As I often tell patients, a top Tennis Player or Golfer or athlete may have the best coach to train them, the best physiotherapist to look after their injuries, the best manager to handle their affairs – and even the best dietitian to advise them about what they should eat and not eat – but when it comes to performing in the middle, it is the player himself who has to perform. Nobody else can go out on to the tennis court or golf course or athletics field and perform for them.
In similar fashion, a Diabetic can have the best doctor, the best personal trainer and the best dietitian – but when it comes to taking care of their Diabetes, these health care professionals are not waiting like flies on the wall to watch the Diabetic’s every move 24 hours a day and manage their diabetes for them. It is the Diabetic himself or herself who has to manage their Diabetes – by making the correct informed choices when it comes to eating, drinking, exercising and taking their medications.
One of the most effective diabetes educators I know used to explain to newly diagnosed Diabetics that the principles of controlling Diabetes efficaciously could be understood if one knew at the outset how to spell the word DIABETIC. Each letter of that word, she explained, was useful in designating one of the methods a Diabetic needed to use to control the condition.
Being Diabetic Requires Dietary Discipline
“The letter D” she used to say “stands for “Dietary Discipline”. In simple terms, what this meant was that what you ate was in large part responsible for the sugar (or glucose) in your blood. Diabetes is brought about by the body being unable to properly process the food a person eats, which results in this food being converted in the intestines into glucose which then entered the bloodstream and circulated through the body in large quantities. Consequently, one of the most important ways of maintaining the glucose level in your blood at the appropriately low level is to ensure that what you eat is not rapidly converted into glucose. It is important for a Diabetic to understand what sort of foods are easily converted into glucose – and so rapidly enter the circulation soon after the food is ingested – and what foods are more slowly digested into sugars.
Glycaemic Index of Foods
In medical terms, foods are categorized by their GLYCAEMIC INDEX or GI factor. The higher a GI factor a food has, the more rapidly it is digested into sugar. In this category of high GI foods come sweets, cakes, desserts, white bread, alcohol and soft drinks. Low GI foods on the other hand take a longer time to be digested – and as a result, the glucose into which these foods are converted is absorbed into the blood stream more slowly and so do not rapidly raise the blood sugar level. Low GI foods include vegetables like beans and bitter gourds, leaves like spinach and cabbage, nuts like walnuts and almonds, pulses like lentils and chickpeas etc.
In addition to learning all about the GI values of foods from which a Diabetic can choose what is best for them to eat, they must also learn to develop Dietary Discipline – the ability to refuse, reject and avoid foods that will put their blood sugar up. All the tablets and injections that a doctor can prescribe are useless if the person having the diabetes has an eye bigger than his stomach – and eats the wrong foods in the wrong quantities!
Sanjiva Wijesinha - Dr. Sanjiva Wijesinha, Associate Professor at Monash University medical school, writes on health, travel and medical topics.
