the protein is completed in the small intestine. Here, several enzymes from the pancreatic juice and the lining of the intestine carry out the break down of huge protein molecules into small molecules called amino acids. These small molecules can be absorbed from the hollow of the small intestine into the blood and then be carried to all parts of the body to build the walls and other parts of cells.
Question 38 : What are fats?
Answer : All oils like Saffola, sundrop, fortune etc are fats. Other than these the main source of fat in our food is through our intake of animal products like full-cream milk, milk and milk products like ice cream, chocolate, butter and cheese.
Fat is not considered bad for a diabetic who is not suffering from hypertension, heart disease or obesity. But keeping in mind the rate by which heart disease is rising nowadays, one must restrict fat in the diet because an intake of good quantity of fat may lead to heart disease.
However, if you are diabetic but do not have heart disease you may take some fat.
Question 39: How are fats broken down in the GIT?
Answer : Fat molecules are a rich source of energy for the body. The first step in digestion of a fat such as butter is to dissolve it into the watery content of the intestinal cavity. The bile acids produced by the liver act as natural detergents to dissolve fat in water and allow the enzymes to break the large fat molecules into smaller molecules, some of which are fatty acids and cholesterol. The bile acids combine with the fatty acids and cholesterol and help these molecules to move into the cells of the mucosa. In these cells the small molecules are formed back into large molecules, most of which pass into the vessels (called lymphatics) near the intestine. These small vessels carry the reformed fat to the veins of the chest and the blood carries the fat to the storage depots in different parts of the body.
Question 40: What are vitamins?
Answer : Vitamins are a very important food component. Vitamins do not contain glucose molecule in their structure, hence do not provide any calories. they are necessary for the normal functioning of our body. Vitamin B complex is necessary for the proper functioning of all metabolic processes going in our body; vitamin C builds up our immune system, helps in wound healing; vitamin D is important for our proper bone development; and vitamin E is an antioxidant. Other vitamins like vitamin A which is essential for proper vision and vitamin K are also equally important.
Question 41: What is saturated oil, monounsaturated oil and polyunsaturated oil?
Answer : There are 3 types of oil:
- Saturated oil
- Monounsaturated oil
- Polyunsaturated oil
All oil is triglycerides. Triglycerides are composed of glycerol (something like glycerine) to which three fatty acid chains are attached. Fatty acid chains contain carbon atom and can be attached to two hydrogen atoms. When in a fatty acid chain all the carbon atoms are attached to two hydrogen atoms and there is no carbon atom left without hydrogen attachment it forms saturated oil. Oils can be saturated by the process of hydrogentation in which hydrogen is passed through the oils and it hardens. Example: vanaspati, dalada, ghee.
Whereas in monounsaturated oils, one of the hydrogen atoms from the fatty acid chain is removed. Example: olive oil.
However when more than one hydrogen atoms are removed from the fatty acid chain it forms polyunsaturated oil. Example: sunflower oil, mustard oil.
A diabetic patient who does not have any heart problem can take the above three kinds of fat but remember it should not exceed beyond 20-30% of the total calories. This means, if a person is taking 1600 calories he can take 20% i.e. 320 calories or in other words can take 35 gms of fat.
If the diabetic person really wants to improve it is good to take mixture of oils i.e. 10% saturated, 10% monounsaturated and 10% of polyunsaturated oil.
Question 42 : What is fibre?
Answer : Fibre is that part of the plant which remains undigested by the human digestive system. It is commonly termed as roughage. Fibres are present in almost all food items. Few foods like refined flour does not contain any fibre. Though fibre does not provide any calories it is an important component of our diet. It is helpful in preventing many diseases like colonic cancer, gastrointestinal cancer, constipation. Fibre also helps in lowering cholesterol and triglyceride level in the blood. It slows down the absorption of glucose, hence is good for diabetics.
Question 43: What are the fruits which have high fibre content?
Answer : Fibre content of some of the commonly consumed foods is given below:
Vegetables: Asparagus, beans, broccoli tops, sprouts, cabbage, carrots, cauliflower, cucumber, lettuce, mushrooms, onion, peas, potato, spinach, tomato.
Fruits: Apple, apricots, banana, cherries, dates, figs, grapes, mangoes, cantaloupe, orange, peach, pear, pineapple, plums, prunes, raisins, strawberries.
Breads and cereals: white bread, brown bread, cornflakes
Nuts: almonds, peanuts
Question 44 : How many meals should a diabetic take?
Answer : A normal non-diabetic individual must take 1600 calories divided into 3 main meals i.e. breakfast, lunch and dinner as 30%, 35% and 25% respectively. People also like to have something in the evening, so you can consume the remaining 10% in the evening.
But if you are a diabetic then you must eat small frequent meals rather than a single large meal. You should follow 6-7 meal pattern. You can divide the meals as early morning, breakfast, midmorning, lunch, tea, dinner and bed time. This helps in the better utilization of insulin and hence better control of blood glucose.
Question 45: Should a diabetic patient consume less food than his actual calorie requirement?
Answer : No, a diabetic patient must consume food according to his actual calorie requirement. A normal sedentary person should consume around 1600-1700 calories, whereas a heavy worker should consume around 2500 calories in a day.
However, if you are obese than you need to cut down your calorie intake. But if you are underweight, then you must consume extra calories i.e. around 2000-2500 calories/day. Maintenance of normal weight is very important for proper control of diabetes.
Question 46 : How can a diabetic reduce the number of calories he is consuming and still feel satiety?
Answer : Centre for controlling hunger is situated in our brain. When the stomach is filled up, it sends signals to the hypothalamus (area that controls hunger) part of the brain that informs us that now we do not need to eat more food but if the stomach is not filled up, it does not send signals to the hypothalamus and we still feel hungry. It is necessary for the diabetic people to keep their stomach filled up, because if hunger sensation is there then they will consume whatever food is available to them at that time. In the process, they may also end up consuming foods which are not good for them.
A diabetic normal weight person does not need to control his calorie intake but an obese or overweight diabetic definitely needs to reduce the number of calories he is consuming. To reduce the number of calories one should consume lots of salads, fresh non sweet fruits and other fibre rich foods. One can also mix chokkar (wheat husk) or stuff the chapattis with vegetables to increase the fibre content and reduce the calories. Fibre will also aid in the slow release of glucose and hence is good for diabetics. This will also help to control the blood sugar level.
Question 47: Does an overweight diabetic patient also have to restrict his calorie intake? What if he is also a heart patient?
Answer : No, an underweight diabetic person must not reduce his calorie intake. These people are always advised to increase their weight but not at a very high speed. They should increase their weight by 1-2 kg/month. For this, they need to eat more calories and reduce their intake of raw salads and vegetables that rich in fibre. An underweight diabetic must also include lot of cereals in his diet. They can eat the cereals with some vegetables or salads to increase the fibre but not in very huge amount. These people can consume any amount of whole grains, lots of chappatis, rice mixed with some vegetable, and other high calorie foods that are not fatty.
If they are not suffering from any heart disease or hypertension they can even include fat in their diet. List of foods for a thin diabetic and for a thin diabetic who is also a heart patient is given below:
List of foods that can be taken by a thin diabetic:
Whole wheat flour roti, besan roti, bread, paneer sandwich, rice (limited) , pulao (limited) , suji, idli, dosa, uttapam, roasted chana, cornflakes, biscuits, noodles with vegetables, macaroni with vegetables, bajra, jowar, millets, corn, poha, all vegetables, potato (limited), diet coke, diet pepsi, all fruits (except mago, grapes, cheeku, banana), cream milk, groundnuts.
List of foods that can be eaten by a thin diabetic who is also a heart patient:
Whole wheat four roti, beasn roti, besan chilla, brown bread, tofu sandwich, rice (limited), pulao (limited), suji, idli, dosa, uttapam, roasted chana, steamed pakora, steamed puri, cornflakes, marie biscuits, dalia, noodles with veg., macaroni with veg., bajra, jowar, millets, corn , poha, all vegetables, potato (limited), diet coke, diet pepsi, all fruits (except mango, grapes, cheeku, banana), skimmed , double toned milk.
Question 48: What is diabetic atta?
Answer : The diabetic atta contains 60% wheat flour, 20% gram flour adn 10% soya flour. Gram flour and soya flour are proteins and do not contain any carbohydrate. Thus they do not increase the blood sugar. At the same time wheat flour being a complex carbohydrate does not contribute much towards increasing the blood sugar.
Question 49: Can I take sugar?
Answer : No, you cannot take sugar. Sugar is a simple carbohydrate. It is made up of one glucose and one fructose molecule. So, as soon as you eat sugar it immediately starts releasing glucose into your blood stream and due to the insufficiency of insulin this released glucose is not completely broken down and your blood sugar rises. So even if you eat only 5 gm of sugar it releases thousands of glucose molecules into your blood thereby raising your blood sugar sharply.
Question 50: Can diabetic people use sugar substitute as much as they want?
Answer : Yes, diabetic people can use sugar substitutes available in the market like aspartame which is available in the market in the form of “Equal” or “Sugar Free”. They can also use saccharine (trade name Sweetex). They do not contain any carbohydrate and hence do not increase your blood sugar level. But they must not be used without any restrictions. One must never use more than 15 tablets of aspartame or saccharine in a day. Not more than 10-12 tablets of aspartame and 10-15 tablets of saccharine in a day should be taken.
Question 51: What is the mode of action of sugar substitutes? How do they give sweetness to the tongue?
Answer : The structure of sugar substitute is such that they can reach the taste buds present in our tongue, stimulate them making them feel that the sugar is there. The taste buds get cheated and they inform the brain that sugar has been taken. The brain feels satisfied and the food passes from the oesophagus to the stomach and is digested and absorbed. Thus without sugar you get sweetness.
Question 52: If we take glucose or sugar in our food how long does it take to increase blood sugar level?
Answer : If glucose or sugar is taken in raw or liquid form, it goes directly to the intestine from the stomach, where it is absorbed within 5 minutes and starts increasing the blood sugar level. This the reason why sugar or glucose syrup is a given to a hypoglycemic patient.
Question 53: Can I take honey?
Answer : No, a diabetic patient cannot take honey because it is a simple carbohydrate. It is full of sugar molecules. But honey has unique food values and medicinal properties. If taken with lukewarm water it helps to reduce weight. Honey reduces uric acid, hence it is useful in gouty and rheumatic cases.
Question 54: Can I take jaggery (gur)?
Answer : No, you cannot take jaggery because jaggery is also a simple carbohydrate. It is an unfinished product. Jaggery has only 5.2% fibre and the other materials are equivalent to sugar. So, taking jaggery can increase blood sugar level to a great extent.
Question 55 : Can, I take sugarcane juice?
Answer : Sugarcane juice is very sweet because it is made from sugarcane which is simple carbohydrate. So it must not be taken by diabetics. Also these juices are available at the roadside and are exposed to pollution, germs which may lead to jaundice. So, it is better to avoid sugarcane juices for diabetic patients.
Question 56 : What are the raw materials from which sugar or jaggery is made?
Answer : In India sugar or jaggery is made from sugarcane. In certain other places it is made from beetroot or dates.
Question 57: Is there any sweet that a diabetic can take?
Answer : A diabetic person can take any sweet made of aspartame, equal, sugarfree or saccharine. They resemble glucose or sugar in the structure that stimulates our sweet sensitive taste buds. But they do not contain any glucose molecule and can be used to make sweets for diabetic heart patients. They have another advantage that they do not have calories. They can be taken by heart patients for losing weight.
Question 58: How can one increase fibre in diet?
Answer : Fibre is present in all fruits and vegetables. Fibre is considered very good for diabetics as it helps to keep their blood sugar under control. Diabetics can consume any amount of raw salad, they can also eat chapatis stuffed with some vegetables or mix chokar in the flour to increase the fibre content of the chapati. Raw vegetables instead of soups should be preferred. Juices must also be consumed with the pulp.
Question 59 : What are the fruits that a diabetic patient should avoid?
Answer : A diabetic person must understand one thing that all the fruits which are sweet in taste should be avoided. Because the sweet fruits are full of sugar molecules and as soon as the person consumes these fruits the blood sugar rises up quickly. There are many people who ask for papaya and once it is allowed they start taking ripe papaya which is very sweet in taste. And these papayas are not good for diabetic patients. They can take “Desi” papayas which are not sweet. Same is true for apples also. The diabetic person can take green apples which are not sweet. They are small in size and do not increase blood sugar level. So, all the fruits in unripe stage can be taken by the diabetic patient.
Question 60: Which is good-fresh fruit or juice?
Answer: Non-sweet fruits are always good as compared to juices. For diabetics none of the juices are allowed as they are sweet and rapidly increase the sugar.
Question 61 : What are the foods to eat in an emergency or when feeling unwell?
Answer : For a diabetic person the emergency to take food arises when the blood sugar goes down. It is very common in diabetic people on drugs or insulin. It happens when a diabetic patient misses a meal or is not eating properly or when he overexercises, in such cases the blood sugar level goes down suddenly. At that time they need instant supply of glucose and therefore for instant supply you can give glucose, candy, or any other sweet products because they are simple sugars and are absorbed as soon as you eat. Your blood sugar will rise within 5 minutes.
However, if you are not well because of any other problem you can take normal food.
Question 62 : Can I take papaya?
Answer : Yes, a diabetic can take papaya. It is mostly seen that for a diabetic patient if papaya is allowed they start taking ripe papaya which is full of sugar. So, it is advisable to take papaya when it is not in the ripe form. Most of the papaya sellers ask the customers whether they will like to eat the fruit today or after 2-3 days. Always tell them, “after 2-3 days”. So that they will give you unripe papaya which you can easily consume and your blood sugar level will not increase. A diabetic patient can also consume papaya by dipping it in saccharine or equal syrup if he is very fond of sweet fruits.
Question 63 : Is lauki juice beneficial for diabetes?
Answer : Lauki juice has many beneficial effects. The juice which is extracted after grating the whole fruit serves as a safeguard against heart conditions, quenches thirst, prevents excessive loss of sodium from the body and prevents fatigue. If 5 ml of lime juice is added to lauki juice and taken once a day, it will remove the burning sensation in the urine which is caused by high amount of acidity in the urine. Lauki is also an antioxidant and since it does not contain any calories it helps in weight reduction.
To prepare lauki juice take 500 gms of lauki and grind it in a mixer and consume it as such. Do not strain it as this will remove the fibre. Its cooked vegetable has diuretic, sedative, antibilious and cooling effect on the body.
Question 64: Can I take karela (bitter gourd)?
Answer : Yes, you can eat bitter gourd. Bitter gourd is the only vegetable, which is bitter in taste. It has many beneficial effects. It cures and prevents fever and is antidote for wrong eating. It is tonic for stomach, laxative and antibilious. It has plant insulin factor which helps in lowering sugar in blood and urine. The diabetics should take 120-140 ml juice of fresh bitter gourd in empty stomach, in the morning daily but at the same time they must keep a watch over their sugar level. A teaspoonful of its powder can also be taken with fresh water daily, once or twice, to control diabetes.
It is equally beneficial for various skin and blood disorders like scabies, proriasis, itching, ringworms and other fungal infections as it has been regarded as a great blood purifier. It also antidotes and detoxifies bad effects of alcohol like damage of liver and digestive disorder.
Question 65 : Can I take neem?
Answer : Neem is a tree that is very commonly found in India. Leaf or bark of the tree consumed as juice, is very helpful in lowering the blood sugar level, as it contains a hypoglycemic factor that helps to control diabetes.
Question 66 : Can I take mustard seeds?
Answer : Yes, you can eat mustard seeds but it should be taken moderately especially by a diabetic patient who also has heart problem because it contains fat i.e. triglycerides. Mustard seeds are small reddish black seeds of annual herbs. The leaves of this plant are consumed as vegetable. Mustard seeds have a pungent flavour. It is used in the vegetable preparation, chutneys, and also raitas. It is used mainly for the seasoning purpose. Mustard grains are rich in vitamin A, B and C and contain bulk fibre, which has a laxative effect. It should be taken sparingly because it can cause inflammation.
Question 67 : Do methi seeds lower the blood sugar level?
Answer : Yes, methi seeds help to lower the blood sugar level. Methi seeds contain a hypoglycemic factor-hence very good for diabetics.
Question 68: How methi seeds can be taken and how frequently?
Answer : Methi seeds contain a hypoglycemic factor that helps to lower the blood sugar level. It is thus considered very good for diabetics. To take methi seeds, soak them overnight for 12 hours, make a paste of it in the morning and eat it as a medicine. Methi leaves are also helpful in lowering the blood glucose level. Methi leaves can be consumed in the form of chutney, soups and also as vegetables. 250 gms of methi seeds eaten early in the morning offer good diabetes control.
Question 69: Can I take jamun (black berry)? Is it good for diabetes?
Answer : Yes, you can take Jamun. Jamun is also known as black berry. It is known for its hypoglycemic effect. It has specific effect on pancreas and sugar metabolism, which helps in reducing blood sugar levels. It is also claimed and propagated that 3 gms powder of jamun, seeds, taken thrice daily with water, reduces and ally the unquenched thirst and also reduces the quantity of sugar in urine.
Question 70 : Can I eat rice?
Answer : Rice is a mixture of simple and complex carbohydrates, but it has more of simple carbohydrate. So a diabetic patient should avoid taking plain rice. They can consume it by adding a lot of vegetables to it and with salads. They can also add dals and can eat it in the form of khichri. Nowadays brown rice is also available in the market. It has more fibre than white rice. It is unpolished rice. Therefore, a diabetic patient can take it in limited quantities but again it is better to take it with vegetables, salads and dals.
Question 71 : Can I eat potato?
Answer : When talking about diabetics there is an old conception that they cannot eat potatoes. But now it is scientifically safe for diabetics to take potatoes in moderation. Like rice, potato is also a mixture of simple and complex carbohydrate. Therefore it is better for a diabetic patient to take potatoes by adding other green leafy and fibrous vegetables to it.
Question 72: Can I take Guava?
Answer : Yes, you can take guava. There are two kinds of guava available in the market. The raw guava which is not very sweet can by consumed by diabetics in a good quantity. The ripe variety of guava is very sweet and should not be consumed by diabetics.
Question 73: Can diabetics take aerated drinks?
Answer : All aerated drinks, Pepsi, Thumbs up, Coke are very sweet, as they contain lots of sugar and hence are high in calories. So these should not be consumed by diabetics. However, nowadays Diet Pepsi, Diet-Coke area available that are sweetened with saccharine or some other artificial sweetener and these can be easily consumed by diabetics. These Diet Pepsi and Diet Coke do not contain any calories and have no side effects. A very small quantity of preservatives are added to these drinks that do not have any side effects.
Question 74: Can I take whole milk?
Answer : Yes, a diabetic patient can take whole milk. But nowadays heart problems are rising at an alarming rate. And since milk is an animal product that contains about 4-6% of fat, it should be avoided. Moreover being an animal product it has cholesterol in it which is the main culprit of heart disease. Therefore a heart patient who also has diabetes should not consume whole milk. However if you do not have heart disease then you can consume whole milk but taking into consideration the rate by which heart diseases are rising and as diabetes is one of the causes of heart disease it should better be avoided or consumed in limited amount. Instead you can consume 500 ml of skimmed milk or 200 ml of double toned milk.
Question 75 :