by The Welthi Bureau | 14th November, 2019
As we celebrate World Diabetes Day, let’s take a moment to understand the fundamental root causes, preventive measures and available treatment options for the most common Type 2 Diabetes. When it comes to India, number of persons getting diagnosed with Type 2 Diabetes is growing exponentially at rapid pace. The graph is very steep when compared to any other country. The primary reason behind this occurrence could be attributed to Sedentary Lifestyle and consumption of food that is high in carbohydrates, for instance rice. Dr. TNJ Rajesh, Consultant - Internal Medicine, STAR Hospitals will brief you about Embrace Our Age-old Practices to fight agianst Diabetes Mellitus
PROMINENCE OF RICE
Rice is the staple food of India and particularly in South India, it is the primary food item. We have been consuming rice from centuries but it has become one of the significant factors behind Diabetes only since past few decades. Have you ever wondered what went wrong? The introduction of white polished rice in 1960s is the major paradigm shift that lead to numerous health issues while Diabetes being one of them. Ironically, all the healthy nutritious portion is on the outer side of the rice grain which is removed during polishing and we have been consuming the inside stuff which is full of carbohydrates. People are used to the taste so immensely that it has become very difficult to get back to our age-old practices. Uneducated people or the individuals, who are not aware of its importance, usually consider unpolished rice as cheap or low-class food item because it doesn’t taste good to the palate.
Patients with uncontrolled Diabetes Mellitus who are suffering with complications because of uncontrolled sugars have no other option but to stick to a strict diet. Since they are already facing the problem their brain is more inclined towards adapting new food and getting accustomed to the taste. On the contrary, a diabetic patient with no such serious complications usually feels reluctant to change their lifestyle. They don’t have the zeal or will power to make changes. They think they are fine until they reach rock bottom. In such cases, there is only one solution to bring in permanent transformation. Read further to know more.
SYSTEMATIC DESENSITIZATION OF OUR PALATE
Systematic Desensitization of Palate is a proven and tested strategy wherein a person is gradually exposed to the new taste without letting our system know that we are making changes to it. For example, if an individual is looking to shift from white polished rice to brown rice or Quinoa rice, he shouldn’t completely avoid polished rice from day 1 because our palate won’t get used to it and we will be back to white rice very soon. Instead, he should start with altering the proportions. Here’s the trick, cook polished rice and brown rice in separate bowls (because brown rice will take more time) and mix it up with 75% white polished rice and 25% brown rice initially for 10 to 20 days. Later on, gradually reduce the quantity of white rice, let’s say 60% white rice and 40% brown rice for next 2 to 3 weeks. And then, 50% white rice & 50% brown rice for another 2 to 3 weeks. Eventually in 3 to 4 months you should be able to switch your palate completely from white polished rice to brown rice. By doing this the compliance goes up because your palate doesn’t even recognize that we are making changes. During this process, one should strictly adhere to the proportions. There are no cheat days. If in case, brown rice is not available at some occasions, it’s always better to go with alternatives such as chapatis or else we will be back to square one in no time.
In order of preference, following food items are low in Carbohydrates, rich in Protein and have very low Glycemic Index when compared to White Polished Rice.
1st Option - Quinoa Rice
2nd Option - Brown Rice
3rd Option - Bombay Upma Rava
4th Option - Unpolished Rice
Ragi (Finger Millet) Idli
Ragi (Finger Millet) Dosa
*Ragi is a rich source of iron, calcium, protein & potassium
*Cardiac patients should consult their doctors before consuming Ragi because it may not be suitable in few cases
Godhuma (Wheat) Rava Upma
Pesarattu (Green Gram Dosa) - very good for both Diabetic & Cardiac patients as well
Chapati (but we should avoid potato curry, if you have a strong liking towards it, then you should consume with skin, all the healthy nutritious portion is in the skin and not inside)
Whole grain bread sandwich with egg white, cucumber, tomatoes and veggies
Vegetables are extremely good for a Diabetic patient and off course in general for everyone. Apart from potatoes you can have all other vegetables.
Semi-ripened Water Melons
Unsalted & Fresh
Almonds (8 to 10)
Pista (8 to 10)
People with good teeth and who can chew well need not soak Almonds in water, they can consume it directly. Almonds have thick skin, we usually soak to make it softer for Geriatric patients and elderly people so that it can get digested easily
Yes indeed, for a patient avoiding sugars is the most challenging aspect of Diabetes Management. Here are few alternatives which you can consume to suppress and come out of your craving.
Sugar Cane Juice (it is of very low Glycemic index)
MODERATE INTENSITY PHYSICAL ACTIVITY
Apart from following healthy diet, it is imperative to do moderate intensity physical activity for a duration of 2 hours 30 minutes per week. But we should be calculating it from the time we start sweating because it is when we will be burning calories. It is to be noted that sweating will increase our stamina, let’s say if a person starts sweating in 10 minutes initially then after 1 week he will be sweating after 20 minutes. When it comes to physical activities, we shouldn’t set high targets, it will make us faint easily and eventually we will give up citing various reasons such as body pains. We should have patience; there is no quick fix or short cuts to lose weight permanently apart from imbibing Physical Activity.
60% of the treatment for diabetic patients includes good diet & decent physical activity. Rest 40% depends on appropriate medications. Meticulous research and advanced technology has enabled scientists to formulate innovative and most effective medications. The newer medications not just controls sugars but also improvises heart functioning, improves kidney functioning, prevents brain stroke and reduces the weight from 2 to 5 kgs. The newer insulin minimizes the risks of Hyperglycemia.
And in extreme cases, when there are no positive results after implementing all strategies, Bariatric Surgery is the only option for certain patients who are morbidly obese because of genetic mutations. Obesity patients are prone to Diabetes and are at very high risk. Bariatric Surgery is an efficient methodology to get control over weight.
THE MYTH THAT WEST IS ALWAYS THE BEST
In India, particularly in urban areas, we have a misconception and tend to blindly believe that western world is always the best in regard to food & diet. We need to understand that there are lots of cultural differences and their food practices don’t apply to Indian scenario in many cases. For instance, it is hugely marketed that olive oil is extremely good for heart but in reality it is unstable at high temperatures and ironically majority of Indian cooking takes place at high temperatures. It is better only for mediterranean diet where westerners use it for items like salads, they don’t cook at high temperatures. For Indians, rice bran oil is the best option which has good amount of monounsaturated fatty acids and it is stable at high temperatures. Break the myth, come out of cliché and embrace our age-old Indian practices.
This year’s World Diabetes Day is themed around Family & Diabetes. It is intended to create awareness amongst the people on how we can improvise our lifestyle, get over obstacles and stay away from Diabetes Mellitus. On this occasion, we are happy to share few insights as mentioned above and contribute our bit.
The department of Internal Medicine at STAR Hospitals provides comprehensive primary and specialty care to treat a wide array of potential diseases. They provide unrelenting services in managing patients with diabetes, as well as those with pre-diabetes, metabolic syndrome and insulin resistance. By focusing on life style interventions and employing the latest medications and technologies to treat or prevent diabetes, STAR Hospitals seeks to improve the health and well being of patients.
Book Appointment: Dr. TNJ Rajesh, Consultant - Internal Medicine, STAR Hospitals
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