Did you know India is called the 'diabetes capital of the world'? According to the data collected by the International Diabetes Federation in 2021, around 74 million people suffered from diabetes in India, accounting to for 1 in 7 of all adults living with diabetes worldwide.
Diabetes is a chronic disease that occurs when your blood glucose, also known as blood sugar, is too high.
It either occurs when the pancreas aren't able to produce enough insulin, hormone to regulate blood sugar, or when the body isn't able to use the insulin it produces.
As every year the world celebrates 14 November as World Diabetes Day, we decided to reach out to nutritionists and doctors to learn more about what a diabetic person should eat or avoid in their diet to regulate their blood sugar levels.
FIT spoke with Mrs Sweedal Trinidade, HOD Dietary Services, PD Hinduja Hospital, Mahim, Dr Sweta Budyal, Consultant Endocrinologist and Diabetologist, Fortis Hospital, Mulund and Dr Sandeep Ghanta, Consultant Internal Medicine, Citizen's Speciality Hospital, Hyderabad.
If I am diabetic, should I avoid sugar completely?
Consuming excessive sugar can be risky for a diabetic patient. It's very important to keep the blood glucose levels under control, which are dependent on sugar intake.
Dr Sandeep Ghanta says, “Diabetic individuals need to avoid taking direct sugar because their normal diet has plenty of carbohydrates in it, so taking additional sugar will increase sugar levels in the blood and that can be harmful for diabetic patients.”
Can I still have carbs if I have diabetes?
Yes, carbohydrates or carbs can be consumed in a regulatory method.
Carbs are broken into glucose, which is a type of sugar. This is also called blood glucose or sugar.
While consuming carbs has a very serious impact on the blood sugar level of our bodies, it also provides energy to the body.
Dr Sweta Budyal states that balancing the quantity of carbs intake is very vital.
“If you avoid carbs completely, you will feel out of energy. But carbs which get converted into glucose immediately like sugar, rice, maida, refined starch or potato should be avoided. Food with complex carbs in moderate quantity is okay."Dr Sweta Budyal, Consultant Endocrinologist and Diabetologist, Fortis Hospital, Mulund
Will drinking alcohol affect my diabetic levels?
Drinking alcohol has several harmful effects on our body, and serious diseases like diabetes might also get affected by too much intake.
According to the American Diabetes Association (ADA), the biggest risk a diabetic person has while drinking alcohol is hypoglycaemia, which happens when alcohol gets combined with diabetic medications.
Mrs Sweedal Trinidade, a nutritionist, explains that diabetic patients should avoid alcohol as far as possible because when your sugars are dropping while you are consuming alcohol, the body first aims at clearing alcohol rather than making sugars available for your systems leading to hypoglycemia.
"According to research, males with diabetes can have two drinks per day and women can have one drink per day but avoiding alcohol completely is more beneficial. However, it is important to eat while drining otherwise the person may land up with low sugar."Dr Sweta Budyal, Consultant Endocrinologist and Diabetologist, Fortis Hospital, Mulund
Most of the fruits are sweet, should diabetic patients avoid eating them?
The key is to maintain the intake of different types of fruits.
A study by the Journal of Diabetes Investigation in 2015 concluded that the risk of type 2 diabetes can be decreased with a higher intake of fruit, especially berries, and green leafy vegetables, yellow vegetables, and cruciferous vegetables.
Mrs Trinidade explains that different fruits have different sugar levels called glycemic index but the amount of fibre and sugar that fruits contains may affect your system. She adds, “Fruits with lower glycemic index fruits can be consumed. We should not combine fruits with our meals because meals are already rich in carbs and fruits being high in carbs may increase your blood sugar levels. So it should be eaten separately.”
Can diabetic patients have food mixed with artificial sweeteners?
Artificial sweeteners are synthetic chemicals that stimulate the sweet taste receptors on the tongue and they contact no calories.
According to Dr Budyal, using artificial sweeteners in a limited and recommended quantity is okay because it is safer than sugar.
“Recently, some research has found that consuming artificial sweeteners can affect the gut microbiota, which is the good bacteria in our stomach," she adds.
Another study has found that consumption of artificial sweeteners can contribute to the development of metabolic derangements that lead to obesity and cardiovascular disease.
A different research from 2018 also concluded that artificial sweeteners cannot control diabetes because they can alter the insulin sensitivity and might also have other safety concerns like cancer.
Am I allowed to have sweets if I am intaking insulin?
No, according to Dr Budyal, just because you're on diabetic medication doesn't mean you can consume more sugar.
Insulin is injected by diabetic patients if their body in unable to make the required amount of insulin. Insulin allows glucose or sugar in your blood to move into your cells where it can be used for energy.
"The diet for diabetic patients is the same for both – those who are taking insulin and those who are not," she explains.
"If you are on insulin and you consume too much sugar and very little proteins, you may land up with hypoglycemia."Dr Sweta Budyal, Consultant Endocrinologist and Diabetologist, Fortis Hospital, Mulund
If I am on a keto diet, would my diabetes be under control?
The ketogenic or a keto diet is a diet with low carbohydrates, more fats and proteins. The answer to this is complex.
According to Mrs Trinidade, while following the keto diet, the body is forced to derive energy from proteins wherein ketone bodies are produced.
During this process, the body gets dehydrated and it also requires more energy for this process.
She advices to consult a professional before undergoing any diet.
Studies have shown keto diets may initially lead to weight loss and improvement in blood sugars, in obese people with type 2 diabetes, but it’s unclear if there is any long-term benefit.
I am a vegan, can diabetes still affect me?
Yes, diabetes can affect anyone. Two different studies each from 2017 and 2018 have concluded that a vegetarian diet including by whole plant foods is beneficial for preventing type 2 diabetes and managing it.
Dr Ghanta says, "You can get diabetes irrespective of being a vegan or vegetarian as the risk depends on hereditary factors and also on lifestyle."
I am diabetic but I can have sugar-free products, right?
A sugar-free product is an alternative for diabetes than its counterparts containing sugar.
Mrs Trinidade clarifies that sugar-free products may have zero sugars but they do have other additives which are not safe for diabetic patients unless monitored. She suggests the consumption to be in a limited portion.
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