Diabetics – 100 common doubts answered PART 2
In the first part of my article, I have cleared 50 common doubts of diabetics related to its basic facts, insulin injections, pre-diabetics, different tests for its detection and why body becomes weak if you are attacked by diabetics. As I know all doubts can’t be included in a single article, I am continuing the already started discussion with its second part. I am providing the link of its first part in the end of this article. I am hoping all your doubts related to diabetics will be cleared by the first and concluding parts.
In the first part, I have stopped with 50 common questions. We were discussing about why diabetics make patients tired? I would like to resume my writing from that subtopic itself.
Why diabetics make patients tired?
51. How can uncontrolled diabetics affect kidney functioning?
In the primary stages, blood circulation to kidneys will be slightly higher in diabetic patients. It develops swellings in kidneys. When the disease grows older, urine begins to show micro albumin content which indicates the kidney damage. If diabetics is not controlled it slowly affects the functioning of kidneys. As kidneys reduce their functioning rate, urea and creatinin content of blood increase leading to chronic renal failure.
52. How can diabetics affect liver functioning?
Both through disease and disease treatment, liver may be affected. Major percentage of diabetic patients are suffering from obesity and do have paunch. In such persons due to insulin resistance, truncal obesity may develop. Also, such persons have higher fat deposits in liver which leads to swelling of liver and reduces its proper functioning. This condition is known as fatty liver. Also, if insulin injections are taken from hospitals it gives more changes to hepatitis B and C.
53. Can diabetics damage thyroid gland? Will it lead to future complications?
There is no direct relationship between thyroid diseases and diabetics. Type-1 diabetics seen in kids is due to autoimmune. Due to the same condition, hypothyroidism may be formed in kids. Type-2 diabetics has no such problems. Though thyroid problems don’t indicate diabetics in future, diabetics is seen increasing in thyroid patients.
54. Why do diabetic patients become slim quicker?
It’s mainly due to the deficiency of insulin. When proper functioning of insulin is reduced blood sugar level increases and is lost through urine. Since food is not absorbed by the body and lost through urine, patient losses weight quickly. In addition to sugar, salt and water content are also lost. When energy supplements are lost through urine, he feels tired.
55. Do diabetic patients have touch sense problems?
Diabetics affect nervous system directly and hence patient may loss sensing of touch gradually. If it happens so, he feels like walking through cotton even if he is traveling through a cement road. Even if he losses his sandals he hardly notice. He may not even notice if a stone or thorn prickles his foot.
Take food with great care
There is direct relationship between food and sugar level. To keep diabetics under control, he needs to check input of calories as well as sugar content.
56. What’s the relationship between diet and diabetics?
First we need to know basic facts about our food. Main factors of a diet include carbohydrates, fats, proteins, sugar, vitamins, minerals and water. Carbohydrates, fats and proteins are the energy suppliers to our body. Water, vitamins and minerals are the essential factors needed for the proper functioning of our internal organs. When we take food, carbohydrates, fats and proteins decompose to small particles and in respond to digestion and absorption, glucose level of blood increases. Almost all carbohydrates are converted to glucose except fibers. This blood sugar is used for various purposes of body and what remain, will be stored as fat for future purposes. Blood level is controlled by insulin produced by pancreas and its production demand adjusts to the intake of sugar. In diabetic patients, as insulin level is low or not produced, blood sugar balance is not kept resulting in the increase of sugar in the blood. So, food taken in excess will increase glucose level of blood in an uncontrolled manner.
57. What’s the relationship between diabetics and glycemic index?
It’s an index used to classify food according to deviations in blood glucose level. Food items having high glycemic index increase blood sugar level rapidly. So, food control measures should be taken keeping in account of the energy released by each item. Let me give you a few examples.
Rice – 58
Wheat – 48
Chappathi – 58
Steam cake – 63
Idiyappam – 63
Appam – 58
Idli – 57
Dosa – 52
Upma – 57
Green banana – 72
Elephant yam – 52
Potato – 74
Tapioca – 83
If value is above or equal to 70, it’s considered as high glycemic index.
If value is between 56 and 69, it’s moderate glycemic index.
If value is below or equal to 55, it’s low glycemic index food.
58. Can diabetic patients take dried tapioca and tubers?
Glycemic index of tubers are high which increase blood sugar level suddenly. You can include elephant yam in moderate amount. Dried tapioca contains more energy than fresh one. So, diabetic patients should avoid it.
59. Which fruits should be excluded and which ones should be added by a diabetic patient?
A diabetic patient can eat a fruit every day. Avoid small banana, mango, dried fruits etc. You can include musambi, orange, apple, water melon, guava and pears.
60. How to regulate supper time of a diabetic patient?
It’s best to take supper before 8. Otherwise food intake may affect metabolic activities of the patient. Quantity of food, intake of calories, physical work done at day time, time gap between meals and exercises – all are important. Snacks take more than 2 hours to digest while lunch and supper need 2-4 hours. If he takes supper at 7 pm, he should go to bed between 9 and 10. Our body is taking rest while we are sleeping. Excess amount of food taken late can increase the storage of fat in our body. That’s why it’s told, eat supper like a beggar.
61. Can diabetic patients eat rice food?
He can take rice, wheat or ragi which supplies carbohydrates. All these grains contain almost equal amount of energy. So, quantity is more important than the grain selected. One person may eat less chapatti if we compare it with rice food. That’s the main reason why, many opt chapatti for supper. Brown grain is best if we compare with white rice as fiber content is high. Since it needs more time to digest, glucose level of blood won’t see a sudden increase with the intake of brown rice. Also, wheat contains more fiber than rice.
62. Can protein rich food increase chances of diabetics?
15% of our body energy is attained from proteins. There is no problem of protein intake for diabetic patients. But, if you have kidney problems associated with it, you should reduce protein intake.
63. Can diabetic patient intake milk?
Milk contains proteins, calcium and B complex vitamins. It can be used as milk or curd. Avoid fat content milk and curd. So, diabetic patients need not take milk in excess. Milk contains a carbohydrate, lactose which is converted to glucose and galactose.
64. What’s the amount of intake of meat by diabetic patients?
Fat less content meat is best for diabetic patients. Chicken is good, but skin removed. But red meat – mutton and beef contain excess fats, not well for health. 75 gm meat (before cooking) can be included in a daily diet (in any one meal).
65. If sweet is taken in excess by a person belonging to diabetic family, what are his chances for the disease attack?
Diabetics are hereditary and he has more chances. But if he controls the calorie intake even if he adds sweets to his meal, it’s not a problem. Otherwise he will become obese giving more chances. It’s also important, which type of sugar is he taking. Sugars in fruits are fructose while it’s sucrose if taken normal sugar. Sucrose is dangerous. Excess food, sugar and preserved items – all these are factors that lead to diabetics in future. So, direct relatives of a diabetic patient should keep these things under control.
66. What things should be noted during fish meals?
Fish is the source of proteins and including it twice daily is enough to supply adequate amount of proteins to the body. Tuna, mackerel and sardine contain Omega-3 fatty acids that protect your heart. Use any curry or steamed item with less addition of oil. Fried items increase cholesterol intake.
67. Is it possible to adopt a diet ‘without meal’ similar to ‘without tea’?
To avoid rice meals at lunch is almost impossible for south Indians. So, instead of avoiding it, it’s better to keep certain rules while having lunch. Eat food at right time. For meals, ¼ can be reserved for grains (rice/chappathi/dosa), ¼ for proteins (fish/chicken/legumes). You can include skin removed chicken once in a week. But avoid fish the same day. ¼ of your plate should be reserved for vegetables and ¼ for salad including carrot, salad cucumber, tomato and onions. You can also include a bowl fatless curd or butter milk. Otherwise include any vegetarian curry.
68. Is jaggery better than sugar? What’s the opinion about sugar free?
For a diabetic patient, jaggery won’t give much benefit as it contains sugar. It increases blood sugar level. Calorie low sugar free can be taken, but under strict instructions given on the packet cover. But gradually you should reduce its intake. Pregnant and feeding ladies should never use sugar free and you should never use more than 3 or 4 a day.
69. Gestational diabetics – what should those ladies eat?
She should eat everything needed for herself and healthy growth of her baby. But her diet should not break the balance of sugar level in the body. She should take more food for energy, yet she should check the intake of sugar and fried items.
Food habits should be maintained by a normal person according to his height, age, weight and functions. For example, if 2200 calories are needed for a normal person, he should take 325 gm carbohydrate, 90 gm proteins and 60 gm fats.
70. If a diabetic patient skips his breakfast, does it cause any problems?
Most important meal of a day is breakfast as body is provided food after a long break of 8-12 hours. If we skip breakfast, we become less energetic, loss of concentration and body becomes weak. In the case of diabetic patients, a small frequent meal is most efficient. It helps to keep control over blood sugar. Breakfast should contain carbohydrate, proteins and fiber. It’s best to have combination food for breakfast like idli-sambar, dosa and peas curry or appam and vegetable stoo.
71. Can he take eggs and other high fat content food?
He can take food with moderate fat content. 20-25% of our energy should be obtained from fats. Fat is of two types – saturated and unsaturated. Saturated fat can lead to increase of cholesterol which results in heart problems later. White yolk contains less cholesterol and high proteins. In addition to these factors, it contains vitamin A and riboflavin. Yellow yolk contains cholesterol and fat. So cholesterol patients should avoid yellow yolk from their diet while diabetic patients can take eggs in alternate days.
72. Can fiber rich oats reduce diabetics?
A diabetic patient should include a lot of fiber in his food, which helps in reducing bad cholesterol content of blood as well as fat content. Excess hunger seen in diabetic patients can be controlled by the intake of fiber rich food. Fiber reduces the absorption of carbohydrate to blood thus reducing its sugar level. Oats is a whole grain which contains a lot of vitamins, minerals as well as fiber. But portion size should be noted during the intake of oats. You can use less fat or fat free milk along with oats.
73. How should a diabetic patient eat? Chew the food well or just swallow (intake of food with excess speed)?
If you eat food by taking a lot of time, input can be decreased considerably. Take 15-20 minutes to take a meal. You will take less amount of food, thus reducing calorie intake. Also chewing well helps you to enjoy and taste the food well. For a diabetic patient, if he takes a meal spending 20 minutes, sudden increase of blood sugar level can be decreased considerably, thus helping to bring diabetics under control.
74. Can they take maida foods like perotta, samosa and cakes?
Maida is a processed form of wheat with fiber content removed. So avoid maida food as much as possible. Maida increases sugar level of blood and perotta is prepared by using dalda, another harmful substance for blood. Instead opt for wheat content food and snacks.
75. Can nutrition imbalance lead to diabetics?
In normal conditions, it won’t. But lack of proper nutrition may lead to changes in pancreas which may result in diabetics later. It’s known as malnutrition related to diabetics mellitus. Most recent studies have proved that deficiency of vitamin D and B12 and Chromium can lead to diabetics. Deficiency of vitamin B12 during gestation period can lead to diabetics of the baby later. Yet, such results are not confirmed.
76. What should be the diet of diabetic children?
Since it’s growing age, they should be given complete food providing full nourishment. Yet packet food items and bakery items should be avoided. Since insulin injections are given to such kids, they may be given three liquid foods in addition to solid meals, 3 times. For their better body and mental development, control of glucose is a vital factor.
Exercises for good control
To control diabetics and protect you from it, exercises play a vital role. A person should start exercises at least during his middle ages so that he can live long with a healthy body and absence of diseases. Diabetics show its first shades when a person is not willing to give proper exercises to his body.
77. What’s the significance of exercise in diabetic treatment?
It should not be seen as a task or job. Instead enjoy it as a sport or play. Exercise does many things for you. It reduces sugar level of blood, increases the functioning of insulin, reduces obesity, gives muscles more efficiency and gives you a mental pleasure and relief from daily tensions.
78. What exercise style should be adopted by a diabetic patient?
Exercise should be fixed to reduce diabetics. It should be done on a regular basis with proper time table. Keep a fixed time everyday and do exercise exactly at the same time. Then only, insulin production increases, resulting in control of diabetics.
79. Are upper body exercises effective?
Yes, of course. It’s most effective for patients having knee and joint pain. Bending down and getting up repeatedly is a good exercise to hip and belly. Hand exercises give more strength to muscles helping you in doing your daily activities more effectively. But one should choose exercise items according to his capability.
80. How long should we exercise? Which time is best?
Morning, before breakfast is the best time to exercise. If not possible, opt for evenings. Do exercise regularly at least 5 days a week, minimum 30 minutes a day. You should do a warm up before you start an exercise. Jogging and brisk walk are good exercises. If you choose a nearby park or garden, it gives you a lot of fresh air as well as a few new friends. If you have chosen walking as your exercise, walk straight with shoulders held high. Never lean forward. You should walk 1.5 to 2 kms in every 30 minutes. Shuttle, badminton and table tennis are also good.
81. When we exercise, usage of food and water?
Before and after exercise, drink 1-2 glasses of water to avoid dehydration of body. But never use fruit juice or cola. Butter milk or lemon juice without sugar can also be preferred. Never exercise after a meal. Also, never exercise if you are feeling hungry as it may lead to hypoglycemia.
82. When hypoglycemia patients exercise?
If diabetic patient do exercise regularly for a fixed time and fixed timetable, chances are low for hypoglycemia conditions. But if he tries to do exercise than usual, it may happen. Hypoglycemia patients should never isolate themselves while doing an exercise. Choose any open place, also where transportation services are available.
83. If sugar dips suddenly while exercising?
If you feel discomfort, dizziness, vomiting, body shaking, shivering or sweating, consult a doctor immediately. If primary conditions of hypoglycemia are shown, eat some sweet. Such patients can keep sugar candies while doing exercises. If condition is not restored within 15 minutes, he should be taken to nearby hospital. Glucose will be injected directly to nerves in this condition. Chocolates and sweets won’t prove worth as it takes long time for digestion. If a person becomes unconscious due to hypoglycemia never pour sugar content liquids directly to his mouth. Instead put a little glucose inside his cheek or beneath his tongue.
84. Why walking is considered as the best exercise for a diabetic patient?
It’s the most convenient exercise which sheds a lot of calories as well. When one person walks freely, his whole body is involved. Thus all body parts are getting movement and thus exercise. When you walk with your hands to and fro, it’s an excellent upper body exercise. Chances for injuries and joint pains are low. One can continue it for a long time, particularly if he is aged. Fewer chances are there for hypoglycemia.
85. When should a diabetic patient never do exercising?
Some diseases do need complete body rest. If so, such patients should avoid exercises. Do ECG or treadmill exercise to confirm that he is not a serious heart patient. Those persons having problems with joints (may be due to injuries) should not exercise without the advice of doctor. If your feet have wounds avoid exercising. If you have high blood pressure or sugar level or if you have lost eye sight due to diabetics, it’s better not to exercise. Those persons having retinopathy, if do exercises it can affect their eyes a lot.
86. What about yoga, aerobic exercises and strength training?
Aerobic exercise is good as whole body is involved in it. It gives more result than walking and jogging. Also you will enjoy it as it’s dancing. It reduces mental strain as well. Yoga is also a good exercise as it’s flexible and strengthens muscles a lot. It also lessens movements of joints giving freshness to mind. Strength training belongs to isometric category and they may adversely affect the patient. Muscles may develop injuries or cramp. Lifting dumb bells and weight lifting is not suitable for diabetic patients.
87. What exercises a diabetic patient should never do?
Lengthy exercises giving more strain to muscles should not be done. Yoga methods like sheershasanam giving stress to eyes should not be done. Retinal detachment may occur resulting in loss of sight.
88. What type of exercises should be done by diabetic patients having joint pain?
Such patients should avoid tread mill and climbing steps, as it give more troubles to knee and joints. Choose exercises that give less trouble to knees. Yoga is best. But take an expert opinion.
89. Can a diabetic patient exercise if his sugar level is high?
If sugar level is very high, avoid heavy exercises. This time body tissues may go some chemical changes. So exercises may lead to loss of water and salt content of the body which may lead to a severe condition diabetic keto acidosis. If sugar levels show slight deviations, there is no problem in exercising.
90. What special care should be given to feet?
Before and after exercise, he should check his feet using a mirror. If you find thorns or stones, remove it and wash using soap water. Use shoes of correct size for doing exercises.
91. Doing some activities which give regular movement to body is equally important as exercise. Is it true?
Except rest time, a diabetic patient should keep himself involved in one activity or another. Never sit or lay at a place continuously. Every one hour give a small exercise to your body. Just 5 minutes walk is enough. Walking short distances or using steps instead of lift for a three storey building is also good.
Will diabetics affect your sexual life?
92. Is it true that diabetic patients can’t lead sexual life?
No. Diabetic patients should do HbA1c test once in every three months. Glycocylated Hb should be equal to or below 7. Otherwise he may have problems with sexual life. In addition to diabetics, he should control cholesterol and blood pressure as well.
93. Is married life possible for type 1 diabetic patients?
Yes, it’s possible. But he should undergo diabetic treatment.
94. Should type-1 diabetic males conduct test before marriage?
Such patients should never hide this matter before marriage. If he undergoes diabetic treatment and brings sugar level under control, no need for tests to prove potency as sexual life for such patients is possible as normal people.
95. Can prolonged diabetics lead to sexual problems in both male and female?
Since diabetics affect nervous system, erection problems may appear in males if diabetics is detected long time ago. It may lead to mental problems as well. In ladies diabetics may lead to urinary or fungal infections.
96. Can diabetics lead to early menopause in ladies?
Chances are there. But it’s rare. If diabetics is not controlled it may lead to hormonal variations resulting in menopause.
97. Do diabetic persons have infertility problems?
It diabetics is detected earlier, yet treatment not started yet, it may lead to reduce sperm count in males. But if treatment is started at early stage itself, such problems can be avoided in future.
98. If type-2 diabetic patients get married, what things are to be noted in their sexual life?
As diabetics affect nervous system, he may feel less touch sensations. So, his life partner should understand it and give him proper care. But if diabetics is brought under control, normal sexual life is possible for diabetic patients. They should do regular exercise at least 5 days a week. Leave bad habits of smoking and drinking.
99. Can insulin injections and other medicines affect sexual life?
Never. But if he is taking medicines on blood pressure or heart diseases, chances are there. For example, beta blockers, a medicine for heart disease can cause sexual problems.
100. If both the parents are diabetic, what are the chances for their kids to be diabetic?
Yes, 40% chances are there as diabetics can be carried forward to next generations. If one of their parents is diabetic, 20% chances exist for kids getting diabetics in future. Even if parents don’t have diabetics, yet their ancestors have, then kids need to maintain proper life style to keep this disease distance away. Such kids should check sugar levels periodically once they reach 30. If you have excess weight, start this program at 20 years itself.
So, we have come to an end of this discussion where I have explained different aspects of diabetics. Hoping it will be helpful for you for clearing common doubts. If you want to read its first part, just go through this link.
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