The truth about sugar

Sugar has earned a bad reputation as it is linked to various diseases like diabetes, obesity, heart disease and cancer. The truth is that sugar is not only important for your body, it is also important for your life. However, it is important to understand what kind of sugar is good for you and what is not. 

Understanding sugar 

The sugar sold in grocery stores is an unnatural substance, i.e. it is produced by industrial processes mostly from sugar cane or sugar beets. It is refined with chemicals such as sulphur dioxide, phosphoric acid, calcium hydroxide, and activated carbon, and stripped of all the natural nutrition it originally had. By refining it down to sucrose and stripping away the vitamins, minerals, proteins, enzymes and other beneficial nutrients, what is left is a concentrated unnatural substance that the human body is not able to handle, let alone use. 

It is interesting to note that 'raw sugar' - which most people think is natural - is also refined. Once the cane juice crystals are harvested, they are washed, boiled, filtered and dried. This process removes most of the fibre and nutrients existing in the original crystals. The sugar then becomes refined, with no nutritional value. The use of artificial sweeteners is often a case of trading one problem for another and is definitely not the path to good health. Needless to say, artificial sweeteners are more harmful than refined sugar. 

Sugar is a deadly addiction; people not only develop a strong taste for it but also develop an insatiable craving for it. The reason: refined sugar stresses the pancreas and depletes the body's supplies of chromium. A common symptom of chromium deficiency is sugar cravings. Satisfying these cravings further lowers chromium and increases cravings. What's more, refined sugar depletes your body of all the B vitamins; it leaches calcium from your hair, bones, blood and teeth. As if that is not enough, sugar also affects your body's digestion. It ferments in your stomach and stops the secretion of gastric juices, inhibiting the stomach's ability to digest. Weight gain, mood swings and irritability are a some side effects from consuming too much sugar. 

Sugar plays a major role in altering one's mood. Refined sugar has a chemical reaction on the brain by releasing serotonin - the 'feel good' hormone; this tricks the body into a temporary high, causing a rise in blood glucose levels. This 'feel good' lift is followed by the crash where you feel tired, irritable and even depressed. 

So what's good for you? 

Intrinsic sugars are natural sugars found in fruits and vegetables. These sugars are not harmful to your health nor are they fattening. Natural sugars found in honey, fruits and vegetables are unprocessed and therefore rich in fibre and nutrients. A diet high in fruits and vegetables will ensure that your body gets the small amounts of sugar it needs, while providing you with far more health benefits than refined sugar. 

Eat these to prevent diabetes

Diabetes isn't known as a silent killer just for kicks. The growing number of people falling prey to this metabolic disease has raised quite an alarm worldwide. 

Being overweight, leading a sedentary lifestyle, lack of exercise and consumption of high calorie, sugary and fatty foods are the reasons that give rise to this lifestyle ailment. Here's a list of foods that help in preventing diabetes. 

Turmeric :

Studies claim that curcumin, a compound found in turmeric may help delay if not prevent diabetes. There more research to be done in order to determine the long-term effects of turmeric. However, early result show promise. 

Strawberries :

Strawberries look and taste delicious. So there's no reason why you should not eat them regularly. Scientists are of the opinion that consuming strawberries helps activate a protein in the body which reduces LDL cholesterol and blood lipids. Both these things play a factor in the development of diabetes. Also, scientists who conducted experiments on mice found that consuming strawberries is beneficial in lowering blood glucose levels. 

Cheese and yogurt :

By this we mean low-fat cheese and yogurt. Experts believe that the healthy bacteria found in these fermented dairy products are responsible for this healthy beneficial side-effect. 

Cinnamon :

Cinnamon has numerous health benefits. It helps in lowering fasting blood glucose. Also, it is known to lower triglyceride levels, LDL cholesterol and improve insulin sensitivity too. Sprinkle some powdered cinnamon in your coffee or toast. 

Apples :

Anthocyanin, a compound is found in abundance in apples, which helps in regulating blood sugar levels. 

Spinach :

Spinach is rich in many nutrients which makes it so healthy. A British study showed that consuming spinach daily cuts down the risk of diabetes by 14%.

FRUITS FOR DIABETICS

According to various guidelines laid down by nutritionist and medical institutions, at least 4-5 servings of fruits needs to be consumed daily by every individual. 

If you are diabetic, we are sure that this question has popped up in your head, "is it safe to have fruits?" "Yes, diabetics can have fruits, provided the sugar level of the patient is in control, but these fruits must be consumed in a limited quantity. Diabetics need an equivalent serving of fruits on a day to day basis. One needs to be careful about not going overboard with fruits like bananas, litchis, chickoo, and custard apples." To help diabetic patients, she lists down some fruits which will not affect blood sugar level, provided they're consumed in moderation. 

Foods for diabetics:

Black jamun

Undoubtedly, this is one of the best fruits for diabetics. It is known to improve blood sugar control. Seeds of these fruit can be powdered and consumed by patients to control diabetes.

White jamun

Diabetic patients can consume jamun fruit daily, to control their sugar levels. White jamuns are also high in fibre.

Starfruit

Similar to jamuns, starfruits are good for diabics too as they help improve blood sugar control. But caution needs to be exercised in case the person has diabetes nephropathy.

Guava

Guava controls diabetes and it is good for constipation. Guavas are high in vitamin A and vitamin C and contain high amounts of dietary fiber. This fruit has a reasonably low GI.

Cherries

Their GI value is 20 (or even less in some varieties) which makes it a good healthy snack for diabetes patients at any time of the day.

Peaches

These tasty fruits are a great healthy treat, with a low GI and good for diabetics.

Berries

Numerous variety of berries are available throughout the world and almost all seem to be a rich source of antioxidants. Diabetics can include a serving of different berries to keep their sugars in check. To name a few: Strawberries, blueberries and blackcurrants, raspberries, cranberries, chokeberries, blackberries, and acai berries are good for diabetes patients.

 Apples

Apples contain antioxidants, which help to reduce cholesterol levels, cleanse the digestive system, and boost the immune system. Apples also contain nutrients that help in the digestion of fats.

Pineapples

Good for diabetics, pineapples also benefit the body as they are rich in anti-viral, anti-inflammatory and anti-bacterial properties.

Pears

These delicious fruits are a good snacking option for diabetics as they are rich vitamins and fibre.

Papaya

They are good for diabetics because they are rich in vitamin and other minerals.

Oranges

These citrus fruits can be consumed on a daily basis by diabetics, as they are rich in vitamin C.

Watermelon

Although watermelons have a high GI value, their glycemic load is low, making them good fruits for diabetes patients. However, consume in moderation.

Grapefruit

It is a good option for diabetics as it slows down the blood sugar peak.

Pomegranate

These tiny red rubies help diabetic people improve their blood sugar statistics.

This fruit is high in the Glycemic Index, but has a good amount of fibre. Therefore, within moderation, it can easily be included in the diet of a diabetic.

Jackfruit

Jackfruit contains vitamin A, vitamin C, thiamin, riboflavin, niacin, calcium, potassium, iron, manganese and magnesium among many other nutrients. Good for diabetes as they improve insulin resistance.

 Amla

A fruit loaded with vitamin C and fiber, Amla is a healthy addition to the diabetic diet.

What is diabetes mellitus?

Firstly, diabetes mellitus and diabetes is one and the same thing, expect that colloquially we say diabetes. Diabetes mellitus is a condition where the blood glucose or sugar level is high. In some cases of a diabetes mellitus patient, the pancreas fails to produce insulin that carries the glucose to the cell which in turn produces energy. In other cases the person going through diabetes mellitus does not use insulin well.

Type of diabetes

There are two types of diabetes mellitus:

Type 1 diabetes mellitus - Here diabetes mellitus is hereditary. It is known as insulin-dependent or childhood-onset diabetes, which is characterized by a lack of insulin production.

Type 2 diabetes mellitus - This is caused by lifestyle changes like regular consumption of unhealthy food plus sedentary life and increase in weight. It is also called non-insulin-dependent or adult-onset diabetes. Diabetes mellitus is caused by the body's ineffective use of insulin.

What is gestational diabetes?

Gestational diabetes is a kind of diabetes that comes on during pregnancy. It is often diagnosed on screening tests done between weeks 24 and 28 of pregnancy. According to the American Diabetes Association gestational diabetes affects 4% of all pregnant women. While doctors aren't sure what causes gestational diabetes, it is believed that hormones from the placenta may block the action of insulin in the mother, leading to abnormally high levels of sugar in your blood.

What is pre-diabetes?

Dr. Shalini Jaggi, Senior Consultant with Action Diabetic Centre explains the term pre-diabetes, "When one's sugar levels are higher than normal but not as high to be treated as diabetes that is known as pre-diabetes. People who have a fasting plasma blood glucose in the 100-125 mg/dl range are defined as having impaired fasting glucose and a post prandial blood sugar between 141-199 are defined as having impaired glucose tolerance. These together are defined as pre-diabetes."

Causes of diabetes: 

The symptoms of pre-diabeties are:

- Feeling hungry often

- Weight loss or weight gain

- Slow healing of wounds, weakness, and blurry vision

- Infection of the gums, skin, vagina and bladder

Diet tips to fight pre-diabetes

Dr. Shalini says, "Since pre-diabetics are at a risk of developing diabetes, they should also take appropriate measures when it comes to their diet. They should have small meals, eat moderately, have foods that are low in fat and carbohydrate content. Further, in addition to the diet, they should indulge in some kind of daily exercise or outdoor activity."

Are there any sugar substitutes for diabetics?

Yes, there are a few ways one can replace sugar and still control blood sugar levels. Honey, figs and raisins are sweet and healthy. Diabetics can also try out jaggery but watch out; you don't want to go overboard with jaggery. It should be consumed in moderation.

Should you avoid rice if you are diabetic?

The good news is, Indians with diabetes can consume rice. But it has to be two kinds of rice, Swarna and Mahsuri rice. 'In fact, two types of rice commonly consumed by India's middle classes have now been found to have the lowest Glycemic Index (GI) — the measure of its ability to raise blood sugar levels after eating - when compared with 233 other types of rice consumed around the world'. What is food without rice!

A word of caution for women

It's a known fact that men with diabetes are most likely to be impotent. But latest research reveals that women with diabetes are on the cutting board too. 'Based on a survey of nearly 2,300 California women aged 40 to 80 years, researchers found that more than a third of those on insulin treatment said they were "moderately" or "very" sexually dissatisfied.' These women complained about lack of lubrication and orgasm.

Can cosmetics spike diabetes?

Apparently it is true; according to recent study, cosmetics can spike diabetes. The biggest culprit is phthalates, an endocrine disrupting chemical present in different cosmetic products. 'Researchers found that women with higher levels of phthalates in their urine were more likely to have diabetes.' Researchers have scratched the surface on this latest find, wonder what the next step in this field have for us.

Diabetes and its treatment

Diabetes is a condition that causes high blood sugar. It cannot be completely cured but it can definitely be managed. There are basically two types of diabetes, the first being Type 1 diabetes, wherein the body's immune system destroys the insulin producing cells in the pancreas. Due to low insulin level, it is treated with daily insulin injections and a healthy diet. The second type is Type 2 diabetes, here the pancreas does not produce enough insulin or does not use insulin efficiently. It is treated by implementing a diet modification, exercise plan or oral medication.

Time-to-time medication

Medicines and injections are very important to manage your diabetes level. Whichever medicines your doctor prescribes for you, take detailed information about its dosage, and follow it the way advised by your doctor. Whenever you make any appointment with any healthcare professional, take the list of all the medicines you have been advised to manage your diabetes level, to avoid any medicinal complications.

Diet for diabetes

Dr. Sanjiv Bhambani, Endocrinologist and Diabetologist with Moolchand Medcity shares the pillars of good health for diabetics, "Disciplined and responsible eating habits can help a diabetic control their blood sugar levels. There is no real harm with snacking when you are hungry but the key is to snack on healthy alternatives. A diabetic diet should be high on fiber, must contain milk without cream, buttermilk, fresh seasonal fruits, green vegetables, etc."

List of dos and don'ts for diabetics

- Drink tomato juice with salt and pepper ever morning on an empty stomach.

- Per day calorie intake should be between 1,500-1,800 calories with a proportion of 60:20:20 between carbohydrates, fats and proteins, respectively.

- Artificial sweeteners can be used in cakes and sweets for diabetic people (in moderation).

- Keep a check on over-intake of dry fruits.

- Diabetics should eat 3 meals in a day with a good meal plan.

- Have lots of fluid.

- Have at least two seasonal fruits and three vegetables in a diet plan.

- Limit intake of alcohol.

- One teaspoon of methi seeds soaked overnight in 100 ml of water is very effective in controlling diabetes.

- Intake of 6 almonds (soaked overnight) is also helpful in keeping a check on diabetes.

How is diabetes linked to feet and leg problems?

Dr. Sanjeev says, "Foot problems in diabetics result from poor circulation, nerve damage and decreased resistance to infection. High blood sugar level over a long period may affect blood vessels and nerves. There are various conditions that affect people with diabetes that may result in leg and foot problems."

What are the signs of tissue and skin damage?

He says, "In diabetic patients blood glucose is high and body loses fluid. Due to insufficient fluid skin gets dry. Dry skin tends to crack or split more easily and wounds heal more slowly in diabetics. Thus skin conditions should be treated as soon they're noticed, to prevent them."

There are various signs of tissue and skin damage, which can be categorized as:

Dry skin is one of the most common symptoms among diabetes due to loss of body fluid and frequent urination. 

Itchy skin could be another prior symptom which can be triggered by poor blood flow. Itching can be confined to one spot or may occur in many parts of the body especially in lower legs and feet. 

Digital Sclerosis due to excess production of collagen among Type 1 diabetic patient results in waxy, tight skin on toes, fingers and hands. Dryness, burning, numbness and skin ulcers could be due to neuropathy when nerves are damaged. Patient suffers from pain in the lower extremities, burning and numbness. As a result, nerves in the legs and feet may not release sweat which is required to keep skin soft and moist."

What is the link between morbid obesity and diabetes?

This is a question that has several obese people worried; Dr. Sanjeev makes the link between obesity and diabetes: "Obesity is defined as having a BMI greater than 27 (as per Indian body structure). Approximately two-thirds of adults with Type 2 diabetes are obese. Diabetics are at higher risk for cardiovascular disease, and obesity further increases this risk. Obesity also increases other diabetes complications including end-stage kidney disease. Other complications may include sleep apnea syndrome, arthritis and fatty liver disease."

Stats on the cases of diabetes and limb amputations...

The picture is unflattering; here's what the diabetologist reveals, "All over the world in every 30 seconds, a leg is lost to due to diabetes. 15% of the total diabetic population develops foot ulcers. All over, 85% of all diabetes-related amputations are preceded by foot ulcers. Thus it is advisable that patients should daily inspect their feet and consult the doctor as soon as they find an ulcer or an infection in the foot."

What is retinopathy?

Prolonged uncontrolled blood sugars produce changes in the blood vessels all over the body. The damage caused to blood vessels of the retina is called Diabetic Retinopathy. It is a microvascular complication of diabetes, which if not diagnosed and treated early, can lead to blindness."

Signs and symptoms of diabetic retinopathy

So how do we spot it?  "Unlike other common eye problems, there are no presenting signs or symptoms of diabetic retinopathy in the early stages. So, the patient may not even be aware that he is developing changes in the retina, unless he gets his fundus (retina) specifically checked by his ophthalmologist," says the doctor.

Important test for diabetes prevent and control

- First, get your blood pressure checked - your risk of developing high blood pressure doubles if you have diabetes. The ideal number: Below 130/80

- A foot exam: Pressure sores, cuts or ingrown nails can lead to infections and gangrene. Left untreated, an infection may lead to amputation. Daily self-exams are recommended.

- Every three to six months, depending on your type of diabetes and how well you're controlling your blood sugar levels, have:

- A glycosylated haemoglobin (or haemoglobin A1C) test: This measures how well you have maintained blood sugar control for the last two or three months.

Once a year, have:

- A urine microalbumin test: This measures the amount of protein (albumin) in your urine, which indicates kidney damage.

- A blood fat (lipid) profile: Lipids are the cholesterol and triglycerides in your blood. Triglycerides are another type of fat in the blood. If you have raised cholesterol and raised triglycerides you have an increased risk of CVD.

- Dilated Eye Exam: If you have diabetes, your ophthalmologist or optometrist should perform a dilated eye exam, in which the pupils are widened with drops, to check for signs of diabetic retinopathy.

Tips to control Diabetes and maintain a healthy kidney

Did you know that diabetes affects the kidney? Diabetic nephropathy (diabetic kidney disease) is one of the important specific complications of diabetes. Around 30 to 50 percent of people with kidney failure are diabetics.

Uncontrolled high blood sugar for long period of time produces functional and later structural changes in the kidneys. But what is unfortunate is that the changes occurring in kidneys are not clinically obvious to the treating doctor. The symptom the patient shows is until the kidney function is severely affected and the disease has reached an irreversible stage.

One popular and appropriate way of detecting early kidney damage in diabetes is through urine test. Presence of albumin leak in urine is called albuminuria of proteinuria.

In routine urine examination will detect albuminuria. However, as there are no symptoms this is not given any clinical importance and often goes unnoticed without medical care. Albumunuria is a symptom of early diabetic kidney disease. Aggressive treatment should start at this time and the progression of the kidney damage could be delayed or arrested.

Regular and routine examination of urine will detect albumunura. However, there is another sensitive test for detection of microabluminuria. This test detects minute amounts of albumin leaked into the urine (microabluminuria).

Microabluminuria is a sign of early abnormalities of the blood vessels (endothelial dysfunction) and a forerunner of atherosclerosis (hardening of arteries). Therefore presence of albuminuria is an indication to aggressive treatment of cardiovascular risk factors.

So, could we delay or prevent diabetic kidney disease with the available tools of medical treatment. Most research studies have shown that adequate and long-term control of blood sugar, blood pressure and nutritional changes can help in preventing kidney disease. However, the efforts should start early in the life of people with diabetes. 

New classes of drugs used for treatment of hypertension are called angiotension-converting enzyme inhibitors. These agents were originally invented and used for treatment of hypertension. But they were found to be beneficial in preventing kidney disease in persons with diabetes, especially in patients who have albuminuria.

Other than the specific diabetes kidney disease, people with diabetes are also more prone to urinary tract infections. Chronic recurrent urinary tract infection is more common due to high blood sugar levels. Diabetes can also affect the nerves supplying the urinary bladder and produce abnormal bladder function (diabetes ystopathy). This can lead to deficient urinary evacuation and urinary retention. Therefore prevention of infections also helps in preventing kidney damage in diabetes.

So, remember, if you are a diabetic then have urine examination for albumin periodically to detect kidney disease.