Dr. Jibin John Thomas MD Internal Medicine specialist

Diabetes is one of the most common chronic conditions worldwide, impacting millions of individuals. While it requires consistent management, diabetes doesn't have to define your life. With the right strategies, you can lead a healthy, balanced, and fulfilling life, even in the face of the challenges that come with diabetes.Diabetes, once considered a condition primarily affecting older adults, has become increasingly prevalent among children, adolescents, and young adults in recent years. This shift reflects changes in lifestyle, dietary habits, and other risk factors that young people face in today’s world. Understanding how diabetes affects youngsters and the steps that can be taken to manage their health is critical for ensuring they lead healthy, fulfilling lives.

World Diabetes Day is observed annually on November 14th to raise global awareness about diabetes, its impact, and the importance of prevention and management. Established by the International Diabetes Federation  and the World Health Organization in 1991, the day highlights the need for coordinated efforts to combat this growing health challenge. It also serves as an opportunity to educate the public about early detection, treatment, and lifestyle changes that can help prevent or manage diabetes effectively. The theme for World Diabetes Day 2024 is Diabetes & Well being .

Living with a chronic condition like diabetes can take a toll on emotional health, often leading to stress, anxiety, or depression due to the daily demands of managing the condition. However, there are ways to enhance emotional and psychological well-being while living with diabetes

Stress Management Chronic stress can elevate blood sugar levels, making diabetes more difficult to control. Practicing stress-relief techniques such as mindfulness meditation, deep breathing exercises, or yoga can help alleviate stress and promote relaxation.

Support Systems A strong support network plays a crucial role in managing diabetes. Whether it's family, friends, or a healthcare team, having people to share the challenges of living with diabetes can help reduce feelings of isolation and stress.

Psychological Counseling When diabetes-related stress becomes overwhelming, seeking professional support from a counselor/psychologist or psychiatrist can provide valuable emotional guidance and practical coping strategies. Cognitive behavioral therapy (CBT) is especially effective in managing anxiety and depression related to diabetes.

For individuals living with diabetes, preventing long-term complications is a key priority. This requires regular check-ups, blood sugar management, and making healthy lifestyle choices.

Cardiovascular Health Diabetes significantly increases the risk of heart disease, making cardiovascular health a top concern.Engaging in regular physical activity,eating a heart-healthy diet low in saturated and trans fats,controlling cholesterol and blood pressure levels, avoiding smoking are ways in which cardiovascular well being can be achieved .

Eye Care Diabetic retinopathy, caused by damage to the blood vessels in the retina, can lead to vision loss if untreated. Regular eye exams and early intervention are crucial for preventing severe complications.

Foot Care People with diabetes are more prone to foot infections due to nerve damage and reduced blood circulation. Regular foot inspections and proper care can help prevent ulcers and infections, which could lead to more serious issues.

Kidney Health Diabetes can cause kidney damage over time. Regular urine tests, along with maintaining good blood pressure and blood sugar control, are essential for protecting kidney function.

Raising the level of Self Awareness

Education Understanding diabetes is fundamental to self-management. Learning to monitor blood sugar, adjust insulin or medication, and make lifestyle changes empowers people with diabetes to take control of their health.

Technology in Diabetes Management Advances in technology have made diabetes management more precise and convenient. Tools like continuous glucose monitors (CGMs), insulin pumps, and smartphone apps allow for real time blood sugar monitoring. These technologies help individuals make informed decisions about diet, exercise, and insulin use.

Personal Responsibility While healthcare providers play a vital role, much of diabetes management happens in daily life. Taking personal responsibility for self-care whether it’s monitoring blood sugar, maintaining a healthy diet, or staying physically active is essential for long-term well-being.

Dietary Management for Diabetes Control

Dietary management is essential for controlling diabetes, particularly in Type 2 diabetes, where lifestyle choices significantly impact blood sugar levels. A well-planned diet not only helps regulate blood sugar but also maintains a healthy weight and prevents complications.

A balanced diet is crucial for achieving better glycemic control, improving overall health, and reducing the risk of complications.

Carbohydrate/Starch Management: Carbohydrates have the most significant effect on blood sugar levels, so understanding how different types affect the body is vital for effective diabetes management.

Glycemic Index (GI): Foods with a low glycemic index raise blood sugar levels more gradually than high-GI foods. Opting for low-GI options can aid in managing blood sugar levels effectively.

Low Glycemic Index Foods involve-Whole Grains,Barley,Quinoa,Brown rice,Whole oats (steel-cut or rolled) ,Legumes,Lentils,Chickpeas,Black beans,Kidney beans

Focus on Whole Foods

Whole Grains: Choose whole grains such as brown rice, quinoa, and whole-grain bread instead of refined grains. Whole grains are higher in fiber, which helps stabilize blood sugar levels.

DIabetic Diet & Nutrition :

Fruits and Vegetables: Low Glycemic Index Fruits

Unripe (Green) Banana (GI:30-40), Ripe Banana (GI:51-60),Strawberries (GI: 41),Blueberries (GI: 53),Raspberries (GI: 32),Blackberries (GI: 43),Cherries (GI: 20),Apples(GI: 38),Pears(GI: 38),Plums(GI: 40),Peaches(GI: 42),Oranges(GI: 40),Kiwi(GI: 52),Grapefruit(GI: 25),Avocado(GI: 15)

Lean Proteins: Incorporate lean proteins like chicken, turkey, fish, legumes, tofu, and low-fat dairy products. These help maintain muscle mass and promote satiety.

Portion Control

Understanding Serving Sizes: Be mindful of portion sizes to avoid overeating. Measuring cups or a food scale can assist in controlling portions.

Plate Method: Visualize portions using the plate method: fill half your plate with non-starchy vegetables, a quarter with lean protein, and a quarter with whole grains or starchy vegetables.

Monitor Carbohydrate Intake:Distributing carbohydrates evenly across meals and snacks, rather than consuming large amounts at once, can help maintain stable blood sugar levels.

Choose Healthy Fats

Limit Saturated and Trans Fats: Opt for healthy fats found in avocados, nuts, seeds, and olive oil. Limit saturated fats from fatty cuts of meat and full-fat dairy products, and avoid trans fats present in many processed foods.

Omega-3 Fatty Acids: Include sources of omega-3 fatty acids, such as fatty fish (salmon, mackerel), flaxseeds, and walnuts, which are beneficial for heart health.

Stay Hydrated:

Stay hydrated by drinking plenty of water(3Litre/day) and avoiding any sugary drinks.Be careful of consuming Fruit Juices, fresh or processed both have high amounts of Glycemic Index.

Uncontrolled high blood sugar (hyperglycemia) poses significant health risks that can lead to serious short- and long-term complications. The primary consequences include:

 Acute Complications

•            Diabetic Ketoacidosis (DKA): Often seen in type 1 diabetes or severe cases of type 2, the body starts breaking down fat for energy, producing ketones. High ketone levels lead to DKA, a life-threatening condition marked by nausea, vomiting, dehydration, and confusion. DKA requires immediate medical intervention.

•            Hyperosmolar Hyperglycemic State (HHS): Predominantly affecting older adults with type 2 diabetes, HHS is characterized by extremely high blood sugar levels and severe dehydration. Without prompt treatment, it can lead to coma or death.

Vascular Damage

Prolonged hyperglycemia can damage blood vessels, leading to complications across various organs:

•            Kidneys (Diabetic Nephropathy): High blood sugar can lead to kidney damage or failure, often necessitating dialysis or a kidney transplant.

•            Eyes (Diabetic Retinopathy): Blood vessel damage in the eyes can cause vision impairment and blindness.

•            Nerves (Diabetic Neuropathy): Nerve damage causes pain, numbness, and tingling, especially in the extremities, and may impair digestive and urinary functions.

•            Cardiovascular System: Persistent hyperglycemia raises the risk of heart disease, stroke, and hypertension.

Increased Infection Risk

High blood sugar impairs immune function, making the body more susceptible to infections such as skin infections, urinary tract infections, and delayed wound healing.

Foot Complications- Diabetic Foot

Nerve and blood vessel damage can lead to poor circulation and loss of sensation in the feet, increasing the risk of ulcers and infections. Untreated, these conditions can escalate to gangrene and necessitate amputation.

Dental Problems

Elevated blood sugar can result in dry mouth, gum infections, and a heightened risk of tooth decay.

Mental Health and Cognitive Effects

•            Mental Health: Hyperglycemia can affect mood and concentration, increasing the likelihood of depression and anxiety.

•            Cognitive Impairment: Long-term high blood sugar is linked to an increased risk of dementia, as it can cause vascular changes and brain cell damage.

To prevent these complications, consistent monitoring of blood sugar, following a prescribed treatment plan (including diet, exercise, and medications), and regular check-ups with your physician for blood routines and physical examination are essential.Prevention is Better than Cure.