Diabetes
Before starting my article I want to clarify certain points. I am not a doctor. I am writing my personal experience as a diabetic patient. I will just express my feelings and experiences. There may be conceptual mistakes or other kinds of errors.
I got diabetes during my fifties. At that time I had been working in the Ministry of Agriculture as Deputy Chief. I was very much shocked when it was first revealed that I got diabetes. It was more a psychological problem rather than physical sickness. I was always depressed and suffered from inferiority complex. Every day I wept much and thought about my sins for which God was so angry with me. I was suspicious about all food. I thought each food contained sugar.
I am very fond of sweets. When I understood that I was not allowed to eat sweets, my craving for sweets increased manyfold. It was a great mental shock that my freedom of food intake became drastically limited. Food is a very important part of human existence. It was painful to keep myself away from food that was very favorite to me.
In my office I kept my diabetes hidden from everybody because my colleagues might feel that I was inferior to them. I would lack energy and vigor for all purposes. I might not get a good posting because of my illness. I might not be included in Government delegation to represent the country abroad. The authorities might think that my performance would be limited compared to other non-diabetic officers.
I do not know why and how I got diabetes. My father had diabetes and I am the eldest of all my siblings. I have two brothers and three sisters. My father was a lawyer. It may be so that he had less physical exercise. My job was like that too. I had desk work. Most of the time I remained seated on the chair. Physical movement was very little. In fact I do not yet know what causes diabetes.
It seems to me that in each office there should be breaks for ten minutes to have light physical exercise and this period may be made interesting through music or other games that would make exercise interesting even to the aged people.
Our food habits are important for maintaining good health. Our food items should mainly be vegetables, pulses, beans, fruits and milk that are easily digested. I understand that digestion is a crucial factor in managing diabetes. I feel that we can have protein twice a week. We should drink plenty of water everyday that we often forget. We find that we have no time to drink water again and again. Life has become complex and competitive. We can keep a water bottle on our working table so that we do not forget to drink water.
We can include lemon, fruits and salad with each meal. We should never forget the benefits of citrus fruits that are available in plenty in the tropical countries. In modern days everyone can get citrus fruits anywhere in the world. The non-tropical countries import citrus fruits.
In June/July 2015, doctors felt that cataract in my left eye needed to be treated by phaco surgery. I got my ideas of Phaco Surgery from the web page- en.m.wikipedia.org/wiki/cataract_surgery which says that cataract surgery is removal of the natural lens of the eye (also called “Chrystalline lens”) that has developed an opacification which is referred to as a cataract. Metabolic changes of the crystalline lens fibres over time lead to development of cataract and loss of transparency causing impairment or loss of vision. During cataract surgery, a patient’s cloudy natural cataract lens is removed and replaced with a synthetic lens to restore the lens’s transparency.
My surgery was kept pending for high blood sugar level. Before operation diabetes should be controlled. I found it very difficult to bring down my sugar level as it was necessary for operation. I had to struggle a lot. I was referred to a doctor who instructed me to measure blood sugar level by myself seven times a day. He gave me a blank chart/table to fill out with required information. I had to measure my blood sugar level before breakfast, after breakfast, before lunch, after lunch, before dinner, after dinner and before sleeping. While filling out the chart/table I developed an insight into the matter. I started doing my own research. I found that particular food items increased my sugar level. Earlier doctors advised us to eat wheat bread (Ata Roti) at night but I found that wheat bread increased my sugar level to a considerable extent.
We understand that egg, fish and meat do not contain glucose but my sugar level increased if I ate meat. The reason might be that protein could not be digested quickly.
I felt that I needed knowledge of glucose in different food items. I felt that diabetic education should be the most important part of treatment of diabetes.
Diabetes Mellitus (DM) is a group of metabolic diseases in which there are high blood sugar levels over a prolonged period. Diabetes is due to either the pancreas is not producing enough insulin or the cells of the bodies not responding properly to the insulin produced. (Reference: en.m.wikipedia.org/wiki/Diabetes_mellitus).
I feel that food plays the main role in controlling diabetes. In addition to this we should exercise on regular basis. When we are aged, walking seems to be the best exercise for us. Regular walking helps me to control my high blood pressure as well. I loose weight when I can walk every day regularly.
As a diabetic patient I need to know the glucose contents of food items. It would be better if I could have an instrument that would tell me the amount of glucose in each food item separately. For instance, I will touch the instrument to a banana and my device will show the content of glucose on the monitor, just the same way we read our sugar level on the monitor of a device designed to measure our blood sugar level. This may not be possible but we can learn about the amount of glucose contained in food items from internet, books or other reading materials.
Knowledge of glucose in food items is important even when I eat food that contains much glucose. Sometimes we cannot resist ourselves to keep away from tasty food but if I have knowledge about it this will be my informed choice. I may eat one piece of sweet but when I will go for the second one my glycemic knowledge of food will discourage me to take more.
Some food contains more glucose than others. We can choose the food items that contain less glucose. The scientists have given us Glycemic Index Value of food items. en.m.wikipedia.org/wiki/glycemic_index says that the Glycemic Index (GI) is a number associated with a particular type of food that indicates the food’s effect on a person’s blood glucose level. A value of 100 represents the standard, an equivalent amount of pure glucose. The GI represents the total rise in a person’s blood sugar level following consumption of the food; it may or may not represent the rapidity of rise in blood sugar. The steepness of rise can be influenced by a number of other factors, such as the quantity of fat eaten with the food.
I learnt that egg, fish and meat contain no glucose but when my meal included meat my blood sugar level increased. I found no impact of one boiled egg in the meal but when the egg was fried with onions and oil, it influenced blood sugar level. I thought that meat was digested later than vegetables. That might hamper digestion or absorption of glucose too. Actually I do not know it exactly. A doctor may explain in an appropriate manner.
American Diabetic Association has classified Glycemic Index as low GI food (55 or less), medium GI food (56 to 69 and high GI food (70 or above).
Let us look at GI values of some food items that are regarded as low GI food: -
Apple-36, banana-51, Cherries-36, grapefruit-25, grapes-46, orange-43, pear-38, strawberries-36, peanuts-7, bean sprouts one cup-25, raw carrots-35, cooked carrots-85, brown rice one cup-55, red rice one cup-55, honey one tablespoonful- 55, chickpeas-10, kidney beans-29, lentils-29, soybeans-15, cashew nuts-27, beans black eyed-41, wholegrain oats-40, black beans-35, green peas-35, orange-35, peaches-35, plums/prunes-35, tomatoes-30, French beans-30, red kidney beans-30, barely blanched-25, black berry-25, eggplant-20, lemon-20, broccoli-15, cabbage-15, cucumber-15, radish-15, avocado-10, spinach-15.
From the above information I noticed that raw food and cooked food have different GI values. For instance, when carrot is not cooked, its GI value is 35 only but when it is cooked, GI value increases to a great extent.
Let us look at some high GI value food items: -
Wheat bread-70, white bread-70, potato-104, parsnip-97, popcorn-72, watermelon-76, Celery/turnip-85, corn starch- 85, pumpkin gourd-75, broad bean-65, beet/beetroot-65, sweet corn-65.
It seems that the diabetic centres or institutions can arrange training programmes for the patients. For this disease, patient’s knowledge is vital. They will be able to manage their diabetes with their knowledge. Understanding the disease provides insight and confidence to the patients. the diabetic centres can distribute a booklet to the patients that will provide information about food of high, medium and low GI value.
liverstrong.com/article/360955-basmoti-rice-as-a-diabetic-food/#page=1 says that carbohydrate is the key nutrient to control diabetes as it is the one that influences blood sugar level the most. After the digestion process, carbohydrates are converted into glucose or sugar, molecules, which then make their way into the bloodstream elevating blood sugar level at the same time. An excessive carbohydrate intake lead to blood glucose levels above target because insulin is either present in insufficient quantities or is simply ineffective with diabetes. For this reason American Diabetic Association recommends aiming for a carbohydrate intake ranging between 45 and 60 glycemic value at each meal.
tilda.com/news/basmati-rice-diabetes informs us that wholegrain Basmati rice has the lowest GI of all rice types, which means once digested it releases its energy slowly keeping blood sugar levels more stable, which is a crucial part of diabetes management. The higher magnesium content found in Basmati can help with blood sugar control.
Wholegrain Basmati rice is also a good source of fibre which is important for gut health and improves bowel function. High fibre intake have also been associated with a lower risk of bowel cancer, reduced risks of type two diabetes complications, increased satiety and weight management. A high intake of wholegrain food has been associated with lower risk of heart disease and stroke. Both wholegrain and white Basmati rice contains a type of fibre known as resistant starch. This has a prebiotic effect in the bowel, which means it can help to increase the number of friendly bacteria. This in turn, protects the bowel and keeps it healthy and boosts the body’s immunity.
Basmati rice has a superior nutrient content compared with other rice types. They contain higher amounts of B vitamins and minerals such as copper and magnesium. I read this web page and started eating Basmati rice for each meal. It was of immense benefits to me. My sugar level came down without much effort. I felt light and healthy with Basmati rice.
First of all I prepared my plate for one meal. I did not add any food for the second time. I took one cup of Basmati rice and included other low GI value food on my plate. For instance, I added vegetables, cashew nuts, cucumber and lentil of one cup with Basmati rice. I understand that I got the main energy from rice. The other time I added vegetables, tomatoes and one cup of milk with basmati rice. Sometimes I ate one boiled egg instead of milk. If I felt hungry during the interim periods of meals, I ate low GI value fruits, such as, half of an apple or half of an orange.
I noticed that quantity of food had effects on blood sugar levels. For instance, I had low GI value food but if the quantity was large, it had negative impact on my blood sugar levels.
I abandoned the habit of having food frequently besides meals. In our culture we eat fried food often, such as Samusha, Singara, Dal Puri etc. I found that fried food increased my blood sugar level.
Once I read a Reader’s Digest, wherein it was written that watery food and boiled food is the best for us. We should cook soup like food. Fried food and baked food is not healthy. When we cook food, some water should be there for maintaining good health.
Rice is the staple food in Bengal and some parts of Asia, specially in southern part of Asia. The agricultural scientists can innovate diabetes friendly rice. They have given us golden rice that contain vitamins and minerals. So, it is possible to have diabetic friendly rice. Collaborations among the diabetic institutions and the agricultural research centres are necessary for this.
In the end, I controlled my diabetes and had cataract operation on 18 August, 2015. Diabetes Should remain under control for the purpose of healing as well. I got very sincere cooperation and excellent care of my husband, Engr. K. M. Johur Ali. I am profoundly grateful to him. I am doing fine now.
